How do I Prove a Back-Pain-Based Disability?

Submitted by Deanna on

If you suffer from a disabling medical condition, you may be able to receive financial assistance in the form of disability benefits. These benefits are available through the Social Security Administration (SSA) and can help cover the costs of medical treatment and everyday living.

Some conditions, such as severe back pain, may make it more difficult for you to prove your disability to the SSA. If you have a back-pain-based disability and are seeking to apply for disability benefits, there are certain factors you should be aware of.


The SSA's Blue Book


The SSA uses a large listing of medical conditions, called the Blue Book, to determine applicants’ eligibility for disability benefits. There is currently no listing in the Blue Book for general back pain – no matter how severe – meaning approval cannot be automatic. However, you can “equal” a listing in the Blue Book that is similar to your condition and be approved for benefits that way.

Applying for disability benefits with back pain

Section 1.04 of the Blue Book, spine disorders, is often used to equal listing for back pain. The SSA will look at your objective symptoms to see if you qualify for another listing. Some of these conditions include:

  • Lumbar spinal stenosis with pain in the thighs, buttocks, and lower extremities that causes difficulty in walking and standing
  • Spinal arachnoiditis with pain and burning in the back as well as the need to shift positions at least once an hour
  • Nerve compression with a major loss in reflexes and range of motion


Functional Limitations From Back Pain


The SSA will perform a residual functional capacity (RFC) assessment to see how the symptoms affect your ability to perform any type of work. For instance, your back pain may make it so that you cannot stand for an extended period of time, making most types of non-sedentary work difficult. On the other hand, the pain may require you to shift positions frequently, making an office job just as difficult and painful.

An RFC assessment also takes your age, work history, and education level into account. This means that if your back pain, coupled with an older age, low education level, and experience performing only one type of work, would make learning a new type of work that you can perform with your back pain an unreasonable expectation.


Evaluating Credibility of Your Social Security Disability Claim


The SSA will look into your medical evidence and treatment history to see if your back pain is a credible disability. Important factors include:

  • How often you have been to the doctor for your back pain
  • Any treatments you have tried to mitigate the pain
  • Your treating doctor’s opinion of your medical outlook and ability limitations
  • How your pain affects your quality of life
  • Whether or not you appear to be exaggerating the pain
  • How others with similar physical conditions normally report their pain levels

Hire a Social Security Advocate or Lawyer

If you are unsure about how to apply for disability benefits with your back-pain-based disorder, you should seek the help of a lawyer or disability advocate. A lawyer or advocate can help you understand your options, fill out your initial application, gather medical evidence, establish your credibility, and more.

Additional Resources

Blog comments

Susie (not verified)

One thing that helped me with

One thing that helped me with getting Social Security disability for back pain was my on-going treatment at a pain clinic. I saw specialists, had diagnostic testing, and treatment. It was one key step in my process to document back pain/problems.

Sun, 05/22/2016 - 01:08 Permalink

In reply to by Susie (not verified)

Hi Susie,

Hi Susie,
Thanks for sharing your experience! It's true, documentation is key to making sure your claim is approved.

Mon, 05/23/2016 - 15:59 Permalink
Donna (not verified)

What do I do if I have a

What do I do if I have a herniated disc and need surgery but I do not have insurance and can't afford surgery right now? My pain runs all down my left leg and is pretty much constant.

Tue, 03/21/2017 - 16:27 Permalink
Shirley (not verified)

Most states if you are

Most states if you are eligiable for SSI you are also eligiable for Medicaid, apply thru adult public assistance (RX are like $4.00 as well as most medical visits) while some have to wait 2 years to get Medicare, ifyou have been approved for SSI that is. Free cell phones or nearly free even in Alaska this is available. Apply for food stamps, housing, call utility companies to get reduced rates. Those with children apply for WIC( women infiant & children). Some SSI recepiets can do better than those working. The programs are there.

Thu, 05/18/2017 - 03:15 Permalink
Shirley (not verified)

Those applying for disability

Those applying for disability SSI or SSA may want to try for benefits on your own( this way it will not cost you some of your benefit $) as in being represented by an attorney. And more importantly if your medical condition is well documented by your doctors. Then if not approved you can appeal the decision at which point I would recommend getting some representation like an attorney. Do not reapply, if you reapply vs appeal your benefit start date will start over. If you appeal, & are approved your benefits go back to your origional application date.

Thu, 05/18/2017 - 03:32 Permalink
Shirley (not verified)

Here is one of SSA best kept

Here is one of SSA best kept secrets. If someone has a severe disability & needs assistance from another as in a care taker. Can that care taker be paid by SSA?

Thu, 05/18/2017 - 03:36 Permalink

In reply to by Shirley (not verified)

Hi Shirley,

Hi Shirley,
Some states have programs that help people pay for the caregiver of their choice, and in certain circumstances that can be a family member... Most have income and other eligibility requirements that the care recipient must meet, and strict rules often apply as to who can be paid for the caregiving.


Thu, 05/18/2017 - 11:41 Permalink
Shirley (not verified)

What is with the sudden work

What is with the sudden work requirements from SSA for those that have been SSA eligiable for years.I know the country has taken funicular hits?

Thu, 05/18/2017 - 03:40 Permalink

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