August 20, 2019

Why Might a Case Not Meet a Listing?

Each listing sets out specific medical criteria for a specific disease or condition.   The listings are not meant to be exhaustive.  Instead, they reflect medical problems that Social Security has determined will cause overwhelming work reliability problems.

Your Medical Records May Not Follow the Language of the Listing

Your medical record may reflect a significant medical problem that falls within a body system described in the listings, but if your records do not contain the exact requirements of the listing, you will need to either have your doctor clarify the record or you will need to pursue disability under another theory of disability.

Social Security makes it difficult to meet listings on purpose but the payoff is a fast decision (usually).   But don’t be discouraged and give up if you do not get approved based on the listings – this does not mean that your case is without merit.

Almost every favorable hearing decision is awarded based on a theory of disability other than a listing argument, and about half (50%) of hearing level cases are approved.  Therefore you should not assume that your case is not worthy if it does not meet a listing and you should speak to a lawyer about continuing your quest for disability benefits.

There are No Listings for Some Medical Conditions

Not every medical condition has made it into the listings.   For example fibromyalgia is a medical condition that can result in favorable decisions but there is no listing for fibromyalgia.  Thus, if you have fibromyalgia or chronic fatigue, you will have to pursue disability under a functional capacity theory of disability.

Most, but not all, listings describe medical conditions that can be observed using diagnostic testing such as an MRI, CT scan, nerve conduction test, ultrasound, etc.  If your medical issue cannot be confirmed with a test, the judge will most likely need to consider factors other than medical records to approve your case.  Some of these other factors include your testimony, a functional capacity form completed by your doctor and work attendance records.