What conditions don’t qualify for social security benefits?

On Behalf of | Mar 27, 2024 | Social Security Disability

Denials of social security benefits are common. While most people stop pursuing a claim after this, it’s important to know that individuals have the right to appeal.

However, there are some instances where the Social Security Administration (SSA) has valid reasons for denying a claim. This includes certain medical conditions that don’t qualify for social security benefits.

Non-qualifying conditions

The SSA keeps a directory of medical conditions, often called the “Blue Book.” This list contains medical conditions eligible for benefits if they meet certain criteria, like severity and duration.

However, this list isn’t all-inclusive. Some conditions that don’t qualify include:

  1. Short-term conditions: The SSA’s disability programs are for long-term or permanent disabilities. If a disability won’t last at least a year or cause death, it usually doesn’t qualify.
  2. Conditions that are not severe: A condition must be serious enough to limit a person’s ability to work. If it’s not, it usually won’t qualify.
  3. Disability based on drug addiction or alcoholism: If drugs or alcohol contribute to the disability, the person will not get benefits. But conditions caused by past use of drugs or alcohol might qualify.

A claimant with an illness that does not significantly impact their daily activities or ability to work typically isn’t eligible for these benefits. On the flip side, someone who has a severe enough medical condition that limits their ability to work has a better chance of getting benefits.

Appealing a denied claim

If a person believes they have a condition that qualifies and their claim was denied, they have the right to appeal. The appeals process starts with filing a request for reconsideration and could end in a hearing before an administrative law judge. But this is the best-case scenario. Claimants should be prepared for potential complexities and delays.

Many claims are initially denied but approved later during the appeals process, so appealing can be worthwhile if an individual believes their condition should qualify. However, it can be hard to gather medical evidence, file paperwork and attend hearings without help. An attorney can assist with the appeals process.