Do I Have to Meet a Social Security “listing” in Order to Win?

   There are basically three ways to win a Social Security case:

1. you can meet a listing
    
2. you can meet a grid rule
    
3. you can win by proving that your functional capacity for work has been so reduced by your impairment(s) that you would not be able to function in a competitive work environment.

  If your medical condition meets a Social Security listing, you win automatically.  The “listings” are medical definitions published by Social Security.  Most major diseases are described in one or more listing categories.  Not only does a listing describe a specific medical condition, but the evidence Social Security wants is also included.  You can read examples of two common listings:

herniated disk listing

anxiety disorder listing

   My experience has been that many people who meet a listing are approved early on in the process since the medical descriptions in the listings reflect very serious medical problems.  In other words, if a Social Security adjudicator, who may or may not have a lot of medical training, can recognize that your condition meets a listing, you are likely to be very and clearly deserving of benefits. 

Does Your Medical Record Contain “Magic Words?”

  It has been my experience that  in order to win a case on the listings, you will need extensive medical records  and, ideally, a statement or questionnaire on the listing completed by a  treating physician.  In my office, my staff and I have prepared  questionnaires on most of the listings, thereby enabling your doctor to answer  questions about the listings by checking off boxes or completing short answer  questions.

   I sometimes explain to clients that in order to win early (at the initial application or at reconsideration) by meeting a listing, your medical record needs to contain “magic words” - that track the language of the listing specifically.  At the initial and reconsideration levels of appeal, the State Agency adjudicator needs to recognize specific wording in your records and the medical consultant at the State Agency needs to agree that your condition meets a listing.  Social Security is trying to catch these listing level cases earlier and there have been some improvements.  However, a significant number of listing level cases still slip through the cracks.

Using a Listing Argument at Your Administrative
Law Judge Hearing

  If your listing level case is not caught early, you can still win on the listing at a hearing.  Judges that hear disability cases are empowered to call independent medical expert witnesses.  Typically, these medical experts are retired physicians who are called to give an opinion about the records in a case.  Medical experts appear in perhaps no more than 20% of the cases I try, so if I see that the judge has called a medical expert witness, that is usually a good sign.  It can mean that the judge has reviewed the file and sees that your case may be listing level; on the other hand, it could mean that the medical record is very complicated and that the judge really does need help in understanding what is going on.

  If your medical condition meets or equals a listing, then the judge will not spend a lot of time evaluating your vocational profile.  If you meet a listing, Social Security assumes that your condition would cause a significant and on-going impediment to your capacity to function in a work environment.