Chronic back pain can be so debilitating that you may find it impossible to stand, let alone hold a job. According to the American Chiropractic Association (ACA), it accounts for over 265 million hours of lost work each year: that’s two days for every full-time worker in the United States. Back pain is also the third most common reason people visit the doctor’s office, behind skin disorders and osteoarthritis.
If your back pain is so relentless and intense that you can’t work and even daily living is a challenge, you may be eligible for Social Security Administration (SSA) disability benefits. However, the SSA won’t normally award Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits to applicants with intermittent or mild-moderate range back pain: you must have a medically determinable impairment. In other words, your chronic pain arises from a condition that can be detected and assessed by a medical professional.
Spinal Conditions That May Qualify For Disability Benefits
Although back pain can be very debilitating, disability benefits are available only to those diagnosed with a medical condition that has lasted at least a year and/or is expected to end in death.
When evaluating disability benefits applications, the SSA uses its own medical guide called the Blue Book. While back pain itself is not listed, Section 1.04, which covers spinal disorders, outlines several conditions that can cause debilitating back pain. If you can prove that your pain is caused by one of these disorders, you would meet a Blue Book listing and be eligible for benefits.
Listed impairments include those outlined below.
Degenerative Disc Disease
Degenerative disc disease occurs when one or more of the discs in your spinal column wears down, causing intense pain. It can be caused by an injury, tears in the disc due to daily activities or participation in sports, and age-related drying out of the disc. Symptoms include leg pain and weakness in the leg muscles or foot drop.
Arachnoiditis is an inflammation of the arachnoid, a membrane that surrounds and protects the spinal cord’s nerves. The most common symptoms are burning pain, stinging sensations, and neurological problems. In severe cases, swelling can lead to scar tissue forming and fusing your spinal nerves.
Spinal spondylosis occurs when the discs in your spine begin to wear away. Disc shrinkage can lead to osteoarthritis, which forms spurs along the edges of the neck bones. Sometimes it can narrow the space between discs of the spinal canal and cause pinched nerves.
A rare form of arthritis, ankylosing spondylitis causes back pain and stiffness. It causes a hunched back and debilitating pain, which can spread up to your neck or damage your joints.
Although rheumatoid arthritis rarely affects the lower spine, its degenerative changes may cause or worsen low back pain. These changes include weakened bones and/or loss of other tissues.
Spinal Cord Injury
Generally, spinal cord injuries are caused by trauma and are considered disabling if they last for at least three months and will prevent the person from working for at least one year. If the injury is severe, it may result in pain and even paralysis of limbs and organs.
Lumbar Spinal Stenosis
With spinal stenosis, the openings within your spine narrow, putting pressure on the nerves. Spinal changes due to osteoarthritis are the most common cause. Numbness, tingling, and muscle weakness are some of the symptoms that can worsen over time.
The first sign of scoliosis in adults is usually back pain, which is often caused by bone damage. The increasing curve of the spine can also put pressure on nearby nerves and result in symptoms such as numbness and weakness.
Also known as degenerative joint disease, or osteoarthritis, is caused by the cartilage cushioning your bones wearing down, causing swelling, pain, and bone spurs. When you have osteoarthritis of the spine, the cartilage in your neck and lower back degenerates. As spurs form, they can put pressure on the nerves and cause weakness in the arms or legs.
As the cartilage wears down in the facet joints, discs slip, and/or bone spurs form, resulting in facet arthritis. As osteoarthritis develops, inflammation can occur in the joints, causing stiffness, pain, and even spinal cord pressure.
A spinal fusion is a surgical procedure that corrects spinal disorders. Two or more vertebrae are connected to create a single piece. The results are usually successful, but infections, spinal nerve damage, and degeneration are possible risks.
Medical Documentation is Essential
Regardless of which injury or illness causes your back pain, you must clearly show how it affects your ability to work and impacts your daily activities. A person with spondylosis, for example, must demonstrate pain, limited spinal mobility, motor loss, and sensory or reflex loss in addition to nerve root compression. In cases where the condition affects the lower back, you must have a positive result in the straight-leg raising test.
Examples of appropriate medical evidence include:
- Medical imaging such as MRI or CT scan
- Medical records stating that the nerve root compression causes the symptoms listed above
Your application should include notes from your doctor describing any limitations experienced while standing or walking and confirm whether you need mobility aids like a cane, walker, or other mobility device. All of these factors are considered when making a disability determination, so the more information you provide to support your claim, the better.
FAQS About Disability for Back Pain
What Medical Tests Diagnose Back Pain Disability?
Medical tests that diagnose back pain include but may not be limited to:
- Reflex Tests
- Straight Leg Raise Test
- MRI and CAT scans
You can undergo other tests and examinations to confirm that you have a condition that causes severe back pain and difficulty moving. To confirm your condition and the severity of your symptoms, the SSA may order an additional medical examination at their expense.
What If You Don’t Meet a Blue Book Listing?
Even if your condition doesn’t appear in the Blue Book, you may be eligible for cash benefits under a medical-vocational allowance. Using this approach, your age, education, work experience, and transferable skills are taken into account along with your condition, symptoms, and limitations.
When applying for a medical-vocational allowance, you will need to fill out a residual functional capacity (RFC) form. Your doctor will fill out this form to indicate how often you have to change positions, how long you can stand, how far you can walk, and whether you will need assistance walking. Examples of functional limitations due to back pain may include:
- Being unable to sit for more than six hours in a day
- Being unable to stand for two hours a day
- Having to lie down during the day
- Inability to do heavy lifting
- One or both legs must be elevated throughout the day, either one or both
The form should also clearly indicate if you are required to take pain medication regularly as part of your medical treatment and how that medication impacts you, such as drowsiness or dizziness. If, for example, your work duties involve operating heavy machinery, such a side effect could prevent you from doing your job safely.
To determine if you are eligible for a medical-vocational allowance, the SSA looks for skills that can be transferred to another kind of employment. If you don’t have any skills or experience that qualify you for a job that accommodates your back problem and your condition is expected to last at least one year, Disability Determination Services will probably find you disabled.
How Can a Disability Lawyer Help?
Thousands of disability claims are filed each year with the Social Security Administration, but only a small percentage receive approval for disability benefits. Back pain claims can be particularly difficult to win, so you may also think about hiring a disability attorney, especially if your claim is initially denied.
In a study conducted by the U.S. Government Accountability Office (GAO), people who hired an attorney to help them with their disability benefits cases were three times more likely to win benefits than those who did not. Although approval is never guaranteed, a Social Security lawyer can improve your chances by:
- Ensuring that your application is completed and submitted on time and in full
- Persuasively arguing for the disability benefits you deserve
- Representing you at hearings
- Working directly with the DDS Examiner or the Social Security Office
- Representing you during any necessary appeals
Get Help With Your Disability for Back Pain Claim
Chronic back pain can interfere with a person’s quality of life, both at work and at home. If you suffer from daily pain and want to apply for disability benefits or appeal a denial, call a Social Security Disability law firm that cares.
The NJ disability lawyers at Bross & Frankel, PA, can help you file your SSDI or SSI claim for back pain and/or explain the reasons for your original denial. Our team consists of compassionate, caring, and determined lawyers who understand what it takes to get approved and will use our skills, experience, and resources to fight for the disability benefits you need. To schedule your free consultation, call us today at 856-210-3345 or contact us online.