Using Listings to Establish Disability

As my colleague indicated in her post last week, an adult must suffer from a "medically determinable impairment" in order to receive disability benefits, and not every impairment is easily proven by clinical or laboratory findings. There is no gold standard, for example, in making diagnosis of rheumatoid arthritis. Similarly, there are no widely accepted formal diagnostic criteria for myasthenia gravis. Though many claimants suffer from symptoms of pain or fatigue, a "symptom" is not a medically determinable impairment under SSR 96-4p. Thus, further rules may be necessary to establish a medical impairment.

While SSR 12-2p delineates the guidelines for establishing fibromyalgia, Social Security Administration may also rely upon the listings to establish a diagnosis, confirm the existence of an impairment, or otherwise determine that an impairment is disabling (CFR § 404.1525(c)(2)). I often describe the listings as a type of shortcut to getting on disability. They apply to only one step of the sequential evaluation process, but the presence of a severe impairment at this step is usually sufficient to establish that an individual who is not working is disabled.

In considering the medical evidence of record, if all the criteria for a particular listing are met or equaled (along with administrative and durational requirements), Social Security Administration will make a finding of disability (CFR §404.1509; CFR § 404.1525; CFR §404.1526). Rheumatoid arthritis, for example, may be disabling under Listing 14.09D, with documentation of persistent inflammation of one or more major peripheral joints resulting in marked limitations in daily living. Likewise, Listing 11.12B may determine that myasthenia gravis is met with significant weakness of arm or leg muscles while on prescribed therapy. However, an impairment cannot meet a listing based only on a diagnosis; you must satisfy all the criteria of the listing (CFR § 404.1525(d)). Moreover, the evidence must support it. Documenting your symptoms with medical records is paramount to meeting a listing.

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