How to Qualify for Disability with a Spinal Condition in 2023

What Spinal Conditions Qualify For Disability Benefits?

Everyday activities from sitting and walking to sleeping can put tremendous strain on our spines, which can often manifest in the form of pain in our necks and backs. In America, ninety percent of all people suffer from back or neck pain at some point during their lives. For many of those that suffer from severe spinal conditions, the disorder is not simply painful but truly disabling.

Spinal disorders can come in many different forms and have varying medical causes. Some of the most common disabling problems include spinal stenosis, osteoarthritis degenerative disc disease, facet hypertrophy, spinal arachnoiditis, facet arthropathy, herniated discs, facet arthritis, and vertebral fracture. All of these conditions cause severe back and neck pain, and in many cases may cause other symptoms including muscular weakness, immobility, and pain that radiates to other places in the body.

Diagnosis of disabling spinal conditions generally begins with a simple physical exam. If symptoms do not decrease after prescription medications are administered, additional testing is necessary. Depending on the suspected medical cause, physicians will order X-rays, MRI, and CT scans. Should the condition progress to the point where it interferes with the ability to work, then it is time to consider filing for disability.

Back pain diminishes the quality of life for millions of Americans. Research indicates that some form of back pain impacts nearly 80 percent of Americans at some point during their lifetimes. If you suffer from back pain, do you match the medical criteria used for the spinal disabilities list? Do you qualify for Social Security disability benefits if you suffer from a spinal condition?

How Do I File for Social Security Disability with a Spine Condition?

Section 1.04 of the Social Security Administration's impairment listing manual, also known as the “Blue Book,” describes eligibility criteria for spinal conditions. While many spinal disorders are covered under Social Security Disability (SSDI) and Supplemental Security Income (SSI), certain conditions must be met before the application will be approved. The first step in filing for SSDI or SSI due to a disabling spinal condition is having a specific diagnosis made by a qualified physician. Keep in mind, that the state-run Disability Determination Services (DDS) give much greater weight to a diagnosis by a specialist like an orthopedist than that of a general practitioner or family doctor.

Next you must prove that the condition affects your ability to work. Again, medical and disability specialists are the best people to turn to help prove inability to function at work, particular as some spine conditions have additional requirements designated in the Blue Book. For example, there must be diagnostic evidence of nerve root compression, sensory or reflex loss, and a positive SLR (Straight Leg Raising) test for conditions affecting the lower back. Some conditions, such as spinal arachnoiditis, will require surgical notes and tissue biopsy reports. Consulting with a qualified Social Security Disability lawyer or disability advocate can prove invaluable in determining all the specific requirements for pursuing disability benefits on the basis of a spine disability.

How Do I Medically Qualifying For Disability Benefits Through An RFC Analysis?

Just because you are unable to work because of a medical condition doesn’t mean that you will qualify for disability benefits through the medical criteria as specified in the Blue Book. If you cannot meet the Blue Book criteria, you can qualify using a medical vocational allowance. The medical vocational allowance involves considering your age, your medical conditions, your symptoms, side effects, work history, transferrable skills, and educational background to determine if you are capable of working, and if so, what kind of work you can do.

Using a medical vocational allowance, you will need to have a residual functional capacity (RFC) completed by your treating physician. An RFC is a very detailed form. It specifies what you can and cannot do, and clearly indicates limitations and restrictions.

As an example, it may say that you must reposition yourself every hour or two, cannot stand longer than two consecutive hours, cannot lift more than 10 pounds, cannot bend and reach, is unable to squat, and that you need help when getting up from a seated position.

The RFC should give Disability Determination Services (DDS) a clear picture of your overall health and how your medical conditions affect your ability to work and function. If you can show that your ability to perform daily tasks is limited and that affects your ability to work and earn a living.

Through the overall picture of a medical vocational allowance, and then the RFC provided by your regular provider, you are much more likely to be able to get your claim approved. Basically, a medical vocational allowance helps the SSA see that your medical condition keeps you from performing any work duties that you qualify for, and that despite not medically qualifying by the Blue Book criteria, you still qualify.

How Do I Apply For Disability Benefits With A Spinal Condition?

If you have a disabling spinal condition, you may be eligible to receive disability benefits. When you apply for disability benefits you will need to show that you have a disabling condition that will last for 12 months or longer or lead to death. There are three ways to apply for disability benefits. You can start your application online at the Social Security website, or by calling 1-800-772-1213 and speaking to a representative or by scheduling an appointment at your local Social Security office.

If you are applying for Supplemental Security Income (SSI), which is a needs-based disability program, you will need to submit the application at your local SSA field office. There are more than 1,300 field offices spread across the country. To apply for disability benefits, you will need to provide supporting documentation that shows your medical conditions and the severity of those problems.

You must provide detailed medical history information. That means that you should provide a detailed list that includes all the medical providers that you have sought treatment from. This list should include the name of the provider, the address and contact information for the provider, and the approximate dates of service when you received medical treatment from that provider.

You will need to gather your financial records to apply for SSI. This includes financial records to indicate your income, any assets and resources, and bank account balances. You should also gather personal records that the SSA will need to review your claim. This will include details regarding your work history. Your work history will need to include your work duties and your job title along with salary details.

Regardless of whether you are using the Blue Book approach, or you are using a medical vocational approach with an RFC analysis the detailed medical history is required. Your medical records must be detailed and complete.

