June 29, 2015

Social Security Disability Benefits for Back Pain

A large number of my clients suffer from back pain, and there are many possible causes: degenerative disease, injury, or years of overexertion.  The Social Security Administration (SSA) recognizes that severe back pain can be disabling, but you must have adequate documentation to prove you have a severe medical impairment.  In other words, you must be able to provide medical evidence to show that your pain is the result of a medical diagnosis and that it has more than a minimal effect on your ability to work.  Then you must show that your condition either meets or equals Social Security’s Listing of Impairments §1.04 for disorders of the spine, or that it keeps you from working at your past occupation or any other occupation.  Your age, education level, and work experience can also figure into a finding of disability.

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What does the SSA mean when they say you must “meet or equal a listing” to be found disabled?  When it comes to your back, the SSA will look at the criteria in §1.00: Musculoskeletal System.  In particular, Listing 1.04: Disorders of the Spine usually comes into play.  To meet Listing 1.04, you must have medical imaging showing that you have nerve root compression, arachnoiditis, or lumbar stenosis in your spine.  You must also have clinical evidence (treatment notes, for example) indicating specific corresponding physical symptoms.

If you do not meet or equal a listing, you may be found disabled due to your limited residual function capacity (RFC).  If the SSA finds that your ability to stand, walk, sit, and lift is so decreased by your back pain that you are unable to work, you might be found disabled.  In this scenario, the SSA may also take into consideration your age, education, and prior work experience to determine if you are disabled per Social security’s guidelines.  An RFC assessment from your treating physician, sometimes referred to as a medical source statement, may persuade an Administrative Law Judge (ALJ) that you are disabled.  It is the ALJ’s job to review the evidence to determine your RFC, and a statement from your treating doctor about your abilities and limitations in those functional areas can be very helpful.

In any claim for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI), it is important to have good and thorough medical documentation.  As stated earlier, objective testing (such as MRIs, x-rays, or nerve conduction studies) is very beneficial.  It is also important to have doctors’ treatment notes that indicate that you are compliant with doctor’s orders and taking your medication as prescribed.

My office is dedicated to helping Indiana residents get the benefits they deserve.  It seems the SSA has an ever increasing workload, and my office strives to make sure your claims file is complete to make it as easy as possible for an ALJ to find you disabled.  During the extensive waiting time for your hearing it is important to continue to receive the medical treatment you need, not only to improve your health, but to enhance your chances of winning at a Social Security disability hearing.

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