The Listing of Impairment manual has specific criteria for the evaluation of spinal impairments which can be found at here.
These problems can include osteoarthritis, spinal stenosis, herniated discs, spinal arachnoidtis, and degenerative disc disease.
These are common problems which are the basis of many social security disability applications and, unfortunately, many denials. Why is that?
There are two reasons. The first is that back problems are a common complaint the Social Security Administration (SSA) sees all the time and SSA just doesn’t take these complaints or problems seriously. The second is that your doctors don’t go to medical school to write reports that meet Social Security disability criteria.
If you click on the link above, you will see that there are very specific criteria for the diagnosis of your back complaints, exacting requirements for what must be seen on your physical examination including precise measurements, diagnostic studies which support your diagnosis, documentation of the treatment prescribed by your doctor in response to the treatment, specific comments on the effects of the treatment that you have been given, and specific descriptions of the drug or treatment given including dosages, frequency, description of any complications or side effects.
You will also see that Section 1.04, Disorders of the spine, includes specific definitions of spinal conditions including herniated discs, spinal arachnoiditis, lumbar spinal stenosis, and abnormal curvature of the spine. If your condition doesn’t perfectly fit the definition and the criteria required by the listing, the Social Security Administration is going to find that you do not need a listing. So, in many cases, your medical records simply don’t address all the factors that Social Security wants to see before they will agree that you need a listing.
Unfortunately, at Hurdle 4 and 5, most Disability Determination specialists are of the opinion that back problems are temporary and that you can return to the lightest job you’ve held in the last 15 years with the job you were doing at the time it became disabled. That, of course, means that your claim will be denied.
That isn’t to say that these cases can’t be won! In fact, with proper development of the medical evidence these cases are won every day.
What’s the key?
1. Make sure that your doctors notes show a proper diagnosis of disc herniation, back pain, lumbar problems, spinal stenosis, or degenerative joint disease.
2. Make sure that your medical records have objective evidence of the diagnosis in the form of x-ray reports, CAT scans, MRI studies, bone scans, EMG/NCS studies, and surgical reports.
3. Make sure your doctor documents your functional limitations on your activities such as bending, stooping, standing, walking, sitting, and alternating positions.
4. Make sure your doctor documents any side effects of medication.
5. Make sure your doctor documents you are physical findings on examination such as decreased range of motion, reduced muscular strength, how you walk, positive straight leg raising tests, and any sensory or reflex changes.
6. Make sure that your doctor’s reports are consistent with what you’re reporting about your condition, physical problems, pain and side effects of medication.
7. When you fill out forms for the Social Security Administration explain what problems are having with pain and how it limits your ability to function 24/7.
8. Getting regular medical treatment so that there are medical records that backup your claim.
Back claims can be won with proper development of the evidence that meets the Social Security criteria and your best chance will be to contact skilled Social Security Disability lawyers Cavey & Barrett!
