![]() SSDRC Filing an Application for Disability Benefits Social Security Disability List of Impairments Social Security Disability and SSI Back pay Social Security Disability Status SSI Disability Benefits Social Security Disability and SSI Requirements Social Security, SSI, and Mental Disability How Long Does It Take To Get Disability Benefits? Qualifying: What do you Need to Prove to Qualify for Disability? |
Are Social Security Disability Claims Based On Back Pain Usually Turned Down?When I was a Social Security disability examiner, I noticed that it was often difficult to approve individuals who alleged back pain. Although the Social Security disability impairment listings do address back or spine conditions, it is difficult to meet or equal the criteria contained in those listings. Additionally, some individuals have back pain that is caused by conditions that do not have a lot of objective tests available to prove their severity. For instance, many individuals suffer from osteoarthritis of the spine. And while it can be detected by imaging techniques, the amount of pain and limitation it causes often depends upon the individual. Unfortunately, the more subjective a disability determination is, the more likely it will end in a denial of disability benefits for the disability claimant. The first impairment body system listed in the disability evaluation book “Disability Evaluation Under Social Security” is the musculoskeletal system. The first impairment listing in the musculoskeletal system section deals with major dysfunction of a joint or joints; the second involves reconstructive surgery or surgical athorodesis of major weight bearing joint; the third involves disorders of the spine; the fifth listing addresses amputation, the sixth involves fractures of the femur, tibia, pelvis, or one or more of the metatarsal bones; the seventh involves fractures of the upper extremity; and lastly the eighth listing addresses soft tissue injury. Like all disability determinations, loss of functional ability is a major factor in approving an individual based upon back pain or any other musculoskeletal condition. The fourth impairment listing (1.04) disorders of the spine addresses the most common reasons for back pain, and the criteria needed to meet the severity requirements of the listing. If an individual’ s back pain is due to a herniated nucleus pulposis (ruptured disc), arachnoiditis, spinal stenosis, degenerative disc disease, facet arthritis, osteoarthritis, or a vertebral fractures, this is the listing used to determine if they are able to meet or equal the criteria outlined in the impairment listing. To meet the listing, an individual has to have one of the following: Part A requires that an individual have a compromise of the nerve root or spinal cord along with nerve root compression that has causes limitation of motion of the spine, neuro-anatomich pain distribution, and motor loss with atrophy that involves muscle weakness or muscle weakness along with sensory and reflex loss. If the lower spine is involved, the individual must also have positive straight-leg raising (in the sitting position or lying down). Positive in this situation means positive for pain. Part B provides the criteria needed to meet or equal the severity of 1.04 if the individual has arachnoiditis. Part C of the listing provides the requirements for lumbar spinal stenosis.For the purposes of our question, the criteria for part C needs to be explored further because so many disability claimants with back pain have lumbar spinal stenosis. An individual’s spinal stenosis must result in pseudoclaudication. This is pain caused by a narrowing of the lumbar spinal canal that generally causes pain or discomfort in the feet, legs, and buttocks upon prolonged standing or walking. Individuals with pseudoclaudication might also experience numbness or weakness in their legs. Sitting or bending forward at the waist often relieves leg pain that is caused by pseudoclaudication because it decreases the pressure on the affected nerve or nerves. Lumbar spinal stenosis must also be documented by medically acceptable imaging (i.e. CT scans, MRIs, or X-rays) and it must be evidenced by chronic non-radicualr pain and weakness that causes the individual to be unable to ambulate effectively. For the purposes of a disability determination, “to ambulate effectively”, a person has to be able to sustain a reasonable walking pace for a distance that would allow them to complete activities of daily living. Examples of ineffective ambulation might include the inability to walk without a walker, a need for a crutch or two crutches for ambulation, or an inability to walk over rough or uneven surfaces. Additionally, individuals who are able to get around in the home without the use of assistive devices are not necessarily performing effective ambulation. Additional information: For Social Security Disability and SSI, What Does It Mean When A person Can Only Do Sedentary Work? Social Security Disability SSI and Degenerative Disc Disease What kind of cases win Social Security Disability or SSI benefits?. Can I get SSI or Social Security Disability for RA, Rheumatoid Arthritis?
Return to: Individual Questions and Answers Return to Social Security Disability Resource Center Or click to one of the following: Return to -- Social Security Appeals Time Limit Return to -- Can I Talk To the Disability Examiner Working On My Case? Return to -- What Expenses Will A Social Security Attorney Charge In Addition To The Fee? Return to -- Do Most People Need To See A Judge To Get Disability Benefits From Social Security? Return to -- Social Security Disability Lawyers and 25% Back Pay Return to -- Will Social Security Attempt To Get A Letter From Your Doctor To Help Your Case? Return to -- What Is The Difference In SSD and SSI? Return to -- How is Social Security Disability and SSI Awarded? Return to -- Will my children get benefits if I get approved for disability? Return to -- Why Does It Take So Long To Get A Call Back From The Social Security Office? Return to -- Does Being Represented On A Disability Claim Win The Case Faster? Return to -- Applying for Disability according to state of residence Return to -- Social Security Disability SSI Blog , About the Author Return to -- Social Security Disability and Money in the Bank Return to -- How long do you have To Be Out Of Work Before You Get Social Security Disability (SSD)? Return to -- The first appeal in a social security disability or SSI case Return to -- Using a Lawyer for an SSDI Disability Case Return to -- Social Security Disability SSI, Medical and Mental Conditions and Problems Return to -- Disability Lawyers - Questions about Hiring a Disability Attorney Return to -- Disability Lawyers in Various States |