Applying For Disability On the Basis of Back Pain in California

Back pain is the fifth most common reason for doctor visits in the United States and it has been suggested that nine out of ten Americans will suffer from some type of back pain at some point in their lives. Studies further indicate that five out of ten working Americans suffer from back pain each year. With statistics like this it is not at all surprising that many individuals file for Social Security Disability for a back condition that produces a significant amount of pain.

As a former Social Security Disability examiner, I found that the Social Security Disability process was not very favorable to disability claimants at the initial disability claim and reconsideration appeal level. It was also my experience that Social Security did not give much credence to the pain caused by an individual's back condition or the side effects caused by pain medication and muscle relaxers.

However, individuals who suffer from back pain also have another problem filing for disability in California. Many individuals do not have sufficient medical treatment records documenting their back condition. Sometimes this is simply because doctors inform patients with back problems that there is no treatment for their back condition (or additional treatment beyond what they are currently receiving that might be helpful); as a consequence, many do not seek out any other treatment.

These individuals often seek relief from chiropractors. But Social Security does not give the same weight to chiropractic treatment notes that they give to other treatment sources such as orthopedists or family physicians (another way of putting this is to say that the records obtained from a chiropractor are not looked at whatsoever). In fact, disability examiners can only use the objective testing or laboratory results contained within the medical notes of chiropractic sources for their medical disability determinations.

A lack of current medical treatment information often leads to consultative examinations being scheduled for claimants whose cases are pending at the initial claim and reconsideration levels (though, sometimes, consults are also ordered by judges at the hearing level). Social security medical exams are actually performed by physicians who do not work for Social Security but who have contracted to provide such services.

Consultative examinations are usually not that favorable for a claimant, and very very few claimants win disability benefits on the basis of a consultative examination. Why? Mainly because they are one-time medical examinations (paid for by Social Security) that are quick and often not very thorough. Even in cases where Social Security requests a spinal x-ray, it is unlikely for a claimant to be approved on the basis of back pain (Spinal x-rays do not show the detail of MRIs or CT scans and often do not show the source of an individual's back pain).

Some practical advice for any individual who is applying for disability on the basis of back pain is to attempt to have medical treatment notes that document your back pain and the treatment you have received. Better yet, of course, are treatment notes that either indicate what your functional limitations are, or allow some judgement regarding your functional limitations to be extrapolated. It goes without saying that claimants who have no medical treatment notes generally have much weaker disability cases.

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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