No one knows your pain better than you. And if you seek relief through Social Security Disability Insurance it may be quite a “pain in the back.” Be assured, back problems are the most common of all petitions to the Social Security Administration (SSA). Social Security Disability benefits may be available for chronic back pain but it will not be easy to prove. Evidence of pain and other symptoms, severity of impairment, and your credibility will all be considered.
Objective Signs of Chronic Back Pain
Benefits primarily go to those who have “medically determinable” back impairment; applications for moderate or intermittent back pain will not be granted. Success on your application for disability benefits are most likely to succeed when there is medical evidence supporting spinal disorders such as:
- Spinal stenosis
- Nerve root compression
- A chronic and untreatable herniated disc
Accordingly, the back injury must meet or “equal” those listed in the Social Security regulations “Listing of Impairments” found in The Social Security Bluebook Section 1.04 for Disorders of the Spine. In order to be eligible for Social Security disability benefits you must meet any of the three parts: A, B, and C listed in this section.
The Social Security Administration (SSA) will consider medical evidence of abnormalities on X-rays, CT scans, or MRIs of the spine. But objective abnormalities on these exams, standing alone, are not conclusive. At times, an individual may experience no or minimal symptoms, but an X-ray could reveal significant degenerative abnormalities. Contra, an individual whose X-ray revealed minimal or moderate objective abnormalities could experience severe and debilitating pain when bending over, standing for a length of time or walking long distance.
Thus, since objective evidence alone is insufficient, the SSA may also consider your behavior in seeking relief from the alleged symptoms, the nature and frequency of your visits to your treating physicians, responses to treatment, and activities performed and limited by pain.
A functional limitation is something you cannot do because of your back pain or injury. The question of disability depends on how much the chronic pain experienced interferes with the ability to perform everyday activities, such as walking, bending, lifting, or twisting. Most acute lower back pain is a result of a strain of ligaments and other soft-tissue supportive structures of the spine which will recover in less than one year even with no treatment. The SSA scrutinizes for chronic pain.
Some examples of limitations related to back problems that the SSA considers:
- Being unable to bend or stoop to pick something up
- Inability to walk more than a block without taking a break
- Not being able to lift or carry more than ten pounds occasionally
- Inability to sit or stand for at least two hours in a day
- Requirement that you be allowed to get up and move around or to change positions whenever you need to
- Need to keep at least one of your legs elevated throughout the workday
- Need to lay down throughout the day, and
- Inability to sit for at least six hours in a workday.
Most claimants with back problems do not qualify for Social Security disability benefits under the social security listing 1.04 and require a residual functional capacity (RFC) assessment. Functional limitations are used to determine your residual functional capacity (RFC). Although SSA doctors will prepare an RFC assessment form that considers functional limitations, it is still an essential part of your claim to have your treating doctor, a back specialist, also fill out an RFC form.
Your credibility matters. Since pain is subjective and hard for doctors to scientifically measure, it may be helpful to record your pain, discomfort, and functioning capacity in a journal. Your credibility compares the medical evidence in your file with statements of treating physicians as well as statements made by you to others (particularly employers and doctors) regarding symptoms impacting the ability to work, attempts to work, and how well you responded to treatments.
Your file should be consistent. The SSA will be looking for statements or behaviors that are not consistent with the record. If you tell the SSA that you cannot bend or stoop to pick something up, yet the record indicates that you continued to perform gardening and routine yardwork tasks, your credibility will be damaged.
Another factor in determining your credibility is the efforts taken to alleviate pain symptoms. The SSA is more persuaded by records that indicate a long-term effort at finding successful treatment to relieve the back pain. A claimant who has tried alternative treatments or different medications with varying dosages is more persuasive.
If you are seeking to obtain Social Security Disability benefits for chronic back pain, consult our knowledgeable and experienced representatives with Adams & Associates Disability, Inc. by calling (888) 551-1190.