Can I Get Disability For Degenerative Disc Disease
Degenerative disc disease is one of the most common causes of low back and neck pain leading to disability. Many claimants seeking Social Security Disability Insurance or Supplemental Security Income benefits live with this condition for years. They often work impaired for many years until they no longer can before they contact a Social Security disability lawyer.
Does Back Pain Qualify As A Disability In Canada
Heres the good news: All Canadian insurers see back pain as a cause of disability. While most people with back pain recover quickly, it can also be chronic. Often, it interferes with work and daily life.
Following is a list of back problems that can qualify for disability:
- Degenerative disc disease refers to pain that originates from a degenerated disc in the spine. Pain from this type of disorder decreases over time.
- A bulging disc, or a slipped disc, is when an intervertebral disc expands beyond its normal bounds. Pain happens when the disc presses on a nearby nerve root.
- Lumbar radiculopathy is nerve irritation caused by damage to vertebrae discs. Pain increases with hip movements, coughing, and sneezing.
- Sacroiliac joint disease is the inflammation of the firm joint between the spine and the pelvis.
- Sciatica is when the sciatic nerve gets pinched. This disorder can cause back pain, numbness, weakness, and tingling that radiates down the body.
- Fractures of the spine happen when vertebrae break or collapse. If left untreated, this can lead to more severe problems.
- Osteoarthritis of the lower spine is when the cartilage in the joints and discs of the back break down.
- Ankylosing spondylitis is a type of arthritis that affects the spine.
- Spinal stenosis is when the bone channel the spinal nerve goes through gets narrower.
Requirements For A 100% Disability Rating
If your degenerative disc disease is severe enough, the ultimate goal is to receive a 100% disability rating. There are two methods to use. The first one is to have one or more disabilities that reach the 100% disability rating. The other way is to receive the rating through TDIU.
is if you cannot work, which means you should be eligible to receive a 100% disability rating. If you cannot work at all, you may be eligible for Total Disability Individual Unemployability . It gives the same amount as a 100% rating, but does not require the full 100%.
The specific requirements for this include:
- Have veteran status
- Have a minimum of one service-connected disability with a 60% rating
- Have two or more service-connected disabilities with one having an individual rating of 40% and a combined rating of 70% or more
- The inability to keep gainful employment
To prove that you have met the requirements for TDIU, you have to gather certain types of evidence. Start with proof of at least one service-connected disability. Youll also need to show that your disabilities prevent you from getting or keeping a job. Your disabling condition can affect your physical or mental ability to do a job, so list both on your application.
Its also necessary to have at least one disability thats rated at 60% or if you have more than one disability, at least one that is rated at 40%, with a combined amount of 70% or higher.
Tip 4: The Examiner May Call Your Friends And Family
Keep your family and friends up to date on your physical limitations. Disability examiners often call claimants to ask questions about their daily activities, but they also routinely contact the relatives and friends of claimants as well. Examiners refer to these calls as ADL calls. Technically, ADL calls are for the purpose of gathering “supporting” information on claims.
In actuality, though, they are used almost exclusively to gather evidence to deny cases. As an examiner, I witnessed many ADL calls during which examiners prompted claimants to give responses that were not helpful to their case. As terrible as it sounds, this happens in many cases. In fact, it is for this reason that disability examiners are not allowed to make ADL calls to claimants who are represented by a disability lawyer or nonlawyer representative.
For more information, see our article on getting disability for degenerative disc disease.
Can You Get Disability For A Bad Back
While back pain is the main symptom of degenerative disk disease, the location of the pain may vary depending on where the impaired disc is. The pain may reach the neck, lower back, buttocks, or even thighs. It may come and go, and feel worse when you bend, twist, or sit. In more severe cases, the damage may affect surrounding nerves, causing weakness, tingling, or numbness in the arms and legs.
Is degenerative disc disease disabling you? The Social Security Administration uses a 5-step process to decide if you are disabled.
Step 1. Do you have a Substantial Gainful Activity?
First, the SSA considers your work activity. If you are engaged in Substantial Gainful Activity you will not be found disabled. The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your degenerative disk disease and any other physical or mental conditions are considered.
Step 2. Can your medical condition be considered severe?
Social Security Medical Evaluations
Although Social Security will have access to your medical records, they may also order a medical examination by a different doctor. These exams do not cost you anything. The exams are not for medical treatment but to determine whether or not your claims are accurate. Specifically, they will ensure your limitations and medical conditions are as described. These exams may include blood work or X-rays.
