January 23, 2014

Back Pain and Social Security Disability Benefits

In my Indianapolis Social Security disability practice, most of my clients include back pain as an impairment that keeps them from working.  If you have ever suffered from back pain, you may understand why these individuals claim they are simply in too much pain to perform even the most simple tasks.  You can receive disability benefits for back pain, but it will take more than simply claiming that your back hurts.  In my experience, you are going to need medical records that support your claim.  In this blog I will describe what I find helpful in proving your case.

  • Objective testing – Tests such as MRIs and x-rays can show the severity of your condition.  In my experience these tests, especially MRIs, can make a big difference in proving that your pain is caused by a severe medical impairment.  Some findings that indicate severe impairments include nerve root impingement and severe stenosis.
  • Medical procedures –  What are you doing to try to resolve the problem?  If you are not receiving treatment for your back pain, or if you are resisting the treatment options presented by your doctor, Social Security may conclude that your pain does not bother you that much.  Some of the procedures doctors recommend for back pain include surgery, injections, and physical therapy.
  • Medical source statements –  Sometimes winning your disability claim requires an extra push and some support from your medical provider.  My office strives to get our client’s treating physicians to complete medical source statements.  These statements include Physical Residual Functional Capacity Assessments and questionnaires regarding whether you meet or equal Social Security’s Listing of Impairments as described below.

One of the ways Social Security can find you disabled is if you meet or equal its Listing of Impairments.  Listing 1.04 details how an individual can be found disabled for a back disorder.  Some examples that the SSA gives of conditions that may qualify include: herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, or vertebral fracture.

According to the Social Security Administration, to qualify for disability benefits under listing 1.04 you must have a disorder of the spine resulting in compromise of a nerve root or spinal cord with one of the following:
  • Evidence of nerve root compression distributing pain through the nervous system, limitation of motion of the spine, motor loss accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test;
  • Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, displayed by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every two hours;
  • Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in an inability to ambulate effectively.
Another way to win your claim is if your physical residual functional capacity (RFC) is so low you simply cannot work a full eight hour day, five days per week, on a continuing basis.  My office provides our clients questionnaires to take to their doctors.  These questionnaires ask the doctors to indicate how long, based on their medical expertise, they believe their patients can sit, stand, or walk in an eight-hour work day.  If a doctor indicates that the client cannot work for eight hours a day and the medical evidence supports the doctor’s conclusion, a case can be made that the client’s RFC is too low to allow him or her to work. 
 


Disabilities can vary, and back impairments are just one type of disabling condition that I find in my practice.  If you have other types of physical or mental impairments that prevent you from working, feel free to look through my other blog entries about many other disabling conditions that I have encountered with my clients.

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