Tips on Applying for Disability with Degenerative Disc Disease

Degenerative Disc Disease, or DDD, is among the most common impairments for which the Social Security Administration (SSA) receives disability applications. While it is a qualifying disability under certain circumstances, proving your condition meets the SSA’s duration and severity level requirements can be difficult. Use the tips that follow to strengthen your claim when applying for Social Security Disability (SSD) benefits.

Ensure Your Degenerative Disc Disease Medical History is Lengthy, Detailed, and Includes Recent Records

DDD is a condition that gets progressively worse with time. Most people experience symptom flares, with pain, numbness, and muscle stiffness and weakness arising and then subsiding with time and proper treatment. Bouts of symptoms and the severity level of those symptoms increase over time.

For the SSA to see that your DDD has progressed to the point that it now prevents you from working, your medical records must clearly demonstrate worsening symptoms. Additionally, the SSA must see that you have been under the care of a qualified physician, and chiropractors do not count. Instead, your doctor should either be:

  • A Medical doctor (MD)
  • OR

  • An Osteopath (OD)

Consistent treatment from a qualified physician ensures your medical records contain sufficient information for the SSA to evaluate your claim. Recent medical records can prevent the SSA from ordering a consultative examination (CE) by a contracted physician.

Thorough records can also provide clear evidence of how your DDD limits or prevents you from performing standard job functions.

Work Closely with Your Doctor to Obtain a Formal Diagnosis of Degenerative Disc Disease and Record Work Limitations Due to DDD

While finding the root cause of back problems can be a long and frustrating process, the SSA needs to see a formal diagnosis in order to grant benefits. The DDD disability listing in the Blue Book requires your condition causes one of the following:

  • Nerve root compression
  • Spinal arachnoiditis
  • Lumbar spinal stenosis

You may be able to meet the SSA’s DDD listing, or you may have to prove through a “residual functional capacity” (RFC) analysis that your back issues prevent you from working. Either way, it is best to have your symptoms and resulting limitations well defined.

Your doctor is an invaluable resource in documenting your limitations and accurately reflecting your work restrictions.

Collect Other Documentation Supporting Disability Due to Degenerative Disc Disease, Because You May Need It

Many people that apply for SSD with back issues are initially denied benefits. This is especially true for those under the age of 50. Additional documentation can help fortify your claim, including any evidence that documents your specific symptoms and the types of common job functions they prevent you from performing. Use the following evidence to your advantage:

  • Statements from your former employer or a human resources representative,
  • Records of sick days, short term disability leave, and family medical leave from your former employer,
  • Information in the disability application,
  • AND

  • A formal statement or report from your doctor, summarizing your condition and its effects on everyday activities, including employment-related activities.

Other items that may be useful as part of your appeal hearing include job descriptions, performance evaluations from work, and formal statements from family members or others that can attest to your daily limitations and your common need for assistance in completing everyday tasks.

Completing a Residual Function Capacity Form For Degenerative Disc Disease

If you have been diagnosed with degenerative disc disease and you are applying for Social Security disability benefits, you should make sure that you complete the Residual Function Capacity Form (RFC).

When the Social Security Administration reviews applications, they are looking at an applicant’s ability to work based upon his or her medical diagnosis. If the applicant is able to perform mental or physical work with his condition, then the applicant is not considered disabled and the applicant will be denied disability benefits.

The Residual Function Capacity is a determination of the maximum amount of work you are capable of performing given your condition. The goal of the RFC is to determine whether there are other jobs you could perform based on your condition and your work experience.

With degenerative disc disease, you may be unable to stand or sit for long periods of time, or your treatment plan might include medication that makes it impossible for you to stay alert and awake. All of these things could combine to prevent your ability to work, but you must provide these details to the SSA so that they understand your case.

Your physician can help you fill out the form so that there is no question of what you can and cannot do. Since this form is to be completed by your doctor, the SSA can trust that the information provided is accurate and representative of your specific situation.

What To Do If You Degenerative Disc Disease Claim Is Denied

A majority of Social Security disability benefits applications are denied the first time around. With so many claims being filed on a daily basis, many of those claims do not have enough supporting documentation for the SSA to make a decision on the case.

A denial is not a stopping point for the claim, rather it leads to the next steps in the process.If your disability benefits claim is denied, you have 60 days to appeal the decision.

You must file a request for reconsideration, which essentially means that you submit the application again in hopes that another representative from the Social Security Administration will take a different approach and approve the claim.

Since time has passed between when you initially submitted your application and when you were denied, there could be new information that casts your claim in a more favorable light. This is your chance to include all new information, including new diagnoses, updates on your diagnosis, responses to treatment, new medications and new test results.

The appeal process is also an opportunity to review the original application to make sure that you have provided as much medical documentation as possible, along with contact information for your physicians, test results and any other pertinent information like the Residual Function Capacity Form.

The next step after the appeal is to go to a disability hearing to meet with an administrative law judge, who might consult with a medical expert and vocational expert to determine whether your claim should be approved.

The appeal process can be very stressful and challenging, so you might consider working with a Social Security disability lawyer to help you through the process.

Consider Getting Help With Your Degenerative Disc Disease Claim

While degenerative disc disease is a qualified disability when it causes serious and consistent complications, you may need help proving you are no longer able to work. If your medical records do not meet the SSA’s listing for DDD as it appears in Section 1.04 of the Blue Book, you will need to qualify for benefits through an RFC analysis instead. This can be quite tricky and will probably require an appeal hearing as well.

A Social Security disability advocate or attorney that is familiar with DDD claims can assist you in:

  • Filling out your application and any other required forms,
  • Collecting the documentation you need to support your claim,
  • AND

  • Understanding notices and other communications you get from the SSA.

An advocate or attorney can assist in every stage of the disability application and review process. If you must file an appeal, their help can be essential when preparing additional documentation and in getting ready for the hearing.