Applying for Social Security Disability benefits can be difficult. Not only do you have to collect and submit medical evidence for your condition, but that evidence needs to prove that your illness and/or symptoms actually qualify you to receive benefits. If the Social Security Administration (SSA) decides otherwise, you’re facing a potentially long appeals process.

Some medical conditions, however, are so severe that they can automatically qualify you for disability, provided you meet other criteria – such as earning enough work credits and not engaging in substantial gainful activity. They are included in the SSA’s official listing of impairments (commonly referred to as the Blue Book), and a diagnosis can qualify you for benefits without having to provide additional evidence about its impact on your life.

In addition, certain particularly serious illnesses are covered under the Compassionate Allowances Program, which fast-tracks the approval process to ensure those suffering from these life-threatening or disabling conditions receive financial support as quickly as possible. In this guide, we’ll cover some of the conditions that can automatically qualify you for disability and how a Michigan SSA benefits lawyer can help.

The Blue Book: What It Is and How It Helps

The Blue Book is the SSA’s official guide for evaluating medical impairments in disability claims. It details the conditions that automatically qualify for Social Security Disability benefits, along with the medical criteria that must be met to obtain approval. This book serves as an important tool for both applicants and the SSA to determine if a medical condition warrants disability benefits based on its severity and impact on a person’s ability to work.

The Blue Book is organized by body system. Each listing contains a description of the medical condition, the evidence required, and the degree of severity necessary to qualify for approval. These criteria can include specific test results, clinical findings, and the duration of the impairment. For some conditions, it is not enough to have a diagnosis alone; the SSA looks for certain medical benchmarks, such as functional limitations, test results, or documented symptoms to support the claim.

Some of the body systems included in the Blue Book are:

• Musculoskeletal System: Covers disorders such as spine issues, joint dysfunctions, and amputations.
• Cardiovascular System: Includes heart-related issues such as chronic heart failure and ischemic heart disease.
• Neurological System: Includes severe conditions such as epilepsy, ALS, and multiple sclerosis.
• Respiratory System: Lists disorders such as chronic obstructive pulmonary disease (COPD) and asthma.

It is important to note that the Social Security Administration does not automatically approve SSDI and/or SSI applications, but you may still be able to shorten the process or even receive benefits before your application has been completely processed. If you have questions, reach out to a Michigan Social Security disability lawyer to schedule a free initial consultation. 

The Compassionate Allowances Program: Fast-Tracking Severe Conditions

The SSA’s Compassionate Allowances Program allows people with particularly severe and life-threatening conditions to receive disability benefits more quickly. This program fast-tracks applications for those with qualifying conditions, such as ALS, advanced cancers, and Huntington’s Disease. If your condition qualifies under the Compassionate Allowances Program, your application will be prioritized and reviewed within a shorter timeframe, often resulting in faster approval and access to benefits.

Now let’s take a look at some of the most common listed illnesses that automatically qualify for Social Security Disability benefits.

Amyotrophic Lateral Sclerosis (ALS) – Lou Gehrig’s Disease

ALS is a progressive neurological disease that affects the nerve cells responsible for controlling voluntary muscles. This condition causes muscle weakness, paralysis, and eventually respiratory failure, making daily activities impossible. Because of its severe and fast-progressing nature, ALS is included in the SSA’s Compassionate Allowances Program.

Advanced Cancers

Certain types of cancer automatically qualify for disability benefits, particularly those that are advanced or aggressive. They include:

• Lung cancer that is inoperable or has metastasized.
• Pancreatic cancer, which is notoriously aggressive and difficult to treat.
• Brain cancer, including certain types of malignant brain tumors.
• Acute leukemia and other fast-growing blood cancers.
• Esophageal cancer that is inoperable or has spread.
• Inflammatory breast cancer that has spread beyond the breast tissue.

Most cancers that have spread to other parts of the body (metastasized) or are considered inoperable are automatically fast-tracked for approval under the Compassionate Allowances Program.

Stage IV or End-Stage Kidney Disease (Chronic Kidney Disease)

Stage IV or Stage V Chronic Kidney Disease (CKD) and end-stage renal disease (ESRD), where the kidneys are no longer able to function properly, automatically qualify you for disability benefits. Those living with these conditions often require regular dialysis or a kidney transplant to survive. The Blue Book specifies that individuals undergoing regular dialysis or those with severely impaired kidney function may automatically qualify for disability benefits.

End-Stage Liver Disease (ESLD)

End-Stage Liver Disease (ESLD) occurs when the liver can no longer perform its essential functions, resulting in life-threatening complications. ESLD, cirrhosis, or claimants who are waiting for or have received a liver transplant can automatically qualify for Social Security Disability benefits. These conditions are also fast-tracked through the Compassionate Allowances Program due to the critical nature of the disease.

Spinal Cord Injuries Resulting in Complete Paralysis

Severe spinal cord injuries resulting in paraplegia (paralysis of the legs) or quadriplegia (paralysis of both arms and legs) automatically qualify for disability benefits. Individuals with these injuries experience permanent loss of motor function, making it impossible to perform many work-related activities. If your spinal cord injury results in complete paralysis or extreme physical limitations, you may be automatically eligible for disability benefits under the SSA’s guidelines.

