Disability for Back Pain: What Qualifies for SSDI Benefits?
Back pain causes millions of people to suffer throughout their workday. Many can’t make it to the end of the day. Suffering to a point where you are unable to work means you could qualify for Social Security Disability (SSD or SSDI) benefits. At MJ Ellis Disability Law Office, we focus our entire legal practice on helping people in Northern New Jersey and the surrounding area get the disability benefits they deserve.
In this blog post, we’ll explain how the Social Security Administration (SSA) determines who is disabled enough to qualify for monthly benefit payments and what kind of back pain is likely to be recognized as a qualifying disability. If you have any questions about your back pain and Social Security Disability benefits, contact us anytime for all the information you need. We’d love to help you get all the benefits to which you are entitled.
How Bad Does Your Back Pain Have to Be to Get Disability Benefits?
The Social Security Administration operates two disability benefit programs, one for people with a substantial work history called Social Security Disability Insurance (SSD or SSDI), and a second one for people whose employment history is more limited called Supplemental Security Income (SSI). Both programs use the same criteria to determine what qualifies as a disability:
“A qualifying disability is a medically determinable physical or mental impairment that lasts, or is expected to last, at least 12 months (or result in death), and prevents the person from performing substantial gainful activities.”
Determining the “severity” of someone’s back pain can be difficult for several reasons. Often, the cause of the back pain is not able to be objectively confirmed through standard testing methods, like x-rays, CT-scans, MRIs, bone scans, and nerve conduction studies. Without this clear source of validation, your doctor’s examinations, observations, and treatment notes will need to be the source of all documented medical evidence. Your doctor will record the pain you report and exhibit as well as the results of the doctor’s testing of your limited range of motion, and ability to reach, bend, stand, etc. They’ll also document your ability to lift, hold, and carry weight, and to sit or stand without suffering with too much pain to continue.
What Back or Back Pain Conditions Will Qualify for Disability Payments?
Back pain can be caused by injury, illness, or natural degeneration. And each of these sources of back pain affects people to varying degrees, some much more severely than others. Some of the causes of back pain that are commonly approved for SSD or SSI benefits when the individual has severe pain include the following:
- compression of the nerve root
- rheumatoid arthritis (autoimmune disorder leading to inflammation)
- osteoarthritis (wearing down of cartilage in joints)
- degenerative disc disorder
- arachnoiditis (swelling or compression of the spinal cord membrane)
- herniated discs
- spinal stenosis (narrowing of space between vertebrae causing pressure on nerves)
- spondylitis (inflammation of joints in the spine and back of the pelvis)
- spondylolisthesis (displacement of one vertebra onto a lower one)
- scoliosis (curvature of the spine sideways)
There is no impairment that automatically wins approval of disability benefits. Each case is reviewed to determine whether the impairment is supported by documentary evidence, whether the impairment will persist in disabling severity for 12 months, and whether the severity of the case prevents the claimant from performing some employment to earn more than a minimum of $1,350 per month (2022 “substantial gainful activity” SGA amount).
Blue Book Impairments vs. Residual Functional Capacity (RFC)
The Social Security Administration publishes a manual listing commonly disabling impairments which include the detailed symptoms and test results the SSA uses as criteria for each impairment to be deemed a qualified disability. These are referred to as “listed impairments.” If your impairment meets the elements specified in the Blue Book, then your likelihood of being approved for SSD or SSI benefits is very high.
However, if your impairment or group of claimed impairments do not match any single “listed” impairment criteria, you can still win the approval of disability benefits if your individual medical evidence demonstrates a long-term impairment severe enough to prevent you from earning a living.
The SSA will also evaluate your case to determine what’s called Residual Functional Capacity (RFC). This is an analysis to determine whether a disabled person who was a bricklayer, for example, might be able to perform alternative work as a customer service representative. The SSD claimant’s impairment could be one that does not prevent light work.
To determine a person’s RFC, all the claimant’s personal history is considered, including age, education, experience, the nature of their impairment, the likelihood of their successfully being retrained, etc. Older SSD claimants are much less likely to be appropriate for retraining than are younger disabled workers.