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
By Bethany K. Laurence, Attorney
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.
The Social Security Administration Revised Its Musculoskeletal Disorders Listings In April 2021 Making It More Difficult To Qualify For Disability Benefits With Those Impairments
If you have spinal stenosis, you may be eligible for Social Security Disability Income however, you will need to depend on your medical providers to submit the needed medical evidence of your functional limitations and restrictions. An experienced Social Security Disability attorney can help you by contacting your doctor and gathering all the information you need to ensure a successful claim.
In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.
The first category is the Work Requirements which has two tests.
The second category is the Medical Eligibility Requirement.
More details can be found on our Qualifying for Disability page.
Other Conditions Which May Lead To Spinal Stenosis Include:
- Herniated disks.
- Thickened ligaments. Ligaments that hold the bones of the spine together can become stiff over time and bulge into the spinal canal.
- Bone spurs on the spine.
- Tumors on the spinal cord.
- Rheumatoid arthritis.
- Spinal injuries for example, from a car accident or other trauma.
- Ankylosing spondylitis a type of arthritis that leads to bone spurs.
- Achondroplasia an inherited condition which interferes with bone formation in the spine.
- Congenital spinal stenosis -a birth defect where the spine is naturally narrow.
- Scoliosis.
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What Kinds Of Back Problems Can Qualify You For Disability
Claims involving neck pain will be evaluated under Adult Listing 1.15, for disorders of the spine resulting in compromise of a nerve root. Compromise of a nerve root, sometimes referred to as nerve root impingement, is a phrase used when a physical object, such as a tumor, herniated disc, foreign body, or arthritic spur, is pushing. Social Security publishes the criteria for a number of common illnesses to qualify for disability, and if you meet the criteria for your particular condition, you automatically qualify for benefits. The listing for Spinal Stenosis is 1.04: 1.04 Disorders of the spine . Disorders of the spine. B)
Please Answer A Few Questions To Help Us Determine Your Eligibility
Spinal stenosis is a narrowing of the space in the spinal canal. Stenosis can occur in both the cervical and/or lumbar regions of the spine. The narrowing can lead to compression of the spinal cord and nerves, which, in turn, can lead to:
- muscle weakness in the arms or legs
- loss of deep tendon reflexes , and
- numbness and pain in the back, buttocks, and legs.
Spinal stenosis often occurs as the result of another back problem, such as degenerative disc disease, nerve root compression from osteoarthritis, herniated discs, or scoliosis. Spinal stenosis can be caused by natural aging or by a spinal injury causing nerve compression.
Many patients who suffer from stenosis are unable to work because of pain in their back and legs and their inability to walk without assistance or stand for prolonged periods of time. Fortunately, lumbar spinal stenosis is one of the few back conditions recognized by the Social Security Administration with an official impairment listing, meaning that those with documented cases of severe lumbar spinal stenosis are automatically granted disability benefitsif you can meet the SSA’s tough requirements.
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What Conditions Qualify For Short
Short-term disability insurance protects your paycheck when you cant work for a short period of time typically three, six or 12 months.
Since it caters to short-term needs, STD tends to cover temporary disabilities and conditions with a relatively quick recovery time. These include:
- Disabling injuries like broken legs, feet or hands
- Prolonged illnesses such as glandular fever
- Bone, joint and spine disorders like arthritis, back pain and tendonitis
- Chronic digestive disorders including gastritis and Crohns disease
- Mental health conditions like depression and chronic anxiety
- Pregnancy and maternity leave, in some cases
When does short-term disability pay out for pregnancy?
You may not think of pregnancy as a disability, but many insurers classify it as one under their STD policies.
If you purchased a policy before you became pregnant, you may be eligible to receive benefits for six weeks after a vaginal delivery and eight weeks after a C-section. If you have a high-risk pregnancy or experience complications, hypertension or postpartum depression after childbirth, your disability benefits might be payable for longer.
Insurers treat pregnancies differently, so check the parameters of your policy before filing a claim.
