If you suffer from a disabling medical condition, you may be able to receive financial assistance in the form of disability benefits. These benefits are available through the Social Security Administration (SSA) and can help cover the costs of medical treatment and everyday living.
Some conditions, such as severe back pain, may make it more difficult for you to prove your disability to the SSA. If you have a back-pain-based disability and are seeking to apply for disability benefits, there are certain factors you should be aware of.
The SSA's Blue Book
The SSA uses a large listing of medical conditions, called the Blue Book, to determine applicants’ eligibility for disability benefits. There is currently no listing in the Blue Book for general back pain – no matter how severe – meaning approval cannot be automatic. However, you can “equal” a listing in the Blue Book that is similar to your condition and be approved for benefits that way.
Section 1.04 of the Blue Book, spine disorders, is often used to equal listing for back pain. The SSA will look at your objective symptoms to see if you qualify for another listing. Some of these conditions include:
- Lumbar spinal stenosis with pain in the thighs, buttocks, and lower extremities that causes difficulty in walking and standing
- Spinal arachnoiditis with pain and burning in the back as well as the need to shift positions at least once an hour
- Nerve compression with a major loss in reflexes and range of motion
Functional Limitations From Back Pain
The SSA will perform a residual functional capacity (RFC) assessment to see how the symptoms affect your ability to perform any type of work. For instance, your back pain may make it so that you cannot stand for an extended period of time, making most types of non-sedentary work difficult. On the other hand, the pain may require you to shift positions frequently, making an office job just as difficult and painful.
An RFC assessment also takes your age, work history, and education level into account. This means that if your back pain, coupled with an older age, low education level, and experience performing only one type of work, would make learning a new type of work that you can perform with your back pain an unreasonable expectation.
Evaluating Credibility of Your Social Security Disability Claim
The SSA will look into your medical evidence and treatment history to see if your back pain is a credible disability. Important factors include:
- How often you have been to the doctor for your back pain
- Any treatments you have tried to mitigate the pain
- Your treating doctor’s opinion of your medical outlook and ability limitations
- How your pain affects your quality of life
- Whether or not you appear to be exaggerating the pain
- How others with similar physical conditions normally report their pain levels
Hire a Social Security Advocate or Lawyer
If you are unsure about how to apply for disability benefits with your back-pain-based disorder, you should seek the help of a lawyer or disability advocate. A lawyer or advocate can help you understand your options, fill out your initial application, gather medical evidence, establish your credibility, and more.
