I previously wrote back in 2017 regarding the rules in a Social Security case that the Social Security Administration (SSA) uses for determining medical equivalence. SSA has compiled what is referred to as a Listing of Impairments and the criteria to meet these listings based on certain severe and medically determinable illnesses. The difference between Medical Equivalence vs Medically Meeting a listing is that Medical Equivalency considers “quality of” instead of “quantity of”.
You may wonder who determines whether a claimant for Social Security meets or equals a listing? At the initial and reconsideration levels, SSA uses medical consultants to consider the evidence and make medical findings regarding the listings. At the hearing level, it is an Administrative Law Judge (ALJ) and sometimes attorney advisors who review medical evidence and make the determination. At the hearing level and at the Appeals Council level, the adjudicator or ALJ may rely on a medical expert to review the file and provide written interrogatories or oral testimony regarding the listings. The ALJ or adjudicator is not bound to those opinions and must still consider those opinions in the evaluation process.
Determining if you meet or medically equal a Listing is step 3 of the 5 step process in determining disability. An individual can win at step 3 if their impairment is found to meet or medically equal a listing, however, you can not lose at step 3. If your impairment does not meet or medically equal a listing, do not be discouraged as this does not mean you are not eligible for benefits. Your impairment can still be found severe and cause limitations which preclude your ability to work.
Deciding medical equivalence or whether your condition meets a Listing can be a difficult and confusing process. Call one of the experienced disability representatives at Gardberg & Kemmerly, P.C. today at 251-343-1111 for a free consultation. Gardberg & Kemmerly specialize in helping the injured and disabled.