The List Of Covered Illnesses And Injuries Comes Down To The Type Of Policy You Have
Disability insurance is designed to protect your paycheck if you cant work due to an illness or injury but it isnt a catch-all policy. Your insurer will only pay benefits if your condition is specified in your policy, and the list of conditions differs between short-term, long-term and Social Security disability.
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What Medical Evidence Do I Need
One of the most important parts of any Social Security Disability claim, if not the most important part is the medical evidence that you have collected that supports your claim. In the case of a spine disorder or back problem, you will generally need to gather sufficient medical evidence. The Social Security Administration requires that in order for a person to receive social security disability payments that they need to present documentation of the existence of their impairment from medical professionals defined by SSA regulations as acceptable medical sources. Once a person has established that they have an impairment, all the medical and non-medical evidence will be considered in assessing impairment severity. Some of the acceptable medical sources are:
It is very important that you take the time to carefully gather this information, and compile it for the Social Security Administration. If you do not have enough evidence that supports your claim then you may be denied Social Security Disability Benefits.
How Spinal Conditions Affect You
There are numerous spinal disorders, and you could have different symptoms that affect you to varying levels depending on the severity of your condition. Most people with a spinal disorder do have some difficulty performing physical work because the spinal cord affects almost every bodily function to some degree.
Most people who suffer from a spinal disorder will suffer pain to some extent. When you file your claim for disability benefits, you will want to make sure Disability Determination Services understand how your range of motion and physical abilities are restricted by your pain.
You will need to provide hard medical evidence that supports your claim. Medical records and physician notes should include how your pain affects you, your limitations, and restrictions that you face because of your medical condition daily.
Corroborating evidence will help you ensure your claims success. Be sure to provide a thorough list of all healthcare providers and include the dates of service and their contact information so the records can be thoroughly reviewed.
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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.
Credibility killers:
Credibility boosters:
Psychological And Social Factors In Back Pain
Although psychosocial factors play a major role in the functional loss caused by low back pain, there is no good way for the Social Security Administration to evaluate these factors. Psychosocial factors strongly predict future disability and the use of health care services for low back pain. Chronic disabling low back pain develops more frequently in patients who, at the initial evaluation for low back pain, have:
- A high level of fear avoidance
- Psychological distress
- Involvement in a tort-compensation system or
- Job dissatisfaction.
These psychosocial factors are particularly prevalent in persons with low back pain for whom imaging shows only degenerative changes 70 to 80 percent of such patients demonstrate psychological distress on psychometric testing or have disputed compensation issues, compared with 20 to 30 percent of patients whose imaging studies reveal definite pathologic or destructive processes. These psychosocial factors should be routinely assessed in patients with low back pain and taken into account in decisions regarding treatment.
Osteoarthritis
Figure 2: Spinal cord and nerve roots.
Figure 3: Normal spinal canal with facet joints.
Degenerative Disc Disease
Figure 4: Vertebral fusion using bone strips.
Herniated Nucleus Pulposus or Herniated Disc
Figure 5: An intervertebral disk with lateral herniation.
Figure 6: MRI view of herniated discs.
Osteoporosis
Trauma
Tumor
Arachnoiditis
Lumbar Strain
Spondylolisthesis
Spinal Stenosis
Scoliosis
Kyphosis
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What Is The Most Approved Disability
According to one survey, multiple sclerosis and any type of cancer have the highest rate of approval at the initial stages of a disability application, hovering between 64-68%. Respiratory disorders and joint disease are second highest , at between 40-47%.
Winning Social Security Disability Benefits For Back Problems By Meeting A Listing
To determine whether you are disabled at Step 3 of the Sequential Evaluation Process, the Social Security Administration will consider whether your back problems are severe enough to meet or equal the listing for spine disorders. The Social Security Administration has developed rules called Listing of Impairments for most common impairments. The listing for a particular impairment describes a degree of severity that Social Security Administration presumes would prevent a person from performing substantial work. If your back pain or mobility is severe enough to meet or equal the listing, you will be considered disabled.
