Social Security Administrations Blue Book
With such a wide variation of disorders and conditions, the Social Security Administration created a guide for their own representatives and other physicians to determine if an applicant potentially qualifies for disability benefits. This guide, called the Blue Book, separates disabling conditions into different categories and lists the specifications needed for each condition to qualify for disability benefits.
There are two parts to the book: Part A is used to evaluate Adults (individuals 18 years or older) and Part B is used to evaluate children (under the age of 18). The SSA separated the book into two parts because some illnesses affect children much differently than adults and thus need to be evaluated under different conditions.
Both parts divide general impairments into categories (part A has 14 while part B has 15) where each category lays out the restrictions and specifications for a condition to qualify for benefits.
Listed below are the main 14 categories with the additional 15th category (Section 0.00) at the bottom for part B.
Also known as the locomotor system, the musculoskeletal system is what allows humans the ability to move using muscular and skeletal systems. It provides the body with stability, form, movement and support. Musculoskeletal impairment or functional loss is defined as the inability to perform fine and complex movements such as reaching, pushing or pulling effectively on a sustained basis for any reason.
Musculoskeletal System disorders can result from several different sources including hereditary, congenital, and acquired pathologic processes. Impairments can also stem from infectious, inflammatory, or degenerative processes. Common disorders include degenerative disc disease, arthritis, fibromyalgia and scoliosis.
According to the SSA, special senses and speech refer to the abilities to see, hear, and speak. The common types of impairments primarily deal with those individuals who are affected by blindness, deafness and speech incapability. There are several tests for these conditions such as the blindness tests that determines an individual as blind which by the SSA’s standards their vision must be 20/200 or less in the better of eye.
Testing for deafness will also be administered to show medically determinable hearing loss impairment and specific audiometric measurements of the severity. Common conditions associated include macular degeneration and Meniere’s disease. Conditions that cause vertigo are also considered under this section.
The respiratory system also known as the ventilatory system are the specific organs that assist in respiration and handle the intake and exchange of oxygen and carbon dioxide between an organism (human) and it’s environment. Respiratory system impairments originate from respiratory disorders based on symptoms, physical signs, and laboratory test abnormalities.
The SSA may require further testing to establish the abnormalities and severity of the impairment. Frequent conditions related with respiratory impairments include asthma, sleep apnea and chronic obstructive pulmonary disease (COPD).
The Cardiovascular system or commonly known as the circulatory system permits blood to circulate nutrients and oxygen throughout the body. According to the SSA, Cardiovascular impairments include any disorder that affects the proper functioning of the heart or the circulatory system. Disorders in this system are generally defines as a disorder that affects the heart from functioning properly; specifically any arteries, veins and capillaries that may cause impairments to arise in other parts of the body such as the kidneys or liver.
Common conditions related with the cardiovascular system include ventricular dysfunction, high blood pressure, chronic heart failure and coronary artery disease.
The Digestive system assists the body breakdown food into smaller and smaller components until it can be absorbed and assimilated into the body. Common digestive system disorders include conditions such as inflammatory bowel disease, gastrointestinal hemorrhage and malnutrition. These conditions can also lead to additional complications within the body or may be accompanied by other impairments in other systems.
Conditions that sometimes are associated with these digestive system disorders include Crohn’s disease, short bowel syndrome, and liver disease.
The genitourinary system, also known as the urogenital system is the organ system of the reproductive organs and urinary systems. The organs that make up these systems are the bladder, kidneys and reproductive organs. Impairments that commonly involve this system are kidney diseases, interstitial cystitis and certain forms of nephropathy.
The SSA will require medical records including laboratory findings, treatments and documentation of the responses to these activities. If the claimant has undergone a kidney transplant the SSA considered the patient disabled for a minimum of 12 months of recovery following the procedure.
The Hematological system makes the blood, bone marrow, liver and spleen. Hematologic diseases and disorders primarily affect the blood stream. The SSA only acknowledges hematological impairments if the condition is “persistence” and has lasted a minimum of 3 months and severely impact the life of a claimant. This requires the SSA to need consistent treatment reports and documentation of the condition to approve an individual for disability.
