The information below is designed to help Cushing’s patients understand the process to qualify and apply for disability benefits, and offers guidance on appealing Social Security Disability decisions if needed.

UNDERSTANDING SOCIAL SECURITY DISABILITY BENEFITS

Cushing’s Syndrome challenges the human body in a variety of ways, making even day-to-day activities difficult to complete. For this reason, individuals with Cushing’s may need financial assistance to offset the expenses associated with lost income and medical treatment. If you have Cushing’s and can no longer work, you may be eligible to receive Social Security Disability benefits.

Benefit Programs and Defining Disability

To be eligible for disability benefits, a person must be unable to engage in substantial gainful activity (SGA). A person who is earning more than a certain monthly amount (net of impairment-related work expenses) is ordinarily considered to be engaging in SGA. The amount of monthly earnings considered as SGA depends on the nature of a person’s disability. The Social Security Act specifies a higher SGA amount for statutorily blind individuals; Federal regulations specify a lower SGA amount for non-blind individuals. Both SGA amounts generally change annually according to the national average wage index.

Individuals who meet these requirements may be eligible to receive disability benefits from one, or both, of the federal benefit programs run by the Social Security Administration (SSA). The SSA administers two programs that provide benefits based on disability: the Social Security Disability Insurance program (SSDI) and the Supplemental Security Income (SSI) program. Each has different technical eligibility requirements:

SSDI

SSDI is tied to your work history. It pays benefits to you and certain members of your family if you:

• Have a disability; and
• Worked enough years to qualify and paid Social Security taxes during the years you worked

SSI does not require you to have a work history. It provides you with money to cover basics like food, clothing, and housing if you are 65 or older or have a disability.

To find out if you are eligible for SSDI or SSI, visit https://www.usa.gov/social-security-disability and fill out the questionnaire. There is also a Disability Starter Kit available to help guide you through the Disability Determination Process website here: https://www.ssa.gov/disability/disability.html

How to Meet Medical Eligibility for SSD Benefits with Cushing’s Syndrome

If you meet the SSA’s definition of disability and the SSI or SSDI technical eligibility requirements, you will then be evaluated medically. Many conditions and their medical eligibility criteria are listed in the SSA’s publication of disability conditions—known as the Blue Book.

Unfortunately Cushing’s Syndrome is not specifically listed in the Blue Book. However, individuals with Cushing’s may qualify for benefits under a separate listing related to their specific impairments and limitations. These may include the following listings:

1.01 —Disorders of the Spine

4.00—Cardiovascular Disorders

9.00—Endocrine Disorders

12.00—Mental Disorders

Access all Blue Book listings at https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

Because Cushing’s syndrome affects people in different ways and has a variety of different symptoms, it is not likely that an individual with this condition will fit under one specific listing. If you find that this is the case, you may qualify under something known as a medical vocational allowance.  The guidelines can be found here: https://secure.ssa.gov/poms.NSF/lnx/0425025005

APPLYING FOR SOCIAL SECURITY BENEFITS

To prepare for your application you will need to gather all medical records and documents that can help demonstrate the degree of your impairment. This includes documents and written statements from all your medical specialists beyond endocrinology.

It is important to keep in mind that over half of applications are initially denied.  Be sure to give as much detail as you can on your application and provide full responses to all questions.

To begin your application you can submit the necessary paperwork on the SSA’s website here: https://www.ssa.gov/apply?benefits=disability&age=adult or in person at your local Social Security office.

Social Security Disability Decision and Appeal

It may take months to find out if your application is accepted or denied. If denied, it is important that you do not panic. You are allowed to appeal this decision within 60 days of receiving notice of denial. Filing an appeal will give you the chance to provide the SSA with updated information and make a stronger case for yourself. At this point in the application process, it may be in your best interest to retain the services of a qualified Social Security Disability attorney or advocate. Read more about the appeals process here: https://www-origin.ssa.gov/benefits/disability/appeal.html

The appeals process consists of two parts—the reconsideration and the appeal hearing. Some states don’t have reconsideration and go straight to the appeal hearing. If, however, your state requires reconsideration, you will have to submit the following forms:

• The Reconsideration Disability Report- intended to provide the SSA with new information about your claim; and
• The Request for Reconsideration- intended to state your intent to appeal the SSA’s decision; and
• Authorization to Disclose Information to the SSA- intended as a medical release form.

The reconsideration stage of the appeals process provides applicants with the chance to refute any incorrect conclusions, to provide additional medical records, and to correct any errors made during the initial application.

If you are denied at the reconsideration stage, you will move on to the appeal hearing. During the appeal hearing, claimants are required to appear in front of an Administrative Law Judge (ALJ) to present their claim. Applicants are strongly advised to have legal representation at this point in the process.

Although the Social Security Disability appeals process is complicated, it is often a necessary step toward receiving financial assistance. In fact, many more applicants are approved at the appeals level than during the initial application. Once you are awarded benefits, you will be able to focus on your health rather than your finances.

Updated 2025-05-25

Original Author: Molly Clarke, writer for Disability Benefits Help, works to promote disability awareness and to assist individuals throughout the Social Security Disability application process.  Get more details at: https://www.disability-benefits-help.org/

From the Archives: CSRF responded to a call for comment by the SSA in 2007.  Click here to read the full background and letter at https://csrf.net/2007-ssa-letter/