As an agency of the federal government, the Social Security Administration (SSA) has the authority to determine which illnesses and injuries qualify for coverage under the Social Security Disability Insurance (SSDI) program. It maintains a list of impairments, known as the “Blue Book,” which examiners use to determine if an applicant meets the SSA’s definition of “disabled.” The Blue Book offers an important guide to SSA examiners’ methods for evaluating SSDI claims and making decisions.
The Blue Book
Officially titled Disability Evaluation Under Social Security, the Blue Book is the product of administrative rulemaking by the SSA. The complete list is codified in Title 20 of the Code of Federal Regulations, as Appendix 1 to Subpart P of Part 404 of the SSA’s regulations. It is also published in book form and on the SSA’s website.
The Blue Book is divided into two parts. Part A covers adult disabilities, and Part B covers childhood disabilities.
– Part A includes 14 sections, each covering certain types of disabilities. This includes disabilities affecting a specific body system, such as the musculoskeletal, respiratory, digestive, or genitourinary system; disabilities affecting multiple systems at once; disorders affecting sight, hearing, blood, skin, or the brain; and diseases like cancer and autoimmune disorders.
– Part B has the same sections, as well as a 15th section covering birth-related disorders like low birth weight.
Each section of the Blue Book is further divided into subsections addressing specific illnesses, injuries, or disorders. The section on the adult musculoskeletal system, for example, identifies multiple possible causes of impairments, such as infection, injury, or a congenital condition. It defines “loss of function” and establishes criteria for proving that a condition constitutes a “disability” for purposes of the SSDI program. It also describes guidelines for diagnosis of musculoskeletal disorders and evaluation of a diagnosis by the SSA.
Changes to Blue Book Impairment Listings
The SSA occasionally modifies Blue Book listings, or adds or removes impairments. To do this, the SSA must follow procedures established by federal law for administrative rulemaking. This typically involves notifying the public of its intent to modify or amend an existing rule. The federal government has a daily periodical, the Federal Register, in which government agencies publish notices like these. Once the SSA has published a notice, it must accept comments and feedback from the public, usually for a period of at least 60 days.
If an agency receives a substantial amount of feedback, it may keep the comment period open longer or even hold public meetings to discuss the proposed rule. Interested parties may object to a proposed rule, and in some cases they can even file suit to prevent the rule change. Usually, though, the agency receives comments from the public, answers them, and publishes these answers, along with a “Notice of Final Rule,” in the Federal Register. With changes to the Blue Book, the length of time from the initial notice to the final rule can be longer than a year.
Recent Changes to the Listings of Impairments
Since mid-2014, the SSA has modified the listings of impairments at least four times, according to notices published in the Federal Register.
In October 2014, the SSA published a Notice of Final Rule affecting Part A, Section 6 and Part B, Section 106 of the Blue Book, which deal with genitourinary disorders. In its original notice, published in February 2013, it stated that it last revised the genitourinary system listings in 2005, and that these revisions were set to expire after eight years. It sought to modify the listings, based in part on issues presented by adjudicators and comments submitted by the public since 2005. Proposed changes included revisions to the sections on renal function impairment and nephrotic syndrome, and additions to the criteria for chronic kidney disease.
The SSA published a final rule in April 2015 modifying multiple sections in the Blue Book’s Part B. In its May 2013 proposed rule, it noted that some of the sections it sought to modify had remained unchanged since 1985. The new rule made extensive changes to the section on growth impairment disorders, and it also revised sections dealing with children’s digestive, respiratory, cardiovascular, and immune system disorders.
Another final rule published by the SSA in April 2015 amended Section 7 of Part A, which deals with blood disorders. As with the extensive changes to Part B published the same month, the SSA stated that this section of the Blue Book had not been revised to any significant extent since 1985.
In May 2015, the SSA published a final rule extensively modifying Section 13, Part A, which deals with various forms of cancer. The SSA last revised this section in 2009, with an effective period of eight years. While that period would not end until 2017, it stated that it decided to amend the listings sooner based on new medical knowledge, the SSA’s own “adjudicative experience,” and “recommendations from medical experts.”
In order to determine whether your medical conditions meet one of the listed impairments (or determine whether you might qualify for disability benefits based on other provisions of Social Security’s rules) , and thus whether you should move forward with an SSDI claim, start by calling the Law Offices of Russell J. Goldsmith at 1-800-773-8622 to schedule a free and confidential consultation.
More Blog Posts:
Lawmakers Must Act to Prevent Depletion of SSDI Trust Fund in 2016, Social Security Disability Lawyer Blog, August 2, 2015
Capitol Hill Hearings, Proposed Legislation Target Dual Collection of SSDI and Unemployment, Social Security Disability Lawyer Blog, August 2, 2015
How to Apply for SSDI Benefits in Maine and Beyond, Social Security Disability Lawyer Blog, July 1, 2015