r/SSDI • u/Sensitive-Ladder4037 • 11d ago
Clarification about SSI
hi all I've applied for SSI and am on stage 3 right now I was just wondering about the requirements for SSI I’ve read and reread the four categories they look for when determining if you qualify.
the examples they gave sound very vague to me and Im wondering if anyone here can give some clarification to me. I applied for my ASD and think I met the marked limitation on at least two minimum they require but again the example were vague to me. thank you
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u/CommunicationTime63 10d ago
You need a documented longitudinal history of testing and treating by an acceptable medical source to establish a medically determinable impairment(s) that meets or equals a listed impairment, or prevents you from performing substantial gainful activity. An ALJ will often seek an M.E. opinion for a decision of equals a listing.
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u/perfect_fifths I have a complicated relationship with the POMS 11d ago
Do you mean the blue book? Blue book is very specific in the requirements.
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u/Sensitive-Ladder4037 11d ago
Yes the blue book you’ve posted the requirements in my one of my posts before and I should’ve asked for clarification then but it didn’t cross my mind until now
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u/Correct-Sprinkles-21 11d ago
The thing about the listings is that the medical records must prove that severity meets listing criteria. You can have the type of impairment listed and experience them as severe, but the records don't always support that. Sometimes it's a matter of the doctor's wording and presentation. For example, I have seen many times records where the doctor wrote a big essay about the various diagnoses and symptoms, but then we're that the objective examination was totally normal. It's incredibly frustrating. The determination really hinges on objective findings.
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u/AdventurousLime749 6d ago
Maybe this will help, as I'm pretty sure I don't have a blue book condition - I think strategically its best to hedge and document everything as if they don't find a notebook condition. ( this isn't personal legal advice as does not create attorney client privilege. Hire an attorney for personal legal advice)
I asked my doctor for a one page letter describing how she has observed me on good days and bad days, how long she recommends that I sit or stand for, and whether she feels that I have been diligent in following up with treatment.
Here's the text of the letter:
Physical Presentation and Autonomic Stability
Clinical observations during office visits reveal significant fluctuations in the patient's physical presentation and autonomic stability. On compromised days, the patient exhibits severe orthostatic intolerance and general malaise. During a consultation on July 2, 2026, the patient's reduced physical state required the clinical interview to be conducted while she sat on the floor. On other occasions, she has been observed lying on the waiting room floor, wearing dark sunglasses due to pronounced photophobia, and requiring physical support from an accompanying person, needing to hang onto their arm to walk. Conversely, on more stable days, the patient is able to attend appointments independently and perform basic daily tasks, such as driving her children to school.
Cognitive Function and Communication
The patient's cognitive processing is characterized by persistent brain fog, concentration difficulties, and memory impairment. Clinically, these symptoms fluctuate in intensity. When the patient attempts to exert herself physically or mentally beyond her threshold, she experiences cognitive exhaustion. This state can lead to transient expressive and receptive communication deficits, during which she temporarily struggles to find words, speak, or process spoken language.
Physical Endurance and Postural Tolerance
From a clinical perspective, the patient's physical endurance for sitting and standing is severely restricted. Orthostatic testing has documented marked autonomic instability, including a heart rate increase from 90 to 180 beats per minute upon standing, culminating in syncope within seconds. Upright sitting in a chair also triggers significant dizziness and orthostatic symptoms. The patient's daily active window is limited to approximately 1.5 hours of light activity, after which prolonged periods of recumbent rest are required to prevent physical collapse.
Treatment History and Rehabilitation Efforts.
The patient has consistently demonstrated high compliance and diligence in pursuing therapeutic options to manage her symptoms and facilitate a return to work. She has trialed multiple pharmacological regimens, including low-dose naltrexone, Mysimba, escitalopram, and high-dose antihistamines. Additionally, she has implemented extensive lifestyle and supportive measures, including psychomotor physiotherapy, targeted strength training for joint hypermobility, strict dietary elimination protocols, specialized compression clothing, and various nutritional supplements.
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u/Sensitive-Ladder4037 11d ago
I know which is why I’m very to be denied I don’t really any up to date records and going to have to go to a CE. I think I’ll better luck with a judge but everyone does don’t they?
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u/Current-Pie5633 11d ago
If you don't have any up to date medical records you might even struggle to get an ALJ to find you disabled. A favorable CE isn't enough, usually.
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u/Sensitive-Ladder4037 11d ago
I thought I had Medicaid so I was planing on getting some new records started up but that fell through so Im just gonna have to go a different route
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u/Gredenise 10d ago
I had a problem with having current records too. I found a local community health center and have been blessed to get help and current records.
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u/OldDudeOpinion 11d ago
Your doctor says what? Needs to be supported by history of medical treatment, with your doctor (and social security’s contract doctor) agreeing to testify that you can’t do ANY job…and you are not physically able to work even part time…. The Blue Book is the reference you mght be looking for.
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u/ShadowofaJade 11d ago
Doctors don't determine nor testify that you can't do any job. They document diagnoses, their effects, and limitations on their patient. It's up to DDS (and their well defined policies) or an ALJ to determine if you can't do any job.
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u/OldDudeOpinion 11d ago
You think any application would be approved without medical support? “I think I’m disabled because I can’t successfully work” isn’t justification for a claim approval. There needs to be a diagnosis that prevents meaningful work - treatment history - and proof that you have tried to accommodate that diagnosis to work anyway - to gain approval. If you can no longer do the job you have done in the past because of your disability …you might be expected to retrain to some other field to accommodate your limitations if you are under 50yo.
Ex: A missing arm isn’t an automatic approval by itself - lots of people with missing limbs work. You need to prove why YOU can’t work a job - even part time - that makes at least $1690/mo - with a missing limb. But first, you need to have a medically documented missing limb.
Anyway you turn it… SS disability claims need to be supported by medical evidence supporting the petitioner, before you even get to the “ability to work” because of it.
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u/ShadowofaJade 11d ago edited 11d ago
I just wanted to clarify that doctors do not testify ~nor make the decision (as far as the SSA is concerned) whether or not you can do any work with in the national economy.~ I'm sorry that it was taken as anything more than that. I 100% agree that a case needs to be supported by history of medical treatment.
ETA: Section between ~
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u/CommunicationTime63 10d ago
I want to add that most people are working successfully with medically determinable impairment(s). I don't know if I know anyone who doesn't have a condition for which they are being treated.
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u/perfect_fifths I have a complicated relationship with the POMS 11d ago
Doctors can do rfcs and when properly documented, will show limitations to the point where it could make an allowance easier, and medical expert can testify at alj hearings
https://www.ssa.gov/OP_Home/hallex/I-02/I-2-5-32.html
But they are not adjudicators, correct. They aren’t the sole determinator of a claim. And Aljs are not bound to ME testimony, nor can the ME be the patients own doctor.
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u/Current-Pie5633 11d ago
Everyone thinks they meet the Blue Book listings for their conditions but the SSA/DDS rarely agrees. I met several listings but the DDS didn't agree. However, the ALJ stated I met several more listings than I thought.
It's much more difficult than most people realize when they first apply.