Common conditions associated with hematological disorders include sickle cell disease, chronic thrombocytopenia and chronic anemia. The SSA is unusually strict with hematological disorders and require specific guidelines be met by requiring monthly documentation of blood transfusions.
Many conditions affect the human integumentary system also known as skin; the organ covering the entire surface of the body acting as a barrier against the external environment. Disorders of this system result from congenital, hereditary or acquired pathological processes. Due to the fact that most skin disorders have treatments available, the SSA reviews several potential factors while assessing skin disorders, including frequency of flare-ups, stress factors, familial incidence, onset, duration, history of exposure to toxins and seasonal variations.
Impairments that are covered by the SSA are dermatitis, Ichthyosis, malignant skin tumors, shingles, burns, hidradenitis, chronic infections of mucous membranes and cellulitis. Unfortunately due to the effectiveness of certain treatments for these conditions the SSA brings much subjectivity to their determination process.
The endocrine system refers to the collection of glands of an organism that secrete hormones directly into the circulatory system to be carried towards distant target organs. Impairments to the endocrine system involve hormonal imbalances that cause complications for the major glands in the system.
Common conditions associated with the endocrine system include diabetes, arrhythmia, pancreatitis, weight-loss or gain and other imbalances in the pituitary, adrenal and thyroid glands.
Impairments in this section fall into two categories: Non-mosaic Down’s Syndrome and all other conditions that affect multiple body systems. Non-Mosaic Down Syndrome is Down syndrome, in which all of the body’s cells (chromosome 21) are affected and can cause impairments in vision, hearing, the heart and more.
Other conditions that affect multiple body systems are congenital disorders that cause deviation or interruption to the normal function or development of the body. Other recognized conditions that affect multiple body systems include Caudal Regression syndrome and Fragile X syndrome.
The nervous system controls all transmission in the body coordinating movement and actions. Diseases and impairments directly affect the brain, spinal cord or nerves and total more than 600 neurological diseases total. Common impairments include difficulties with speaking, breathing, learning or moving properly; along with memory, mood or sense problems.
All neurological disorders are evaluated on an individual case by case basis. A central nervous system disorder will require medical documentation noting either severe loss of motor functions or speech; while epilepsy is evaluated in presence of tongue bites, duration of seizures and severity. Other conditions included traumatic brain injury (TBI), Lou Gehrig’s disease, Cerebral Palsy and multiple sclerosis.
A mental disorder, also called a mental illness or psychiatric disorder, is a mental or behavioral pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life, and is not a developmental or social norm. Mental disorders are generally defined by a combination of how a person feels, acts, thinks and perceives.
There are nine diagnostic categories of mental disorders, ranging from schizophrenia to substance addiction. Common conditions associated with mental disorders include bipolar disorder, post-traumatic stress disorder (PTSD), autism and schizophrenia.
Neoplasm is an abnormal growth of tissue, and when also forming a mass is commonly referred to as a tumor. The SSA defines impairments in this section as malignant tumors that spread to other parts of the body and include various forms cancer and cancer related illnesses.
Common conditions associated with malignant neoplastic diseases include leukemia, lymphoma, and cancer of numerous body parts such as breast, lung, and liver.
The immune system is a system of biological structures and processes within an organism that protects against disease. To function properly, an immune system must detect a wide variety of agents, known as pathogens, from viruses to parasitic worms, and distinguish them from the organism’s own healthy tissue. Any impairment to this system can cause serious health problems.
Common conditions associated with immune system disorders include acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV) and Lupus.
This section is only in Part B and pertains to infant children under the age of 3. Only two conditions are evaluated under this category: low birth weight and failure to thrive.
Low birth weight (LBW) is defined as when a live newborn infant has a birth weight of less than 5 pounds 8 ounces. Infants born with a low birth weight have a higher risk to catch or develop diseases, and to experience inhibited growth development. Failure to thrive (FTT) occurs when a child’s development shows insufficient weight gain or inappropriate weight loss. There are multiple causes for FTT including physical, medical, and psychosocial causes as well as calorie intake.