Diseases and injuries to the neck and back are frequent reasons people file for Social Security Disability (SSDI) and SSI. As we age, the back naturally deteriorates from things like osteoarthritis and inflammatory arthritis such as rheumatoid arthritis. As we age, some people have severe osteoporosis which also can affect the spine.
If you have had a prior injury, as you age, that injury may worsen and then you may find yourself unable to do the work you did before. Or you may get injured in an accident and your spine suffers an injury that you can’t recover enough to return to work. Some people perform manual labor for years and the wear and tear on their backs and other joints making working impossible All of these reasons are valid for filing for SSDI and SSI.
However, disability is a legal term and you must show more than just simple aging or a mild injury. Many people suffer from back pain. The Social Security Administration does not generally consider mild to moderate back pain severe enough for SSDI or SSI.
SEVERE SPINAL PROBLEMS
Social Security has multiple ways in which to qualify for disability with your back problems. For the most severe problems, the quickest way to qualify for disability is through the Listing of Impairments 1.04. The Listing of Impairments are just that, a list of severe diseases and injuries that if you meet these very strict guidelines, you will qualify for disability.*
STEP 1: For the neck and back, you have to have a diagnostic imaging test indicating a condition that results in nerve root compression or spinal cord compression. SSA will sometimes pay for X-rays but not always. It is really up to you to get one of these tests. Some of the tests SSA will consider are:
- X-ray imaging
- CAT scan
- CT scan
- MRI scan with or without contrast
- Myelography; or
- Radionuclear bone scans
STEP 2: Next you must have medical evidence that there is “neuro-anatomic distribution of pain.” If you have nerve or cord impingement, there should be a correlating pain symptom on the nerve path. For example, a nerve pinched in your neck may cause problems in one of your arms. Or a nerve pinched in your back may cause pain down your buttocks to your big toe.
SSA will look at your medical records and your complaints to find this evidence. For example, does the distribution of pain and symptoms follow the same path as the nerves at the affected spinal level. Low back pain should radiate into the buttock, posterior thigh and calf. Coughing, sneezing or the Valsalva maneuver may aggravate the radiating pain. Bending or sitting will characteristically accentuate the pain, and lying down will characteristically relieve the pain. When you push a grocery cart, do you have to lean over the cart? Or if the problem is in your neck, do you have pain in certain fingers?
In the back you may have two types of Pain:
- Lumbago – a deep, aching, and constant back pain;
- Sciatica – sharp shooting pain traveling from the buttock down the leg posteriorly to the foot or toes
These can all help show the neuro-anatomic distribution of pain.
STEP 3: There must be medical evidence demonstrating limitation of motion of the spine, motor loss with sensory loss or reflex loss, and positive straight-leg raise tests. An additional set of signs and symptoms are expected to prove your medically determinable impairment that impinges upon a nerve root or the spinal canal.
- LIMITATION OF MOTION- ANY limitation of motion is sufficient, and it does not have to be significant. Your medical records and reports from physical examinations with detailed description of your gait and range of motion of the spine.
- Gait & range of motion – Motion of the spine should be given quantitatively in degrees from the vertical position – zero degrees.
Observations of the person’ movements during an examination should be reported including getting on and off the examination table. You may have an antalgic gait or a limp. Do you walk slowly with a cane or a walker?
- MOTOR LOSS & MOTOR WEAKNESS
SSA will look to see if you have motor loss or muscle weakness AND Muscle atrophy. To show this, an exam will include limitations in your ability to walk on the heels, walk on the toes, squat, or to arise from a squatting position.
- Atrophy – requires circumferential measurements of both thighs and both lower legs. Measurements must be taken at a stated point above the knee and below the knee and given in inches or centimeters.
- Muscle weakness – tests performed to assess the strength of specific muscles (in the legs or feet) for signs of nerve root compression. The strength of the muscle or muscles being tested is usually reported on a grading system of 0 to 5. The grading system should have 0 being complete loss of strength and 5 being maximum strength.
Do you have Sensory loss or reflex loss?
- Sensory loss – Tests that identify sensory loss measure the ability to feel light touch, a pinprick, heat or cold. For example, reduced feeling on the top of the foot is a common nerve root compression. Sensory deficit on the little toe and the lateral surface of the foot is more frequent with L5-S1 disease, and deficit on the big toe and medial aspect of the foot is more frequent with L4-L5 disease.
- Reflex loss – DTRs Deep Tendon Reflexes, tendons tapped with rubber hammer. A showing of little or no reflex in either knee or the ankle.
- Positive straight-leg raising test in both the sitting & supine positions
Social Security requires for the following if you have lumbar problems;
A positive test is when sciatic pain is reported before 70 degrees and/or pain is aggravated with dorsiflexion of the foot and relieved by knee flexion.
Also, positive when the maneuver elicits an abnormal sensation, such as pain, tingling or numbness, which radiates down the leg beyond the knee.
STEP 4: The last step in meeting the Listing of Impairments is that you must have a “longitudinal clinical record” sufficient to assess the “severity and expected duration of the impairment.” Basically, you must show you have been and continue to be treated for this condition.
Like we said, meeting the Listing of Impairments is very difficult. But there are other ways to get your SSDI or SSI
ANOTHER WAY TO GET DISABILITY WITH YOUR SPINE PAIN
There is another path to getting Social Security disability for your spinal problems. That is, you will need some kind of imaging studies like X-rays or MRI’s showing that you have a problem in your spine. You will need to show that this problem is causing you severe pain and problems in your daily life.
You may not be able to sit, stand or walk for very long without changing positions. You may need to sleep in your recliner or spend time in your recliner during the day to help your back pain.
If you can prove that your pain is caused by a condition and you can no longer perform your job, you may have a very good case for SSDI or SSI.
Either way, a Social Security attorney can help you with proving your case to the Social Security Administration.
Degenerative Disc Disease (DDD)
* You also must meet other non-medical qualifications such as sufficient work credits, currently not be working, etc.