Can you receive disability for scoliosis? Yes, there are options to receive disability benefits for scoliosis. Scoliosis is an abnormal curvature of the spine in an ‘S’ or ‘C’ shape. This spinal disorder affects 2-3% of the U.S. population or between six and nine million people. While it can develop in early childhood, the most common age for onset is 10 to 15 years old. According to the American Association of Neurological Surgeons, approximately 30,000 children are fitted with braces for scoliosis every year, and approximately 38,000 patients undergo spinal fusion surgeries.
People with scoliosis and severe spinal asymmetry often have problems working as they age. Having serious back pain caused by a curved spine can also have a significant impact on a person’s mental and physical health. If you are unable to work because your scoliosis condition is serious and painful, a disability attorney at Bross & Frankel, PA, can help you seek the benefits you need to access medical care and support, meet your living expenses, and take care of your family.
Causes and Symptoms of Scoliosis
There are different types of scoliosis, all based on origin:
- Idiopathic: The diagnosis of idiopathic scoliosis applies when all other causes are ruled out. About 80% of cases fall into this category. Usually diagnosed during puberty, adolescent idiopathic scoliosis is the most common form of scoliosis.
- Congenital: This form of scoliosis is present at birth and can occur in any area of the spine. Due to the vertebral abnormalities, one area of the spinal column lengthens faster than the other, resulting in curvature. Unlike idiopathic scoliosis, congenital scoliosis is usually detected at a younger age due to its presence at birth.
- Neuromuscular: This type of scoliosis is caused by neurological or muscular diseases. Spina bifida, cerebral palsy, spinal cord injury, muscular dystrophy, and spinal muscular atrophy canal result in scoliosis. This type usually progresses more rapidly than idiopathic scoliosis and often requires surgery.
- Degenerative: Degenerative scoliosis occurs as a result of degenerative changes in the spine, particularly in the discs between the vertebrae.
- Traumatic Scoliosis: As the name implies, this type of scoliosis occurs after the spine experiences a traumatic injury. Traumatic scoliosis can result from a fall, a car accident, or other traumatic event
A person with idiopathic scoliosis may experience the following symptoms:
- Visible spinal curvature
- An uneven waist, hips, or shoulders due to sideways curvature
- The person’s head is not centered directly above his or her pelvis
- The ribs protrude unevenly
- A sideways lean is evident
- Chronic pain in the back
- Reduction in muscle strength
In addition to any of the above symptoms, degenerative scoliosis may also present with:
- Lower back pain or stiffness that gradually worsens over time
- Leg pain
- Experiencing pain after periods of inactivity or strenuous activity
- Pain during motion
- Muscle weakness
- Posture changes, such as becoming shorter
- A sharp pain or tingling in the leg or buttocks, often due to nerve compression
If you suffer from degenerative scoliosis, symptoms can develop gradually over time, as it is commonly associated with aging.
Is Scoliosis a Disability?
People often wonder if scoliosis is a disability, and the answer is that it can be. Although scoliosis is a progressive condition that has no known cure, it can range in intensity from mild to moderate to advanced. The severity level generally dictates the impact on your life.
Some people with mild to moderate cases of scoliosis manage to stay employed with the help of braces or physical therapy while others find that spinal pain, muscle weakness, and limited mobility of severe scoliosis makes any kind of work impossible for them. Those in the latter category may need to apply for disability benefits because they can’t sustain employment and access the medical benefits necessary for treating their condition.
Can You Get Disability For Scoliosis?
As disability benefits lawyers, we are often asked, “Can you get disability for scoliosis?” The answer is yes: it’s certainly possible.
If you have been diagnosed with scoliosis, you may be eligible for Social Security Administration (SSA) disability benefits, which cover people with disabling conditions expected to last for a minimum 12-month period or end in death. Scoliosis is not officially listed as a disability, but people with advanced cases can experience residual effects such as severe pain, mobility issues, and respiratory or cardiac problems. Other potential physical limitations with spine disorders include:
- Pain when sitting or standing for long periods of time
- Debilitating fatigue
- Flat-back syndrome caused by surgical insertion of back-straightening rods
Over time, any of these problems can become so severe that you can’t work long enough to maintain gainful employment. In that case, you may be eligible for benefits for scoliosis.
What Disability Benefits Are Available?
The SSA has two disability benefit programs intended to help disabled individuals meet their living and medical expenses. Although the medical eligibility criteria are the same for both, each one targets a different type of applicant.
- Social Security Disability Insurance (SSDI): This program provides financial assistance to disabled workers. To qualify for SSDI, you must have paid into Social Security while employed. Once approved, you will be eligible for Medicare after two years.
- Supplemental Security Income (SSI): SSI is a means-tested program that pays monthly benefits to children, the elderly, and disabled individuals with limited income and few assets. It also provides access to medical coverage through Medicaid.
In addition, if you have long-term disability (LTD) insurance through your employer, you may qualify for benefits under their policy.