You should provide detailed reports from any and all doctors, including specialists. You should provide reports for any tests, including x-rays, CT scans, MRIs, and so forth that detail the severity of your spinal condition.

Also, if your spinal condition has required surgery, be sure to provide copies of any surgical reports and any physician notes about the spinal condition both before and after surgical intervention. Provide all the details that you can so DDS can see the severity of your condition and how it limits your ability to work.

It may also be beneficial if you can get statements from supervisors or co-workers that explain how your functionality and your ability to work has changed since you suffered from the spinal condition. These are people who know first-hand about how your injury has impacted your ability to work and the pain that you suffer from the condition.

Is Facet Arthropathy a Disability?

Facet arthropathy represents a medical condition that negatively impacts the back. The spine consists of a series of vertebrae located along the spinal column. Each vertebra attaches to another vertebra with the help of two facet joints. Facet joints align vertebrae, as well as control the motion of vertebrae. Facet arthropathy develops when facet joints start to lose their connectivity, with the result generating pain up and down the back.

Is facet arthropathy a disability as defined by the Social Security Administration (SSA)? According to the medical guide called the Blue Book published by the SSA, facet arthropathy might qualify as a disability if the severity of symptoms matches the guidelines published under Section 1.04. This section lists all musculoskeletal conditions, like facet arthropathy, that qualify disability applicants for financial assistance.

The SSA defines musculoskeletal disorders as impairments caused by acquired, congenital, or hereditary factors. Infectious, degenerative, and inflammatory processes also can develop into a musculoskeletal medical condition such as facet arthropathy or facet hypertrophy. Although facet arthropathy is on the list of musculoskeletal disorders mention under Section 1.04 of the Blue Book, you might not qualify for disability benefits.

If your facet arthropathy symptoms do not meet the standards for what spinal conditions qualify for disability, you can seek a second opinion by completing a Residual Functional Capacity (RFC) assessment. An RFC assessment consists of several tests that measure your physical capabilities.

What Spinal Conditions Qualify for Disability?

Several conditions might qualify an applicant to make the spinal disabilities list.

Herniated Disc

A herniated disc develops when the soft center in a spinal disc pushes through an opening of the harder exterior layer. Symptoms of the medical condition can include nerve irritation and numbness in one or more limbs. Physical therapy is the most common method for treating a herniated disc.

Compressed Nerves

Also referred to as pinched nerves, compressed nerves often result from repetitive motions or holding onto the same position for prolonged periods. Nerve compression develops mostly in bones, tendons, and ligaments. Nerves are the most susceptible to damage when they move through narrow spaces that contain little or no soft tissue.

Degenerative Disc Disease

Frequently caused by the aging process, degenerative disc disease occurs when the discs between vertebrae stop providing their cushioning benefits. Because the spine tends to become much more rigid, you might suffer from pain and weakness along the spinal column. Exercise and physical therapy can mitigate the painful symptoms of degenerative disc disease.

Osteoarthritis

When the flexible tissue located at the end of bones begins to deteriorate, osteoarthritis can start to develop. The wearing down of tissue at the end of bones can get much worse over time. You might experience constant pain in the hands, hips, knees, and/or lower back. Serious cases of the medical condition might require surgery.

Spinal Stenosis

The narrowing of the spinal column places pressure on the spine and the nerves running through the spine. The result can be intense pain, even if you remain seated. You also might experience muscle weakness and numbness throughout the back.

Facet Hypertrophy

When the facet joints of the spine become enlarged. Facet hypertrophy can be caused by conditions like arthritis or from an injury. Facet hypertrophy can lead to pain, loss of motion, and stiffness. 

Your Spine Disorder Disability Claim

Spinal conditions are some of the most painful and disabling medical disorders. Whether your spinal condition was caused by a traumatic injury or a degenerative disorder like facet hypertrophy you may qualify for SSDI or SSI assistance. When you are diagnosed with a disabling spinal condition, it is easy to feel overwhelmed. While you should be focused on doing everything you can to feel better, the unfortunate fact is that you will probably have to deal with the reality of paying bills and caring for loved ones.

Luckily, Social Security Disability attorneys and advocates are available to help you through every step of the approval process. Qualified legal assistance can help you with everything from preparing your initial Social Security Disability application to assisting with the reconsideration and appeals processes.

You Could Earn Up to $40,140 a Year! Get a Free Case Evaluation

If you have a spinal condition that keeps you from working, you should start the application for disability benefits from the SSA. When you apply for disability benefits, documentation is essential to your claim’s success. Use our disability calculator to see how much you could be able to earn in disability benefits.

When your claim is denied, they will tell you why your claim wasn’t approved and based on that, you will be able to determine what you need to help show them that you are disabled. You should gather that additional information and send it to them after you file your appeal.

Your claim will not be approved for benefits without the needed information. You will also need to file your appeal before time runs out. If you miss the deadline, you will have to reapply for disability benefits and start the process all over.

When you have a disability lawyer, your attorney will be sure that everything is filed by the deadline and that all the needed documentation is provided to the SSA for review. You can retain a disability attorney at anytime during the claims process. Complete the Free Case Evaluation on this page to get connected with a disability lawyer that takes cases in your area today!

Social Security Disability for Scoliosis