Qualifying Conditions And Medical Evidence

The Five Step Review

Every claim runs through the same five questions, in order:

1. Are you working above the SGA limit? If yes, the claim is usually denied here.
2. Is your condition severe, meaning it significantly limits basic work activity?
3. Does it meet or equal a condition in the SSA Listing of Impairments?
4. Can you still do work you did in the past?
5. Can you adjust to any other work, given your age, education, and skills?

The Listing Of Impairments

The SSA keeps a catalog, often called the Blue Book, of conditions and the specific medical findings that qualify. It covers categories such as musculoskeletal disorders, mental disorders, cardiovascular and respiratory conditions, neurological disease, cancers, and immune system disorders, among others. If your records show you meet a listing, you can be approved at step three.

When You Do Not Meet A Listing

The SSA then assesses your Residual Functional Capacity, which is the most you can still do despite your limitations, such as how long you can sit, stand, or concentrate. It weighs that against your past work and, using the Medical Vocational Guidelines, against other work in the economy. Age, education, and skills matter a great deal at this stage.

What Strong Evidence Looks Like

• Consistent treatment history rather than a single visit
• Objective findings: imaging, lab results, clinical exams
• Detailed notes from your treating providers about specific functional limits
• A clear, honest account of how symptoms limit daily activities

Gaps in treatment and vague records are among the most common reasons strong cases get denied. Keep seeing your providers and make sure your limitations are written down.