Every year, back pain affects over 30 million people. This pain ranges from slightly more than annoying to almost debilitating. If your back pain gravitates toward that latter designation, Social Security Disability Insurance may be an option.
As the number of back pain cases has surged over recent years, the Social Security Administration has begun scrutinizing these matters much more closely, underscoring the need for an aggressive and experienced attorney who can get you the benefits you and your family need.
Qualification for SSDI
“Disability” is an inherently subjective term that largely depends on a person’s age, education, work history, and other factors. So, to make the determination more objective, the DDS (Disability Determination Service) officer measures several factors:
- SGA: It is a myth that working people are ineligible for benefits, because the SSA defines “substantial gainful activity” as any work that produces more than about $1,150 a month.
- Extent of Impairment: This inquiry is a two-step process. First, the impairment must be severe enough that it substantially restricts some or all your everyday activities. Second, if the impairment can be cured or substantially reduced after surgery or some other intervention, regardless of possible side-effects, your claim will probably be denied on this point.
- Listed Condition: The DDS expedites claims that contain a recent medical diagnosis of a listed condition. Persons who do not have a listed condition may still be eligible for benefits, but the process is a little more complicated.
- Residual Functional Capacity: Next, the DDS officer will estimate whether you can still perform your prior job, based on your condition and the job requirements. In other words, the evaluator must see an objective basis for your inability to work full time as opposed to your subjective self-evaluation.
- Alternate Employment: This inquiry goes back to the subjectivity discussed above, because people whom the DDS believes can successfully transition to other occupations may be ineligible for benefits. The guidelines are less restrictive for people over 50.
The average amount of disability benefits is about $1,150 per month.
Common Causes of Back Pain
Stenosis (narrowing of the spinal canal and consequent compression of the nerves) is a listed condition. In addition to a medical diagnosis, victims must experience pain combined with weakness on a continual basis, have at least one CT or MRI scan that confirms the diagnosis, and be able to walk only with the assistance of a medical device (two crutches or a walker). A physician-completed RFC (residual functional capacity) form is a great help.
Likewise, a herniated disc is also a listed condition. This illness occurs because the disc has lost its elasticity, causing a compressed nerve. In addition to a diagnosis, disability applicants must have ongoing pain or significant loss of motion. Applicants must also show that they have tried physical therapy and other treatments, but the pain is still about the same.
Failed back surgery probably qualifies under Section 1.03 (Reconstructive Surgery or Surgical Fusion of Weight-Bearing Joints) or 1.04 (Disorders of the Spine). Applicants must establish that their pain has lasted at least twelve months after surgery, because these issues often improve given time and physical therapy.
Procedurally, DDS officers nearly always deny claims, at least in part, so it is important to persevere in these cases and enlist the assistance of an experienced advocate.
Reach Out to Experienced Attorneys
Social Security benefits are available to those who suffer from debilitating back pain. For a free consultation with an experienced disability lawyer in Raleigh, contact Lunn & Forro, PLLC. We do not charge upfront legal fees in these cases.