Most claimants with back problems do not qualify for Social Security disability benefits under the listing, and require a residual functional capacity assessment. See Residual Functional Capacity Assessment for Back Pain.
The listing for spine disorders is 1.04. It has 3 parts: A, B, and C. You will meet the listing and be eligible for Social Security disability benefits if you meet any of the three parts.
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Can You Get Disability For Arthritis In The Spine
If you have a spinal condition, such as arthritis of the spine, it can cause severe pain and limit your mobility. If arthritis in the spine has left you unable to work, you may qualify for disability benefits administered by the Social Security Administration .
How Does Social Security Determine If Your Spondylolisthesis Is Disabling
The Social Security Administration can find you disabled “medically” or “vocationally.” Medical disability means that your medical records have evidence of symptoms or test results that Social Security has already determined are enough to find you disabled under its “listing” of disorders. If you’re approved through a vocational allowance, that means Social Security has found that your particular limitations make it impossible for you to do any job.
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Is It Hard To Get Disability For Back Problems
The SSA knows that many working people have back problems once they reach their forties and fifties, and it expects most of them to be able to continue working until retirement age with moderate discomfort. As a result, it can be very difficult to win a Social Security disability claim based on common back problems.
You Could Be Entitled To $3148 Per Month Get A Free Disability Evaluation
If you have a spinal condition that keeps you from working, you should start the application for disability benefits from the SSA. When you apply for disability benefits, documentation is essential to your claims success. Most claims are denied on the initial review, and if that happens, you can file a request for reconsideration.
When your claim is denied, they will tell you why your claim wasnt approved and based on that, you will be able to determine what you need to help show them that you are disabled. You should gather that additional information and send it to them after you file your appeal.
Your claim will not be approved without the needed information. You will also need to file your appeal before time runs out. If you miss the deadline, you will have to reapply for disability benefits and start the process all over.
When you have a disability lawyer, your attorney will be sure that everything is filed by the deadline and that all the needed documentation is provided to the SSA for review. You can retain a disability attorney at anytime during the claims process. Complete the Free Case Evaluation on this page to get connected with a disability lawyer that takes cases in your area today!
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Qualifying Under The Medical Listing For Skeletal Spine Disorders
Social Security doesn’t specifically name spondylolisthesis, laterolisthesis, or retrolisthesis as one of the “listed” disorders that get you automatically approved. But the agency does provide a listing for spinal disorders that result in “compromise of a nerve root.” Since spondylolisthesis often appears with other spinal conditions, you may qualify as medically disabled under that listing if you can show, through your medical record, that all of the following are true:
- You feel pain, numbness, or fatigue in the part of your body affected by the nerve that your slipped vertebra is touching.
- A doctor has examined you and found weakness, irritation, and decreased sensation in that part of your body.
- You have an MRI, X-ray, or CT Scan showing that your bone is touching a nerve, and
- A doctor has prescribed you an assistive device, like a walker or a wheelchair.
If you think you qualify for disability based on listing 1.15, try to get a “medical source statement” from your doctor. It’s especially helpful to get a statement from a doctor who has special knowledge about your history with spondylolisthesisâfor example, an orthopedic surgeon you’ve seen for several years. The doctor’s statement should specifically address the limitations described by listing 1.15, like any difficulty you have walking without an aid.
What Back Problems Qualify For Disability
To qualify for Social Security Disability Insurance or Supplemental Security Income benefits, chronic back pain sufferers must prove they have a medically determinable impairment. Additionally, the impairment must last or be expected to last for a minimum of one year. SSDI and SSI claimants must also exhibit functional limitations that prevent performance of simple work activities on a full-time basis.
The Social Security Administrations Blue Book provides a checklist of objective symptoms for spinal disorders and other medical conditions. To be approved for disability benefits, individuals must match the symptoms outlined there.
Qualifying conditions include degenerative disc disease, ankylosing spondylitis, spinal stenosis, and several others. However, none of these diagnoses guarantee that your disability application will be approved. Successful applications must provide evidence of the disease as well as the specific qualifying symptoms outlined in the Blue Book.
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