Wisconsin Disability Blog

During an initial meeting with a client, I usually spend a few minutes explaining the five questions that the Social Security Administration (SSA) will ask when evaluating your disability case. First, SSA asks whether you’re engaged in substantial gainful activity – that is, are you working too much to be considered disabled. Second, SSA asks whether you have a severe impairment – that is, do you have a medically documented condition that will affect your ability to work that will last a year or longer.

Third, SSA considers whether you meet or equal a “listing”. The listings are a series of regulations that address specific medical conditions and describe when those conditions are severe enough that your are presumed disabled. There are listings for adults and for children. They are divided into different categories by body system (e.g., cardiac, pulmonary, skin, mental health). The listings are important in all cases, but are more important in certain types of cases. In my experience, if your limitations are based on the pain your condition causes you (e.g., as a result of a back problem or fibromyalgia), it is likely that SSA will not find that you meet or equal a listing, but rather will proceed to decide your case on other considerations. If you have mental health problems, the listings are very important. Many people who are awarded disability benefits for mental health problems are found disabled under the listings. In reading the most recent issue of the NOSSCR Forum, I learned that of those people who are awarded benefits at the initial application or reconsideration levels (that is, when you first apply or after your first appeal), 58% are found disabled under the listings.

If you are a disability claimant who is represented, your representative should be well-versed in these regulations and should be examining your medical records to determine whether an argument can be made that you meet or equal a listing. Your representative should be seeking out additional information from your doctors to determine whether you can win at this stage of SSA’s analysis. If you don’t have a representative, you should consult with an attorney to discuss this aspect of your case. Some of the listings are very complicated.  Also, the listings that are available on the SSA’s website are not updated as frequently as they should be – you’re representative should subscribe to a service that provides the most up-to-date information available.

If you don’t meet or equal a listing, that doesn’t mean you’re not disabled, so you shouldn’t necessarily be worried.  A majority of successful cases that proceed to a hearing before a judge are not decided on the listings.  I have many cases in which I know that my client won’t meet or equal a listing, but fully expect to win the case.  As mentioned, at least 42% of disabled individuals are awarded benefits at the early stages of the disability determination process even though they don’t meet a listing.  These successful claimaints are found disabled based on consideration of the fourth and fifth questions asked by SSA, which I will address in another post.