How to Qualify for SSA Benefits with Scoliosis
When evaluating disability applications, the SSA uses a medical reference catalog called the Blue Book, a listing of impairments covering all recognized disabling conditions and the medical criteria for meeting each one. While there is not a specific listing for scoliosis, the condition could conceivably fall under Section 1.04- Disorders of the Spine. To meet this medical listing, your scoliosis would have to cause one of the following complications:
- Nerve root compression as evidenced by a limited range of motion in the spine, motor loss, reduced sensory reflexes, and widespread distribution of pain across the nervous system.
- Lumbar spinal stenosis (narrowing of the spinal canal in the lower back), causing inflammation of the spinal cord nerves. This particular system causes radiating pain and weakness that limits your ability to walk properly.
- Swelling of the spinal membrane, which causes a severe you don’t move at least once every two hours.
Scoliosis can also be evaluated using medical evidence for listings like Section 1.00 for musculoskeletal disorders, 3.00 for respiratory disorders (due to impacted lung capacity), and 4.00 for cardiovascular issues.
If your condition does not meet a listing in Social Security’s Blue Book, you could still potentially qualify for benefits as part of a medical-vocational allowance. This allowance is intended for applicants who are genuinely disabled but did not meet a listed condition. The SSA will consider the medical records received from your treating doctor to determine whether or not you are able to sustain gainful activity.
Applying for SSDI and SSI
When you apply for SSA disability benefits for yourself or on behalf of a loved one with the condition, you will have to complete a detailed application form and submit medical documentation that confirms your disabling condition. Examples could include:
- Records of surgical treatments
- The medications and medical treatments you’ve received as well as your response to them
- Receipts for back braces and other assistive devices
Your doctor will fill out a residual functional capacity form (RFC) that the SSA will use to determine whether or not having scoliosis has hindered your ability to work. It will also consider whether you have transferable skills that make changing jobs a possibility.
If you are applying for SSI, you will have to be interviewed by an SSA representative and provide documentary evidence that your monthly income does not exceed a certain threshold and that your assets (aside from your home and car) are worth less than the approved amount (which is subject to change).
Is Scoliosis a Long-Term Disability?
Long-term disability (LTD) insurance provides financial benefits to employees who are unable to work for a long time due to illness, injuries, or accidents. In this type of insurance, the employee receives a portion of their income while they are absent from work.
Scoliosis treatment and doctor’s appointments may keep you away from work, and if surgery is required, recovery may take up to twelve months, which may qualify you for long-term disability benefits. You’ll want to maintain documentation of how your condition interferes with your ability to work, such as pain while sitting or recovering from spinal surgery.
If your scoliosis is caused by another medical condition, such as neurological or muscular degeneration, you should document all the disabling symptoms and functional limitations associated with each condition. In order to be approved for long-term disability benefits, you need to provide as much medical evidence as possible.
What Are The Costs of Scoliosis?
Health insurance typically covers medical treatments for scoliosis, but there are some restrictions. With Aetna, for example, scoliosis surgery is only medically necessary in severe cases where certain relevant criteria are met, and some braces are considered experimental.
In the absence of health insurance, treatment for scoliosis can cost $1,000 or more per year, including periodic X-rays and doctor visits. Initial bracing costs approximately $2,000-$6,000, plus at least $1,000 a year for follow-up X-rays and doctor visits. The cost of surgery typically ranges from $140,000 to $175,000. Without disability cash benefits, meeting these costs can be difficult if not impossible when you aren’t working.
What If My Application for Disability Benefits is Denied?
Each year, thousands of disability claims are filed with the Social Security Administration, but only a small percentage are approved. For this reason alone, it’s a good idea to hire a disability lawyer to help you appeal a denial or, ideally, handle the application process in the first place.
Studies have shown that claimants who hired an attorney to help them with their disability claim were three times more likely to be approved for benefits than those who handled their own cases. A Social Security Disability lawyer can increase your chances of a successful claim by:
- Confirming that you meet accepted disability qualifications
- Helping you collect the required evidence of disability for scoliosis (e.g. medical reports, information on your response to treatment, witness statements on how scoliosis affects your daily activities)
- Communicating with the Social Security Office, DDS Examiner, and other involved parties on your behalf
- Representing you at appeal hearings before an administrative law judge and/or the Appeals Council
- Submitting additional evidence as requested
If you were denied SSA or long-term disability benefits, contact Bross & Frankel, PA today. We have been assisting disability claimants in Southern New Jersey, Pennsylvania, and Delaware for years and know how to present a strong appeal. Scoliosis can be a brutally devastating condition that restricts your ability to work, so when you are wrongfully denied the disability benefits you need, it is extremely important that you contact an experienced disability lawyer.
Get a Free Consultation About Your Disability for Scoliosis Claim
At Bross & Frankel, PA, our disability lawyers have years of experience handling long-term disability claims for a variety of conditions, including scoliosis. Scoliosis can be a distressing and painful condition to live with, and we want to make the process of applying for disability benefits as easy as possible for you.
Let us ensure that all the requirements for your claim are met, deal with the SSA on your behalf, and present a compelling case for the benefits you need. To schedule your free consultation, call us today at 856-210-3345 or contact us online.