In this particular situation, the doctor will check to determine that your degenerative disc disease is so advanced that it prevents you from working. They will also ask you how it impacts your daily life outside of work. With degenerative disc disease, odds are that you cannot stand, walk, lift or bend nearly as frequently as you did before the diagnosis.
Barriers To Service Connection For Degenerative Disc Disease
Degenerative disc disease is known to be a condition that develops over time. When filing a VA claim for DDD, veterans will want to be sure they are submitting a current diagnosis from a doctor, a statement explaining what in service events or conditions contributed to the DDD, as well as a medical nexus from a doctor linking the degenerative disc disease to your time in service.
When denying service connection for degenerative disc disease, VA often relies on an examiners finding that the veterans condition is due to normal wear and tear and the natural progression of aging rather than their time in service. However, if VA examiners arrive at this conclusion, they must provide adequate rationale to support it, otherwise, VA should not rely on it for adjudication purposes. It is not enough for the examiners to simply say that a veterans DDD is due to natural progression and aging. Instead, they must also explain why it is not due to other factors, such as service.
What Is Cervical Disk Disease
Degenerative Disc Disease Can affect everyone differently. A common way that someone can experience degenerative disc disease is in the neck. This might be known as Cervical Disc Disease. Cervical degenerative disc disease is commonly a cause of neck pain that can extend into the shoulders and down the arm.
Cervical disc disease is similar to other forms of degenerative disc disease in that it is caused by an aging of the protective flexible discs between the vertebrae in the spine. There is not one cause of degenerative disc disease, however there are a few contributing factors. Genetics often determine how prone one is to cervical disc disease. Injury as well as being overweight can also increase your predisposition to degenerative disc disease.
Almost everyone will experience some sort of degradation of the spine in their lifetime. That is completely normal. However not all experience pain. Degeneration of the spine often wont become an issue until an individual is above 50. At this point in life, it might be difficult to learn a new skill if you are physically unable which is why it is important to learn more about how the disability application process might change.
Role Of Ssd Attorney Or Disability Attorney In Helping You Win Disability Benefits For Degenerative Disc Disease
Even if a claimant has enough documented evidence favoring his or her claim, if it is not presented in front of the judge in an appropriate way, the claimant may not be able to get the decision in his or her favor. For this, the claimant needs to hire an experienced disability attorney who can prepare and present the claimants case in the best possible way so that Disability Benefit is granted. SSD attorneys have significant knowledge as to what the judge might require of the claimant during the hearing and what are the other relevant information that needs to be furnished in front of the judge at the time of hearing to win a disability claim for degenerative disc disease.
It should be noted here that an SSD attorney gets paid only after the claimant has been granted disability benefit, thus the attorney does all he or she can to get the claimant disability benefits
In summary, an individual with a confirmed diagnosis of Degenerative Disc Disease to such an extent that he or she is unable to be gainfully employed in any position and has enough credible evidence supporting his or her claim needs to work in close relationship with his or her treating physician and an experienced SSD attorney so as to win Social Security Disability Benefits due to Degenerative Disc Disease.
Degenerative Disc Disease For Veterans
If you are a veteran that has been diagnosed with degenerative disc disease, you are able to apply for disability benefits even if you are already receiving VA benefits. In fact, going through the process of getting a disability rating from the VA can help with your application.
For both sets of benefits, you will need to provide medical evidence that you do have degenerative disc disease. Degenerative disc disease is often something that is hereditary and progresses over a long period of time. However, if you can prove that your degenerative disc disease was connected to your military service, you will receive a disability rating from the VA.
All of the medical documentation that you have gathered for your VA disability rating can be used as evidence in your SSDI application.
Diagnostic Imaging Helps But Credibility Is Key
The most common reason that long-term disability claims for back problems get denied is lack of objective evidence of disability. However, you can seek out diagnostic imaging to prove the disorder. This evidence alone isnt enough to win disability benefits, but it is valuable for your case. It can help show your pain is legitimate.
Make sure to tell the doctor about your problems and pain in detail. Then, they will choose an imaging technique that fits and analyze the results for a diagnosis.
The most common imaging techniques are X-rays, CT scans, and MRI scans. X-rays can check for instability in the structure of the bones to find issues such as spinal fractures. CT scans are more detailed than x-rays. They can image specific conditions such as spinal stenosis or a bulging disc.
MRI scans are used to assess details of the disc and nerve root. They allow doctors to identify disorders like degenerative disc disease, bulging discs, and spinal stenosis. An important note about MRI results is that there is no accepted link between back pain and what can be seen on an MRI. This is where credibility becomes very important.
