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Do you need a specific diagnosis to qualify for SSDI benefits?

On Behalf of | Aug 26, 2022 | social security disability |

Almost every adult in the United States has contributed toward Social Security by working, but many people don’t understand how the different benefits programs run by the Social Security Administration (SSA) actually function.

Misconceptions about Social Security Disability Insurance (SSDI) benefits are particularly common. Most people have heard stories about someone who needed benefits and didn’t get them or even a tragic tale of someone whose family finally received an approval letter after they died.

Some people believe that the application process is too difficult or that the criteria are too strict to make applying even worth the effort. Others think that they need a specific diagnosis to get benefits. Do you have to have one condition on a list of specific medical issues to qualify for SSDI payments?

The SSA provides a list, but it is not exhaustive

The reason that people sometimes think that they need to have a specific medical condition to get benefits is that the SSA does provide a relatively extensive list of potentially qualifying medical conditions. The SSA groups these conditions by the body part or functions that the condition affects.

Issues ranging from mental health conditions to musculoskeletal disorders can qualify someone for benefits. However, a diagnosis alone is rarely enough. Two patients with the same medical condition may have very different presentations and therefore different experiences. One person with a musculoskeletal condition may be able to continue working with certain support from their employer, while another person with the same condition may find it to be too debilitating.

If your condition is not on the list provided by the Social Security Administration, you can potentially still get benefits. You just need to have medical records regarding the symptoms you experience and an ability to show that they prevent you from working or any significant gainful activity.

A denial is just an opportunity to gather more evidence

When you receive notice that the SSA has rejected your claim, you will probably feel quite disheartened. It may benefit you to shift your perspective. By recognizing that a significant number of people get benefits when they appeal, you may be able to keep your focus on the long-term goal of getting benefits while the appeals process.

The more evidence you have that shows that your condition has a debilitating impact on your day-to-day life, the easier it will be for you to meet the necessary standard and connect with benefits. Understanding how the SSA makes determinations about different medical conditions can help you prepare to apply for SSDI benefits. Talk to an attorney who handles disability claims to better understand the process.