Social Security receives more disability claims based on back pain than any other condition. People with back pain find their situations among the most challenging to prove and win. Frequently, “objective medical findings” may not fully support a patient’s reported experience of pain and movement limitations. Winning Social Security disability claims based on back pain can be tricky. Evidence from multiple sources is key.
In cases of disability based on back problems, there is sometimes clear evidence – such as a CT scan of a ruptured disk. In other situations, surgery has failed to improve the condition. A case may also fall into the category of “other vertebrogenic disorders,” in the words of the regulation. In either scenario, in order to win disability based on back pain, a claimant’s records must show:
- Pain, muscle spasm, and significant limitation of motion in spine
- Documented pain distribution and significant motor loss with muscle weakness, sensory and reflex loss.
These factors must have persisted for at least three months despite prescribed therapy, and last or be expected to last at least 12 months.
Social Security wants your pain symptoms to be supported by “objective” findings of physical abnormalities. Findings can be supplied by x-rays, CT scans, MRI’s, lumbar myelograms or bone scans. Nerve conduction studies may be helpful. Keep in mind that soft tissue damage such as a bulging disc or muscle damage will not show up in an x-ray.
Depression is a common component of back pain syndromes, and this should be documented and considered. Also important: are side effects of pain medications like drowsiness, confusion, lethargy.
Ideally, a treating physician will supply medical records or a report that describes these elements in detail, along with:
- Any surgical operative and discharge notes
- The character, location, and radiation of the patient’s pain
- Activities that increase or relieve pain
- Prescribed treatment, including frequency of medication
- The patient’s typical daily activities
- Description of problems with gait, limitation of movement of the spine, and any numbness or muscle spasm. Medical reports must be based on objective observations during the patient’s examination, not simply from patient’s statements.
You may have pain, muscle spasms, and limitation of motion preventing the performance of past work. Social Security applies a complex set of guidelines to these cases, evaluating other work for which you may be suited.