Huntington’s Disease

Huntington’s Disease is a hereditary and degenerative brain disorder that leads to the progressive breakdown of nerve cells in the brain. As the disease advances, it severely impacts movement, cognition, and behavior, making it impossible for you to work or perform daily activities. Huntington’s Disease is part of the Compassionate Allowances Program.

Early-Onset Alzheimer’s Disease

Early-onset Alzheimer’s Disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It typically manifests in those younger than 65. The SSA recognizes early-onset Alzheimer’s as a severe condition that automatically qualifies for disability benefits. This condition is included in the Compassionate Allowances Program.

Cerebral Palsy

Usually occurring before birth, cerebral palsy refers to a range of disorders that affect movement, muscle tone, and posture. Those with severe forms of cerebral palsy, particularly those who cannot walk or have significant intellectual impairments, may automatically qualify for disability benefits. 

Third-Degree Burns

Severe burns, particularly third-degree burns that cover a large part of the body or affect critical functional areas like the hands, feet, or face, can automatically qualify you for disability benefits. These burns can cause permanent damage and often require long-term medical treatment, reconstructive surgery, and rehabilitation.

HIV/AIDS with Serious Complications

Those diagnosed with HIV/AIDS who experience serious complications such as certain cancers, opportunistic infections, or neurological conditions automatically qualify for disability benefits. The SSA lists specific criteria for HIV/AIDS-related conditions, and if these criteria are met, benefits are granted without the need for further evidence.

Lewy Body Dementia

Lewy Body Dementia (LBD) is a progressive neurological disorder that affects cognition, movement, and behavior. It is one of the most common types of dementia after Alzheimer’s disease and is caused by abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, known as Lewy bodies, affect brain regions involved in thinking, memory, and movement. The rate of progression varies from person to person, but the average life expectancy after diagnosis is 5 to 8 years. 

What to Do if Your Claim is Denied

Even if you have a condition that qualifies for automatic approval, there are instances where your Social Security Disability claim may be denied. A denial can be frustrating, but it’s not the end of the road. Many initial claims are denied, and the SSA has a well-established process for appeals. 

Here’s what you should do if your claim is denied:

• Understand the Reason for Denial: The SSA will send you a detailed notice explaining why your claim was denied. Common reasons for denial include missing medical documentation, incomplete applications, or a failure to meet the SSA’s specific criteria for a condition. Carefully review the denial letter to understand what went wrong and whether it was a technical or medical issue.
• File an Appeal Immediately: You have 60 days from the date you receive the denial notice to file an appeal. This is called a Request for Reconsideration and involves asking the SSA to review your claim again. It’s important to act quickly and meet all deadlines to avoid further delays in receiving benefits.
• Gather Additional Evidence: If your claim was denied due to a lack of medical evidence, you will need to gather additional records to strengthen your case. This may include updated medical records, reports from specialists, diagnostic tests, and statements from your doctors detailing your condition and limitations. The more detailed and updated your medical documentation, the better your chances of overturning the denial.
• Consult with a Disability Attorney: Working with an experienced disability attorney can greatly increase your chances of success. A lawyer can help identify why your claim was denied, gather additional evidence, and present a strong case for reconsideration. They can also represent you in hearings if your appeal progresses to that stage.
• Prepare for a Hearing: If your reconsideration request is denied, you can request a hearing before an administrative law judge (ALJ). This is an opportunity to present your case in person, provide additional testimony, and allow your attorney to make legal arguments on your behalf. The ALJ will review the evidence and make an independent decision regarding your disability benefits.
• Keep Following Your Doctor’s Treatment Plan: During the appeals process, it’s important to continue following your doctor’s treatment plan. Not only will this help manage your condition, but it also shows the SSA that you are making efforts to improve your health. Failure to follow prescribed treatments may be used as a reason to deny your claim.

The appeals process can take a while, but those who persist often ultimately receive their benefits. In fact, many disability claims are approved at the hearing stage or after additional medical evidence is submitted. The key is to remain patient and continue working with your legal team to ensure all paperwork is properly filed and all evidence is collected and submitted.

Get Experienced Legal Representation for Your Disability Claim

Certain medical conditions automatically qualify for Social Security Disability benefits due to their severe and life-altering nature. If you or a loved one has been diagnosed with a condition such as ALS, advanced-stage cancer, end-stage kidney disease, or another severe disorder, you can receive disability benefits without the long approval process that many other applicants face. However, even with an automatic qualification, it is crucial to provide the SSA with clear and detailed medical documentation to support your claim.

At LegalGenius, our experienced disability attorneys can help you submit your original application and handle any appeals, so that you receive the benefits you are entitled to as quickly as possible. To learn more about your rights and to determine if your condition qualifies for automatic approval under the SSA’s guidelines, fill out our Ask the Genius™ form or call (800) 209-4000 today.

Attorney Jeffrey Perlman

Attorney Jeffrey Perlamn is the managing partner at LegalGenius, PLLC. He has helped Metro Detroit accident victims recover the compensation they deserve for over 35 years. He believes everyone should have access to justice and the legal system, which is why Attorney Perlman spends his time outside of the courtroom writing informational blogs on the LegalGenius website that are accessible to all.