The Social Security Blue Book (or the “Disability Evaluation Under Social Security” handbook) lays out the procedure for how the Social Security Administration (“SSA”) determines if an applicant qualifies for disability benefits. The Blue Book contains the key guidelines applicants must follow to receive disability compensation.
Using the Blue Book
The first section of the Blue Book describes Social Security and the programs. Applicants can review this section for which programs they may qualify under and what they can expect to receive. The first section provides general information and is not determinative for any specific application. The second section describes the various medical information and evidence that the SSA will accept in reviewing claims. Applicants should review this section to ensure that the evidence they submit is of the type that the SSA will accept.
The third section describes the impairments and medical conditions that qualify for Social Security benefits. Applicants and their health care providers should carefully review the third section to ensure that they qualify for disability compensation. The applicant’s impairment must match the condition described in the third section. Further, the third section also details what medical evidence is necessary to advance a disability claim for each listed impairment.
The qualifying conditions include physical and mental impairments. The Blue Book has separate sections for children and adult conditions. These sections are further subdivided by disease, injury, condition, and impairment. Applicants must carefully review the acceptable medical evidence for each condition. One of the most common reasons the SSA rejects an application is because the medical evidence submitted doesn’t adequately support the claim. In general, applicants should err on the side of caution and over-include medical evidence in their applications.
SSA claims are submitted through field offices or state agencies (Disability Determination Services or DDS). The field offices receive applications and process them. \The field office then refers the application to a state agency, the DDS. The DDS reviews the medical evidence and makes an initial determination of whether the applicant qualifies for disability compensation. The DDS usually verifies the medical information with care providers directly.
If the DDS determines the applicant qualifies, then the case is referred to the field office to calculate benefits. If the DDA denies coverage, the case is retained by the field office if the applicant appeals.