Experts estimate that 80% of the population will have back pain during their lives. In fact, back pain is the leading cause of disability in the world. In light of those back pain statistics, people have many questions about chronic back pain and disability, and disability for back pain.
- Can I Get Social Security Disability For Back Pain?
- What Back Conditions Are Considered Disabling?
- What Evidence Helps a Chronic Back Pain and Disability Case?
- What Medical Tests Should I Have For a Disability Claim Based on Chronic Back Pain?
- Why Are Back Pain and Disability Cases Lost?
1. Can I Get Social Security Disability For Back Pain?
Like other chronic pain, Social Security Disability can be awarded for back pain resulting from chronic back conditions. Yes, chronic back pain is a disabling condition. In fact, the most common reason claimants file for SSD is back pain. Whether claimant is an office worker who has spent thousands of hours at a desk hunched over a computer or a construction worker who has lifted, bent, stooped and knelt repeatedly, many otherwise healthy people suffer significant back pain that limits their ability to do their job. Over 20% of disability claims are based on disability for back pain. That does not mean Social Security rubber stamps these claims as approved. In fact, disability for back cases are the most challenging to win.
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Pain is a subjective experience for the sufferer. There are not always obvious signs of the problem as there are for other problems, like crippling diseases (i.e., cerebral palsy) or sensory issues (vision or hearing loss). Therefore, in a Social Security Disability Hearing, OHA is cautious about awarding benefits in some back cases.
2. Which Back Conditions Are Disabling?
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The SSD system relies on Listings of Impairments found at Title 20, Code of Federal Regulations, Chapter 3, and Section 404.1505. The Listing of Impairments is found at 404.1525. Specifically, Section 1.04 details disabling back issues caused by inherited factors, trauma, disease and developmental events. Infections, inflammations or degenerative conditions of the spine are also covered. A claimant may or may not have been born with a predisposition to developing a bad back. Time, growth, type of work and other intervening causes may bring the back issue to a head. The SSD system is more interested in how the back condition affects ability to work than how it developed. Specific symptoms and test results are noted in the Listings as relevant to a finding of disability for back pain.
If claimant produces proper evidence and medical reports with test results that meet the criteria in the Listings, he can win his case. Under the Listings, the evidence, tests and reports should at minimum show the following: 1. Back pain, muscle spasm, and significant limitation of motion in spine, and 2. Documented pain distribution and significant motor loss with muscle weakness, sensory and reflex loss. 3. Attempts at physical therapy, followed by persistent symptoms, despite completing therapy, which symptoms last or are expected to last at least 12 months.
3. What Evidence Helps a Disability Case Based On Back Pain?
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The Social Security claim examiners or Judges want objective medical findings to support complaints of disabling pain so they can compare them to the Listings. Even then, a claimant may find his doctor cannot supply such “objective medical findings” without further rounds of tests, even after a surgical intervention on the back. What should the prospective claimant with a bad pain do to raise the odds of winning his case? Pulling together relevant medical records is the most critical step for claimant.
In cases of back pain and disability cases, there can be clear testing evidence-such as an MRI or CT scan showing a herniated disk or evidence of another back condition under SSD Listings of Impairments. Claimants who have had back surgery but who have not found their back pain lessened by it, may fall into the Listings Category off “other vertebrogenic disorders”. Then claimant must make extra sure his medical records are available and clarify the issue fully.
4. Which Medical Tests Should I Have For a Disability Claim Based on Chronic Back Pain?
Social Security takes the position that complaints of back pain can be faked or exaggerated. Therefore, it wants objective support from medical doctors familiar with back abnormalities and knowledgeable of appropriate testing for the condition. Meeting the Listings criteria is made easier with medical support. The claimant should have testing beyond X-rays, as many back issues are soft-tissue injuries, like bulging disks or muscle tears). These do not show on an X-Ray. Other tests such as CT scans, lumbar myelograms, MRI’s, or bone scans are more helpful. Nerve Conduction Studies and Electromyograms can also shed light on whether nerve damage is involved. If nerve issues exist that affect muscular activities of the back these nerve issues can seriously affect ability to work.
The mental health component should not be overlooked in a back case. People with severe and chronic back pain, frequently suffer from depression due to the pain. If claimant is depressed, this must be documented too. Claimant should see a mental health therapist and follow recommendations for therapy. He should also be able to list any side effects of his prescribed pain medications and depression medications. Many commonly prescribed back pain pills and psychotropic pills can cause drowsiness, loss of concentration, confusion, and slower reflexes. These symptoms can affect an ability to work too. They should be reported.
If claimant and his physicians work in harmony, then the treating physicians can supply records and reports to SSD on these objective findings. The physician should always also do a hands-on exam of the claimant to spot objective issues like spasms and trigger points. A doctor’s report is more helpful if it is based on objective observations during an office examination. It should not be a recitation of claimant’s subjective complaints. ”
5. Why Are Back Pain and Disability Cases Lost?
Most back pain cases are lost because the claimant does not get objective medical testing like Magnetic Resonance Imaging (MRI) and electroencephalograms (EEG)! You nearly always have to have objective testing like MRIs and EEGs to even have a chance to win a back pain and disability claim. You must get the correct medical testing and treatment!
Extra effort by claimant should be made to cooperate with his physicians in having the proper tests, doing therapy and otherwise following the prescribed medical regime for his back condition. Depression treatment should also be sought. Going once to a therapist is not enough. Going to physical therapy for a week or two is not enough. Testimony and medical reports of unrelieved back pain with additional side effects are more credible if steady treatment occurred but the objectively verified problems persist.
Sometimes the medical records and tests do not give an SSD claims examiner or Judge all they need to approve the claim. Doctors are busy and often must be reminded by claimant or his lawyer to provide full reports. At minimum, the records from the doctors should be based on hands on exams, patient history and doctor’s objective findings. Then a claimant should be able to rely on his physicians to supply key information. At minimum, the Social Security should receive the following from the doctors:
- Surgical, operative and discharge notes that note clear diagnosis;
- Description of observed problems with gait, and any numbness, tingling or muscle spasm. Any observed or tested limitations of movement of the spine;
- An indication of the type of pain, its location, where it travels to from the back;
- Prescribed treatment, including frequency of medication, therapy, use of braces, canes or other devices;
- Daily activities that trigger an increase in pain or activities that can lower the pain level;
- A description of patient’s usual daily activities and any difficulties performing them; and
- Relevant objective test results.
A disability for back pain claim can be won. Claimant’s medical records should show pain, muscle spasms, and limitations of motion which likely will stop him from doing his usual past work. Objective support from medical test results bolsters these claims.
The Social Security Disability system then applies a complex set of guidelines to claimant’s situation which includes evaluating other work for which the claimant may be suited, despite his bad back. The goal is to see if claimant has any transferable skills. Other factors weighed in are claimant’s age and education. An employee has to be able to maintain a typical work schedule of full time, five day a week work. If after all the medical evidence and testimony is heard, the SSD finds claimant has a functional disability making this impossible, claimant will win his back pain and disability case.
Can Underwood Law Office Help Me With My Disability Claim?
If you need Social Security Disability Benefits based on chronic back pain, call us, we will help.
Our Social Security Disability lawyers in McKinney, TX, serve Dallas and Fort Worth, including McKinney, Frisco and Plano. The McKinney, TX office is a short drive from the McKinney Social Security Office located on Craig Drive.
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