Back, Neck, Social Security Disability and SSI

One of the most common medical conditions for Social Security disability and SSI is injuries to the neck and back. These conditions are usually diagnosed as disk herniations, lumbar stenosis, scoliosis, disc bulge, nerve impingement, herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture and are sometimes commonly referred to my clients as slipped disc, pinched nerve, back pain, and neck pain. For the most part, regardless of the diagnosis these types of claims are handled basically the same by Social Security in an SSDI or SSI claim. People who suffer from any type of chronic back or neck injury will frequently suffer symptoms and other body parts or other diagnosis as well. Back and neck conditions can cause radiculopathy (nerve pain) that can extend down the arms or legs causing pain, burning, numbness, and reduced ability to use these extremities. It is also very common for those who suffer from chronic back and neck pain to be diagnosed with depression due to the constant pain and change in lifestyle due to their neck and back disabilities. It is very important if you were devised by your doctor to get treatment for depression due to back condition that you follow your doctors advice and do so. It is also important, if you notice you are showing signs and symptoms of depression or family members suggest to you that they think you are that you mention this to your doctor. This is important not only for your general well-being but as I will describe later can be extremely helpful in your claim for Social Security disability benefits for your back or neck.

How Are Social Security Disability Claims for Back and Neck Decided?

I will now explain how Social Security Disability claims for back and neck conditions are determined.  To understand how the decision-maker's at Social Security determine if you are disabled based on your back and neck conditions by themselves or in combination with other impairments it is important that you understand the Social Security disability five step test. How your claim is handled by the decision makers using the five step test will depend on many factors. The first thing they will look at is whether or not you are working and if you are not working whether you have been out of work for a year or you are expected to be out of work for a year or more. Social Security will consider any work you have done or are doing as work for Social Security eligibility purposes if you make over $1000 a month for the year 2010 you would be considered working for any month you made over that amount. In 2009, if you made over $980 a month this would be considered work for that month in which you made over the amount. If you are self-employed or were self-employed within the past year it gets a lot more complicated as to what Social Security will consider as work for Social Security eligibility purposes and is beyond the discussion of this page.

Medical Listing of Impairments for Back and Neck

I will assume at this point you have read the five step test for disability. At step three of the test Social Security the decision-maker will determine, whether or not you meet or equal a listed impairment for your back or neck condition. If you meet or equal the Social Security medical listings of impairments then you will be found disabled at this step of the Social Security Disability tests without having to go to the next step. However, it can be extremely difficult to meet or equal the listings for your back or neck condition. Many times, people who have SSD or SSI claims will read the medical listings and think that they meet or equal these listings. If you think you may meet or equal a listing for your back or neck, then you should take a copy of the listing to your doctor and ask him or her if they feel you do. If your doctor feels you meet or equal a listed impairment it is important that you asked them to write you a report which should include which listing, why you meet or equal the listing, how the doctor came to this conclusion and he or she should include all of the treatments performed andx-ray and MRI findings. Even if your doctor believes you meet or equal a listed impairment and supports it with a report, you should still proceed as if Social Security will not agree with his conclusion and continued to prepare your SSDI case for the next two steps of the disability test. Below you will find the medical listing for back and neck conditions but to see the full listings you should visit the Social Security website page on the medical listings of impairments for back and neck conditions. As you will see the below listing refers to other parts of the medical listing which must be read to understand what is required to meet or equal the medical listing for your back or neck.

1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:
A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);
B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;
C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.

Your RFC or Risidual Functional Capacity for Your Back or Neck Condition.

This part of the age is about the importance of your RFC (limitations) caused by your back, neck and other medical conditions.  As you may know by now, from reading the five step test if you are not found disabled at step three you must now be able to show that you cannot perform your past work, and if you are able to show this, then you must be able to show that you cannot perform any other work which exists in significant numbers. Social Security decision-makers will determine each of these steps based on your residual functional capacity (RFC). Your RFC is what Social Security finds you are able to do or not able to do in a work environment based on your back, neck and any other medical conditions you also have that limit your ability to do things (particularly in a work environment). Social Security doctors will look at your records and give their opinion of what your limitations are from your medical conditions. If you had a Social Security consultative exam, these doctors who examined you will also frequently give their opinion of your RFC. It is extremely important that you get your treating doctors opinion of your RFC since your treating doctor isusually much more helpful to your case then the Social Security doctors RFC's. It is also important to get your treating doctors opinion, because if his opinion is supported by the medical evidence in the record, his opinion is supposed to be given more weight than the Social Security doctor's opinions. When determining if you can perform your past work Social Security will look at the requirements of your old jobs you did the last 15 years and determine if you have the RFC to still perform that type of work. If they decide you do then you will be found not disabled at this step. If they decide that your RFC prevents your prior work they will then make a determination as to whether there is any other work you could perform. To understand how the decision-maker's at Social Security do this you must have an understanding of the grid rules. If your RFC fits neatly into one of these rules they will direct a finding of disabled or not disabled based on your age, education and past work. Please go to the page linked above to get a better understanding of the grid rules and how they work. I mentioned earlier that many people who suffer from chronic pain due to neck and back conditions also suffer from depression.  I stated I will explain in detail why this important in your SSD or SSI claim for your back or neck condition. The grid rules are set up primarily to address physical limitations and ones ability to work. If you have additional non physical limitations called nonexertional limitations, these limitations must also be factored into whether or not you can perform your past work or any other work. So a claim that might lose based on the RFC of your back and neck conditions alone may win if the additional nonexertional limitations from depression are included in the decision makers evaluation when determining your RFC of your disability and whether you can perform both your past and any other work.

50 years old or older in a SSDI or SSI Back or Neck Claim

If you have read the grid rules, you will see that if you have purely physical limitations due to your back or neck condition and all of your prior work was light or heavier your chances of being found disabled are greater, because in most cases you would only have to show you are limited to sedentary work to be found disabled under the grid rules. If however, you perform sedentary work in the past 15 years your case is a bit more difficult and its handled more like someone who is under 50 years old because you would first have to show you could not perform your prior sedentary work. This is very general and is meant to give you an idea of the importance of age in a claim that involves purely physical limitations. In the next section, I will address how Social Security handles back and neck Social Security disability claims for those who had prior work that was sedentary or who are under 50 years old.

Social Security disability under 50 years old with back and/or neck conditions.

If you are under 50 years old or 50 years or older and had prior work that was sedentary then generally you will have to be able to show you cannot perform a significant number of simple unskilled sedentary jobs. This is frequently referred to as having to show you are limited to "less than sedentary work". In this situation it can be extremely helpful to have limitations from another condition such as depression that shows you have additional limitations that would further prevent this type of work. Even if you don't have any other conditions other than your back or neck disability you can still show you are limited to less than sedentary work. As I mentioned earlier neck and back conditions can often affect your upper and lower extremities causing limitation of use of these extremities. Some important limitations to be able to show you are limited to less than sedentary work would be things like: numbness or difficulty using your arms or hands, inability to sit and stand for any significant amount of time, bad days where you are unable to even get out of your house, the use of assistive devices for walking, pain medications and the side effects from them, pain itself and its limitations on your ability to concentrate and focus on tasks and there are many other limitations from these conditions that could help show you cannot even do sedentary work. It is always a good idea to consider getting a lawyer to help you with your claim but especially in a claim where you will have to show you cannot even perform a significant number of sedentary jobs since they will know the types of limitations you suffer from that could prevent even simple sedentary work and will know how to highlight these areas. If you have any questions on your neck or back condition and SSDI or SSI feel free to call me at 1-877-527-5529.