One of the best ways to build credibility is to try a variety of treatments for your back pain. You will have a much better chance of getting disability benefits for back problems if you work with professionals who can back up your claims.
Collect Other Documentation Supporting Disability Due To Degenerative Disc Disease Because You May Need It
Many people that apply for SSD with back issues are initially denied benefits. This is especially true for those under the age of 50. Additional documentation can help fortify your claim, including any evidence that documents your specific symptoms and the types of common job functions they prevent you from performing. Use the following evidence to your advantage:
- Statements from your former employer or a human resources representative,
- Records of sick days, short term disability leave, and family medical leave from your former employer,
- Information in the disability application,
- A formal statement or report from your doctor, summarizing your condition and its effects on everyday activities, including employment-related activities.
Other items that may be useful as part of your appeal hearing include job descriptions, performance evaluations from work, and formal statements from family members or others that can attest to your daily limitations and your common need for assistance in completing everyday tasks.
Contact Gillette Law Group
The pain you experience from degenerative disc disease can deeply affect your work, your earnings, and your life overall. If you believe you truly need assistance, do not be discouraged by the strict application process for disability benefits. We at the Gillette Law Group can give you get the best chance at the benefits you need and deserve.
Your consultation with us is free, so dont hesitate to talk to us. Call us today at 873-2604
How Does Va Rate Degenerative Disc Disease
VA rates degenerative disc disease under 38 CFR § 4.71a, Schedule of Ratings Musculoskeletal System, Diagnostic Code 5242. The rating criteria for this diagnostic code is virtually the same as Diagnostic Code 5003, which is used to rate degenerative arthritis.
If degenerative arthritis is established by X-ray findings, the veterans condition will be rated based on limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. However, if the limitation of motion of the specific joint or joints involved is under the appropriate diagnostic codes, a rating of 10 percent will be applied for each major joint or group of minor joints affected by limitation of motion. Finally, in the absence of limitation of motion, a veterans degenerative disc disease will be rated as follows:
- 10% with X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations
- 20% with X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups
When assigning a disability rating based on the severity of symptoms, VA must take into account both anatomical damage and functional loss. Importantly, limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.
Can I Receive Social Security Disability Benefits For Degenerative Disc Disease
Degenerative Disc Disease pain and associated symptoms can impact your ability to work. Social Security Disability benefits may be available to you.
If you are not engaging in gainful activity due to Degenerative Disc Disease, the Social Security Administration must determine if you have an impairment that is severe. This is step 2 of the evaluation process.
Generally, to establish Degenerative Disc Disease as a medically determinable severe impairment, you must show:
- Objective medical imaging establishing degenerative disc disease;
- Consistent complaints of pain or other symptoms for a period of time and which is not controlled through conservative treatment modalities
At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For DDD, SSA will determine if your condition meets any of the Listing 1.04 Disorders of the Spine. There are three parts to this listing that you may meet. They are as follows:
Long Term Disability Insurance Claim For Degenerative Disc Disease
Our law firm has extensive experience with long-term disability claims for back pain and immobility due to degenerative disc disease, osteoarthritis, and various disorders of the skeletal spine. We have filed suit on behalf of disabled clients whose disability claims for degenerative disc disease were denied by major carriers including , The Hartford, and .
You may have purchased an individual disability policy to protect against loss of income should disability strike. These policies are controlled by state contract laws and insurance laws.
Or, you may be covered by your employers group disability benefit plan. Group LTD benefits are controlled by the Employee Retirement Income Security Act of 1974, a.k.a. . For claimants fighting insurance companies who refuse to pay, this cumbersome federal law actually overrides state laws that protect consumers and work more in favor of insurance companies.
In either case, you need to prove to the insurer you are unable to work under the terms of your insurance policy. Insurance providers often deny credible disability claims for degenerative disc disease and other back and neck disorders, by asserting various reasons including:
- You are able to work in sedentary occupations
- There is no basis for the restrictions and limitations imposed on you by your doctor
- There is no objective evidence of the condition
Applying For Disability Benefits Over The Age Of 50 With Degenerative Disc Disease
If you are older than 50, your chances of having your claim approved do improve somewhat. At this point, you are older, and you have been established in your career. It wouldnt be as easy for you to train for a new job or start an entirely different career. Your age and work history are taken into consideration when your disability claim is being approved.
If you are 50, you have earned enough work credits to qualify for Social Security Disability Insurance . SSDI requires that you have worked enough and paid in enough Social Security taxes to earn enough credits to be covered. At this point in life, you shouldnt have a problem with having enough credits if you have worked continuously during the last several years. The older you are, the better your chances of qualifying for disability benefits because you have the additional work credits.
