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How to Qualify for SSD Benefits with a Herniated Disc

Spines do more work in the body than most other bones. They keep us upright, let us bend, house our nerves, and connect almost all of the important working pieces in our body to one another. When a herniated disc occurs, the nerves in the spine become crushed or pushed out from between the vertebrae.

Herniated discs are actually quite common. With the help of pain medication and limited movement, most people heal fully within 6 weeks. However, some herniated discs are stubborn, and they could worsen over time. Eventually, they can become too painful for people to even take care of themselves independently.

If your herniated disc causes you continuous, long-lasting pain, then you may be eligible for monthly financial assistance through the Social Security disability benefits program. Herniated discs in the neck and back can qualify for benefits if your symptoms are severe enough.

Types of Jobs that Herniated Discs Can Make Impossible

Herniated discs occur when the soft tissue slips through the spinal casing. The best case scenario is that medication can treat the condition, but many cases require physical therapy and even surgery. When you are dealing with a herniated disc, the pain is often overwhelming. Even the simplest of tasks can be downright unbearable, and the pain often makes working impossible.

Your back is involved in so many ranges of motion, from standing to sitting. Even if you are able to sit all day at work instead of standing, moving around in your chair or remaining stationary at your desk can cause enough pain to make working impossible.

Physical labor is impossible for people suffering from herniated discs, both before and immediately after surgery during the recovery period. In advanced cases, sitting is also uncomfortable as well, so it is difficult to find modified jobs that allow you to work with a herniated disc.

Social Security Disability Benefits

Disability benefits are provided to U.S. residents whose disorder is severe enough to:

a) prevent them from working or completing necessary daily tasks, such as cooking, getting around, bathing, or dressing without assistance, and
b) last for at least 12 months or expect to result in death.

Those who qualify under these conditions are considered “totally and permanently disabled,” making them eligible to receive monthly financial payments. Depending on your disorder, different symptoms are required to classify you under these terms.

The requirements for each disorder are listed in the Social Security’s “Blue Book”, which you can consult on the SSA’s website at any time.

If you cannot work because of a herniated disc, you may qualify for Social Security disability benefits. See if you qualify!

Blue Book Listing for Herniated Discs

Herniated discs are listed under Section 1.04 of the Blue Book: “Disorders of the Spine”, which refers to it as "herniated nucleus pulposus."

Common disorders from a herniated disc include nerve root compression ( pressure on the nerves of the spine), spinal stenosis ( a narrowing of the spine), and arachnoiditis, which is an inflammation of a membrane around the spine.

Here, the Blue Book states that applicants with a herniated disc can qualify if their disorder:

  • results in the compromise of a nerve root (the initial segment of a nerve leaving the central nervous system) or the spinal cord, such as
  • causes distributed pain, limits spinal motion, and/or causes motor loss due to the atrophying of unused muscles,
  • causes sensory or reflex loss, and
  • if involvement is in the lower back, limits motion in the legs measured with a positive straight-leg raising test (SLR test)

When you're just looking at the listing, it can be difficult to determine whether or not you will qualify. For example, understand the Social Security Administration’s definition of a “compromised nerve root” or “limited spinal motion” can be difficult when seen out of context.

However, if you suffer from a limited range of movement, muscle weakness or decreased reflexes or sensory response due to a bulging disc, you may be able to use documentation of those conditions to support your disability claim.

Since the Blue Book refers to specific medical terms like these, it is best to consult with your physician to see if you qualify. They can also provide you with new or updated tests to compare your results to those listed above.

Qualifying Without Meeting a Blue Book Listing

In some cases, applicants who do not meet their Blue Book listing may still qualify for benefits. If you can demonstrate that your severe herniated disc prevents you from returning to any work you have been trained to do, then you may qualify for a Medical Vocational Allowance (MVA).

Generally, If you are over 50 and cannot do many of the activities that you did in your previous jobs, you may be more likely to be approved for benefits.

For example, say you are a woman in your mid-50’s who has spent her whole life working as a waitress. After your herniated disc, you are unable to bend or lift things over 15 pounds without pain, let alone remain on your feet long enough to work a standard shift.

The RFC determines the maximum amount of work you are capable of performing with your condition. Your doctor is the one to fill out the form, and this allows the SSA to understand the specifics of your case because the information is coming straight from your doctor.

Your doctor understands the nuances of your case, as he or she was likely the one who diagnosed you or has been working with you since your diagnosis. Your doctor can attest to your actual range of movement based on examinations and observations, and this can help the SSA to understand that you are unable to perform certain tasks even though that is not immediately evident from your diagnosis.

The SSA will send you an RFC form to complete as part of your disability benefits application, and it is a good idea to frame your application in terms of the information requested by the RFC so that it is clear that your condition is severely limiting your ability to work.

Technical Side of Being Eligible

Disability benefits are not based upon income, rather everything is based upon need and your inability to work. However, you must have paid Social Security taxes and you must have a predetermined number of work credits to qualify for disability benefits. (There are other disability programs available for people who do not meet these qualifications)

The SSA will look at your work history to determine how many work credits you have earned. You earn four work credits each year that you make a certain amount of money.

You need 40 work credits to apply for disability benefits, and 20 of those credits must have been earned in the 10 years since you were diagnosed. The SSA will consider your age when determining how many work credits you need to apply, as younger workers who become disabled may not have 40 credits.

What Happens If You Can Still Work But Had to Switch Jobs

If you are able to work with your condition and you receive disability benefits, you can continue to work so long as you do not perform “substantial gainful activity” (SGA). In 2020, if you earn more than $1260 then you would would exceed the SGA limit.

The trial work period is an opportunity to test whether you are able to perform modified duties with your condition. If you earn more than $1260 (in 2020) for more than nine months, then you would not be eligible to continue to receive disability benefits.

This is a great way to have the safety net of disability benefits while also continuing to work at a modified level.

Preparing for the Application

When it comes to applying for disability benefits, you can never be too thorough. Before you start your application, be sure to have the following materials from acceptable medical sources on hand:

  • MRI/CT scans, preferably multiple ones over time.
  • Previous and current treatment lists, including medication, braces, physical therapy, or surgery (microscopic diskectomy, laminectomy, etc.)
  • Hospitalization history, especially if your herniated disc has required multiple ER visits within the last year.
  • General medical history, which can show the worsening of your condition over time.

Similarly, if you believe an MVA may be for you, be sure to get a Residual Functional Capacity (RFC) test as well. These tests measure your ability to complete physical tasks such as walking, sitting, standing from a seated position, lifting, pulling, or bending.

Your doctor can help by establishing in what ways you are disabled, what the extent of your disability is, and how it limits your function by filling out the RFC.

The less you are able to do, the greater your chance of being accepted for disability benefits. RFC forms can be printed out online and given to your physician to fill out.

The Importance of Disability Attorneys

Disability attorneys can greatly increase your chances of getting benefits. They can take difficult cases and help you organize paperwork, update the SSA on your condition, and potentially represent you in court should you need to appeal. Better yet, their services come at no cost to you unless they help you win your case.

Consider a free consultation with a disability attorney near you to give yourself the best chance at receiving the benefits you need.