Medical Criteria for Disability Benefits

To qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), your condition must:

• Be medically determinable, meaning it is diagnosed by a licensed medical professional and backed by clinical or laboratory findings.
• Prevent you from engaging in substantial gainful activity (SGA), meaning you cannot earn above a certain income due to your condition.
• Last—or be expected to last—at least 12 months or result in death.

SSA’s Listing of Impairments ("Blue Book")

The SSA maintains a guide called the Listing of Impairments, commonly known as the Blue Book. It contains specific medical conditions and criteria that automatically qualify someone as disabled if they meet or equal the listed criteria.

Some major categories in the Blue Book include:

• Musculoskeletal Disorders (e.g., back injuries, joint disorders)
• Cardiovascular Conditions (e.g., heart failure, coronary artery disease)
• Respiratory Disorders (e.g., COPD, asthma)
• Neurological Disorders (e.g., epilepsy, MS, Parkinson’s)
• Mental Disorders (e.g., depression, anxiety, schizophrenia)
• Cancer (depending on type and stage)
• Immune System Disorders (e.g., lupus, HIV/AIDS)

What If Your Condition Isn’t Listed?

You can still qualify if your condition:

• Matches the severity of a listed impairment, or
• Limits your ability to work to such a degree that you cannot perform your past work or any other job in the national economy.

In such cases, the SSA will assess your Residual Functional Capacity (RFC)—an evaluation of what you can still do physically and mentally, despite your condition.

Medical Evidence Required

Strong medical documentation is critical. The SSA will expect to see:

• Doctor’s records and clinical notes
• Hospital reports and test results
• Specialist evaluations
• Mental health records, if applicable
• Statements about how your condition impacts your daily life and work abilities

Consistency and detail are key.