Types Of Disability Benefits For Back Pain
You may qualify for disability benefits for back problems if you become unable to work. You can get benefits from the government, your employer, or an insurance company.
This list covers the options for disability benefits in Canada:
Lets go over each, so you know whether you qualify, how to apply, and how to appeal if they deny your claim.
Chronic Pain And Proving Back Disabilities
This is one of the fundamental problems regarding disabling impairments that involve pain: only the person experiencing the pain can actually know how bad it is and the degree to which it affects them. For this reason, and because disability examiners give little consideration to complaints of pain, medical records are very important in cases involving back conditions. Social Security ends up granting disability benefits only for those whose disc disease has progressed to having severely impacted vertebrae that can be seen on medical imagingand that cause chronic pain and the inability to sit or stand for periods of time without assistance. That’s why medical records are so important in these cases.
Exceptional Or Unusual Disability
Its necessary for the individual to show or for the VA to find that the case presents an unusual or exceptional disability picture. It should include related factors that interfere with regular employment and frequent time spent in the hospital. These make it impractical for a regular schedular rating to be assigned.
To Get Disability For Back Pain Youll Have To Show The Social Security That Your Pain Is Beyond The Moderate Back Pain That Many People Experience And That You Have Trouble Standing Walking Or Sitting Or Long Periods
Back injuries can be caused by natural aging processes and deterioration like osteoarthritis or osteoporosis, from illnesses like inflammatory arthritis , or from postural problems resulting from scoliosis, improper lifting, extended periods of sitting, bad posture, or years of wear and tear from heavy lifting and bending at work. Back injuries can also occur from car accidents, sports injuries, and falls.
Most applicants for disability based on back pain suffer from osteoarthritis or disc degeneration rather than a traumatic accident or injury. And quite a few applicants are those who have gone through a back surgery and have not recovered well.
Were Here For You Throughout The Disability Process
Dont let a delay or denial stop you from winning your disability claim for degenerative disc disease. We provide significant help, and your initial consultation is always free. If you need help with a disability claim concerning Social Security, an insurance company, or the Department of Veterans Affairs, please contact us.
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About Marc Whitehead
Marc Whitehead has been practicing law for over 27 years in Houston, focusing exclusively on disability law. His firm, Marc Whitehead & Associates files applications and appeals denials for Long-Term Disability insurance policies, Social Security Disability and Veterans Disability. He has authored books on each of these topics and presented nationwide on disability law.
Marc is double board-certified in Social Security and Personal Injury. In addition to his legal work, Marc is a certified practice advisor with Atticus, an organization that provides business training and management skills necessary to build and maintain a profitable practice.
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Can A Veteran Increase His Or Her Rating For Degenerative Disc Disease
Its important to look into worsening symptoms and secondary conditions that may have surfaced as a result of the degenerative disc disease. DDD can trigger other conditions including radiculopathy, herniated discs, neurological impairments, spinal stenosis, and more. Claiming secondary or different conditions and combining ratings can result in considerably higher ratings.If the VA has denied your claim or if you have received an unsatisfactory rating decision, you may need someone by your side. An accredited Veterans claims attorney at our firm is an excellent place to start.
Understanding Degenerative Disc Disease
Degenerative disc disease is a medical condition that occurs when the discs in a persons spine get damaged over time. This can cause substantial pain, as well as numbness, tingling, and weakness in the extremities. It most often affects people in their 30s or 40s who are otherwise healthy and active.
The spine is composed of a number of parts. The discs act as shock absorbers between the bones of the spine. Their purpose is to resist force and provide the back with flexibility.
Spinal discs are composed of two parts: a tough outer layer and a soft, jellylike core . These discs have a very low blood supply. As a result, if a disc is injured, it cannot repair itself.
Disc degeneration has a number of possible causes, including age-related wear and tear. In addition, disc degeneration disease may be caused by:
- The disc drying out over time
- Daily activities and sports
- Injuries that can cause swelling, soreness, and instability
A person with disc degeneration disease may experience a range of symptoms, include:
- Pain that is worse when sitting
- Pain that is worse when bending, lifting or twisting
- Periods of severe pain that come and go
- Pain in the low back, buttocks, and thighs, or the neck, radiating to the arms and hands
- Numbness and tingling in the extremities
- Weakness in the leg muscles or foot drop
- Feeling better when walking or running as opposed to sitting or standing
- Feeling better after changing positions frequently or laying down