Degenerative disc disease (DDD) is a condition that is generally viewed as a “normal” part of aging. It occurs as the cushions or discs between the vertebra of the spine breakdown or shrink over time. For most people, the condition is minor and manageable and many not cause any pain at all. For some however, it can be completely debilitating, causing severe, chronic pain and mobility issues.
According to the Arthritis Foundation, nearly every person over the age of 60 has some degree of degeneration in at least one spinal disc. The Institute for Chronic Pain also reports DDD is common in men and women between the ages of 40 and 60, with more than half reporting minor or no back pain.
Social Security disability is hard to get with DDD. This is because the condition is so common and because many people don’t become disabled from it. Another reason DDD claims are often denied is because chronic pain is usually the primary reason for disability, and chronic pain is hard to prove. After all, there are no tests that can measure or document the pain you experience. Claims are even more difficult to prove when no physical cause for the pain can be shown through medical records.
Although it might be difficult, you can still get approved for disability benefits through the Social Security Administration (SSA). You just need to know that you may have an uphill battle ahead.
The Financial Costs of DDD
The chronic pain and other symptoms of DDD can prevent you from working, no matter what kind of job you have. Individuals that work in physically strenuous jobs may be unable to perform even basic job functions. Office workers and others in sedentary jobs may miss extended periods of work because they cannot sit or stand in the same position for hours on end. Lost work time and loss of earnings are therefore a huge financial concern for DDD sufferers.
Many also face insurmountable medical bills as they continue to search for a definitive diagnosis or reason for their back pain and for pain relief. Test after test is often run, including CT scans, MRIs, x-rays, physical exams, and other diagnostic evaluations. Bills from these tests pile up as DDD sufferers and their doctors seek a root cause for back problems in an effort to find an effective treatment.
Patients may go through spinal surgeries, spinal cord injections, or other treatments to counter their pain. Disc fusion surgery is a common treatment these days and costs between $30,000 and $90,000. Physicians increasingly recommend disc replacement surgery as well. This procedure replaces a degraded disc with an artificial disc and costs an average of $30,000 to $45,000 according to Spine-health.com.
Other treatments may include physical therapy, massage therapy, and chiropractic sessions to counter pain, stiffness, and other symptoms. Prescription medication costs must also be considered, with muscle relaxants, narcotics, and neurological pain medications all being among the common drugs prescribed.
With a loss of income and never-ending medical bills, DDD patients with severe, chronic pain may find help through state and federal programs, including disability benefits.
Medically Qualifying for SSD through the Blue Book Listing
The Blue Book is the SSA’s manual of disabling impairments and contains listings for hundreds of conditions under which applicants can qualify for disability benefits. Unfortunately, there is no dedicated listing for DDD in the Blue Book, but you may still qualify by meeting the requirements in the listing for “Disorders of the Spine.” This listing appears in section 1.02 and requires your medical records show have one of the following spinal conditions along with your DDD:
- Nerve Root Compression, which means that one of more of the discs in your spine has degraded to the point that your spinal nerves are being rubbed, irritated, or pinched by the bones in your spinal column.
- Spinal arachnoiditis, which is a condition that causes swelling or inflammation in nerve membranes in the spine.
- Lumbar Spinal Stenosis, which is a narrowing of the spinal column that can cause nerve pain, loss of feeling, weak muscles, and may even make it difficult or impossible to walk.
Many people with a DDD diagnosis do not have any known physical cause for their pain and other symptoms other than “normal” degeneration of one of more discs in their spine. If you don’t have documented nerve root compression or another physical cause for your chronic pain, then you may not be able to qualify through the Blue Book.
Your doctor can help you understand the complex medical terminology used in the Blue Book. He or she can also help you in know if you can meet the Blue Book listing or if you will have to prove your disability through a “residual functional capacity” (RFC) analysis instead.
Medically Qualifying for SSD through an RFC Analysis
An RFC requires you and your doctor complete “functional reports.” These forms ask for information on your everyday activities, including things like cooking, cleaning, shopping, and bathing. The SSA wants to understand how your DDD limits or stops you from completing tasks in your personal life. This information, along with your application and your medical records, helps the SSA know how your DDD affects your ability to work and perform usual job functions.
For example, DDD may stop you from lifting, pushing, pulling, or otherwise moving objects that weigh over a certain number of pounds. Your usual job may require you to perform these actions. An RFC analysis that shows you must have help doing laundry, mowing grass, or carrying groceries therefore supports the idea that your DDD would stop you from fulfilling your job duties as well.
If there is no medical evidence in your records of a physical cause for your chronic DDD pain, then the SSA will be skeptical of your application. This means all of your application and RFC report answers will be closely scrutinized. You must therefore make a very strong argument for disability based on the evidence you do have.
Consult with an attorney or Social Security advocate, if necessary, to help build your claim. And be sure to take advantage of the space in your application and RFC forms to provide comments about your condition. This request for “additional details” from the SSA is your opportunity to give more information about your DDD, your pain, and your other symptoms, including how they limit you on a daily basis.
How to Apply for Benefits with Degenerative Disc Disease
The SSA has two disability programs you may qualify for with DDD: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). You can apply for both of these at your local SSA office, or you can submit an SSDI application on the SSA’s website.
Whether you apply online or in person, you should gather medical records and other evidence in advance, if possible. Documentation that may help you win your disability claim includes:
- MRI, CT scan, x-ray, and other imaging test results, showing physical changes in your spine over time
- EMG results, if you have nerve signal or muscle weakness problems in your arms, legs, neck, or back due to compression of spinal nerves
- Biopsy results, if you have inflammation in your spinal nerve membranes
- Physical exam notes from your doctor, documenting pain levels, muscle stiffness or weakness, fatigue, concentration problems, and mobility issues
- Records of treatments you’ve attempted and the results of those treatments
In addition to medical records, other documentation may also help your claim, especially if you must go through an RFC analysis. This documentation may include things like:
- Short-term disability or Family and Medical Leave (FMLA) documents from your employer
- Worker’s compensation injury reports, if you’ve strained your back while on the job.
Even if these records are old, they can help you document ongoing back problems that interfere with your ability to work.