Scoliosis and Filing for Disability
Scoliosis is a valid medical condition to include on an application for Social Security or SSI disability. If there were a listing for scoliosis in the SSA Blue Book impairment listings, it would be in section 1.00 of the adult listings, Musculoskeletal System - Adult.
Scoliosis is evaluated under impairment listing 1.04 Disorders of the Spine. The listing requires evidence of severe nerve root damage. Disability claimants must be able to substantiate nerve root damage through proper imaging techniques to meet the listing and be approved for disability.
Note: Filing for disability with degnerative disc disease and spinal stenosis
If an applicant does not have nerve root damage, they may still be approved if their scoliosis is characterized by other severe symptoms. Scoliosis sufferers might have heart, respiratory, or mental disorders that may qualify them for disability should they meet the criteria of another impairment listing.
So many disability applicants are surprised to learn their diagnosis is not a requirement that will qualify them for disability, In actuality, Social Security Disability considers the ways and extent to which a person is functionally limited because this affects their ability to engage in work activity. If a disability applicant's scoliosis does not meet or equal an impairment listing of some kind, they must prove they can no longer work at a level that Social Security considers to be substantial gainful income.
This can be done through A) the information contained in their medical records, and through B) the work information they provided in their work history; specifically, what types of work they have done, the functional requirement of each of those jobs, and what job skills they have that may help them perform other types or work.
Social Security Disability specialists must consider a disability claimant's ability to do any of their past work or other work if they are not able to meet or equal an impairment listing. Basically, they must consider a person's age, education, functional capacity, and job skill transferrability when they make their Social Security disability determination. If they are unable to do any of their past jobs, or any other kind of work, they may be approved through a medical vocational allowance.
Qualifying for disability benefits with Scoliosis
Whether or not you qualify for disability and, as a result, are approved for disability benefits with scoliosis or any condition will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from your doctor. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their disability attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens. These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about Scoliosis
1. Scoliosis is a condition that causes the spine to curve to one side. The literal meaning of the word scoliosis, which is derivative from Greek, is the word crooked. The spine may be curved in shape so it looks like an S or C. It may also be rotated.
2. Scoliosis can be either congenital, idiopathic, or neuromuscular. Congenital scoliosis occurs at birth, idiopathic describes an unknown cause, and neuromuscular involves another condition causing the spinal curvature as a side effect. Around 85 percent of scoliosis cases have no clear cause. 3. Those with scoliosis are likely to have family members who also have the condition, but it is unknown what genetic factors cause this familial link.
4. Scoliosis typically develops in adolescence, during the growth spurt before puberty. Scoliosis is about as common in males as females, although scoliosis in girls is more likely to progress and become worse.
5. Scoliosis causes the sides of the body to look uneven, particularly in the shoulders, waist and hip. Severe scoliosis can make the rib cage twist and cause damage to the heart and lungs, making breathing difficult.
6. Scoliosis is more painful for adults than it is in children, but it is not likely to progress. The greater the curve, the more likely the scoliosis is to get worse.
7. In most cases, treatment for scoliosis is unnecessary and regular checkups several times a year to watch the condition is enough. It is only if the curve becomes moderate or severe that treatment is usually considered.
8. A curve is more likely to progress if it is larger, shaped like an S, and located in the center of the spine. Any one of these factors are necessary to consider in deciding on treatment. Braces may be used to help prevent progression. The risk of progression is very low once the bones stop growing.
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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