How many Social Security Disability cases are approved for back pain?

There is no statistical data to indicate how many Social Security cases are approved for back pain. Current reporting by SSA (social security administration) indicates that, of all individuals in current pay status (meaning individuals who previously filed for disability benefits and were eventually approved), approximately 28 percent of disabled workers receive their benefits on the basis of having a musculoskeletal system or connective tissue impairment. These body systems include all disorders and impairments of the spine.

From this statistic--and from my own experience as a disability examiner working on SSD and SSI disability claims, I think it would be safe to say that a significant percentage of disability cases involve back pain and this can be in the form of Social Security Disability and SSI cases that are filed on the basis of degenerative disc disease, spinal stenosis, arthritis of the spine, scoliosis, herniation, and potentially any other condition that might involve an injury or disease process involving the back and causing functional limitations (and usually pain).

The social security administration has a poor history of addressing the issue of pain and sometimes fails to properly consider the limitations that occur as a result of significant back pain. For this reason, it is advisable for an individual who is filing for disability to have a well-documented medical history of their back pain, as to cause and treatment of the condition. It can never be understated: Social Security Disability and SSI cases are won on the basis of medical records and what they have to say about a claimant's condition, i.e. their ability or inability to engage in daily activities (which translates to "the ability to engage in work").

How is a disability case filed on the basis of back pain won? Primarily by proving that the claimant's functional limitations exceed the requirements of their past jobs. For example, if the claimant's work history is mainly composed of doing work that requires bending at the waist and lifting fifty pounds occasionally, but their current level of functionality is such that, as a result of their condition, they cannot bend at the waist, cannot lift more than twenty pounds occasionally, and also have difficulty sitting or standing for long periods, they will judged to be incapable of returning to their past work.

Note: It should be pointed out that this example assumed that the individual only did that one specific job; however, the social security administration may examine all the jobs that were performed by the claimant in the 15 years prior to their becoming disabled, as long as each job was held long enough for the claimant to actually acquire the skills of the job and as long as the claimant was able to earn what SSA considers a livable wage while doing the job. In other words, to be judged incapable of returning to "past work", a claimant's restrictions, or limitations, must potentially rule out all their past jobs.

However, even if the claimant is rated by a disability examiner to have an RFC (residual functional capacity) that is less than what their past work work required (meaning that they cannot go back to their past work), this still does not necessarily mean that they will be approved for disability benefits. There is still the issue of something known as "other work".

Other work is any other type of work that is performed in the national economy that a person might be expected to be able to perform. This, of course, is when their age, education, residual functional capacity, and the transferability of their job skills is given consideration. Not surprisingly, many claimants who are found by SSA to have severe limitations that rule out returning to a former job are also found to have suitable education and skills to be able to switch to some type of other work.

"Other work" is simply an easy technique for the social security administration to deny claims, including those claims that are filed on the basis of back pain. Speaking as a former disability examiner, it is fairly easy to say that a large percentage of back pain cases are denied because the determination is made that the claimant can do some type of other work.

How does social security decide what types of other work a person might be able to do? By consulting something known as the DOT, or dictionary of occupational titles, a reference source published by the Department of Labor which lists tens of thousands of jobs. The disability examiner working on the case will ascertain what a claimant's skill levels are and, in combination with their rated limitations, will pick several jobs from the DOT that, allegedly, the claimant should be able to do.

This system, of course, is extremely flawed. For one thing, disability examiners are not vocational experts and know practically nothing about occupational fields, other than the job they themselves go to on a daily basis. However, it does point out how very important it is for a claimant to supply detailed information about their former jobs when they supply their work history at the time of filing a claim.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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