SSDI and SSI claims based on back pain are perhaps the most common type of disabling ailment seen by Social Security. Upper and lower back pain can arise from strenuous work activity or from the aging process (if you see the term “degenerative disc disease,” your doctor is referring to the deteriorating condition of the discs in your back brought about by years of wear and tear).
Since Social Security judges frequently see claimants alleging disability based on back pain, you are going to have to show that your pain is more than the mild to moderate discomfort that everyone experiences from time to time, and instead is severe and debilitating to the point where you are not able to perform even simple, sit down job duties.
In my experience, some of the factors that judges look for when evaluating back pain cases include:
- long, solid work history
- objective evidence of problems in your back – such as multiple MRI reports showing disk issues with nerve root impingement
- evidence that you need back surgery and that until you undergo surgery, your capacity to function will be limited (note that a Social Security judge cannot “punish” you if you choose not to undergo surgery)
- evidence that you have undergone surgery but that your pain and limitation of movement have not been cured
- evidence that you are not a surgical candidate at all, and that you have been referred to a pain management physician.
- evidence that you have “failed back syndrome” whereby you have had surgery that was not successful in eliminating pain and restoring function and now you have been referred to chronic pain management
There are basically three ways to win a back pain case. Click on the links for more detail:
- meet a listing at 1.00 (musculoskeletal system listing) 1
- residual functional capacity – prove that your functional capacity for work has been so reduced by your back problem that you would not be a reliable employee
- meet a grid rule (generally limited to those over age 50 with a limited education and an unskilled work background)
Keep in mind that while disability judges see more “back pain” cases than just about any other type of impairment, judges can usually tell fairly quickly if the evidence in your case is sufficient to warrant a quick approval. Take a look at this blog post I wrote that describes a case that is most likely headed to failed back status or at least chronic instability status.
Here are some case studies from recent cases I tried that involved chronic back pain and weakness:
Social Security Disability Back Pain Case Study #1 – this case involves a 58 year old male who had previously worked as a computer programmer.
Social Security Disability Back Pain Case Study #2 – this case involves a 59 year old male who had previously worked as a land surveyor.
Social Security Disability Back Pain Case Study #3 – this case involves a 49 year old female with documented degenerative disc disease that is not severe enough to warrant surgery.
Social Security Disability Back Pain Case Study #4 – this case involves a 50 year old male with chronic cervical (neck area) degenerative disc disease plus depression, anxiety, and bi-polar symptoms.
Social Security Disability Bank Pain Case Study #5 – this case involves a 60 year old man who underwent a multi-level decompression and fusion, stayed out of work for 25 months, then went back to work driving a truck, against medical advice.
Social Security Disability Back Pain Case Study #6 – this case involves a 41 year old female who underwent a cervical (neck) fusion almost 20 years ago, and now experiences myofascial pain, back pain radiating into her legs and carpel tunnel syndrome.
Social Security Disability Back Pain Case Study #7 – this case involves a 47 year old male with severe degenerative disk disease in his lower back following a fall from a ladder. His case was complicated by bilateral knee pain and coronary artery disease.
Social Security Disability Back Pain Case Study #8 – this case involves a 53 year old female with a long and consistent work history, with bulging and herniated discs at multiple levels, thyroid dysfunction and diabetes
Social Security Disability Back Pain Case Study #9 – this case involves a 44 year old female with an 8th grade education who injured her back in a serious car accident but was able to return to work around 18 months after her accident.
Social Security Disability Back Pain Case Study #10 – this case involves a 52 year old male who injured his back after falling from a truck
Social Security Disability Back Pain Case Study #11 – this case involves a 56 year old female whose experienced severe degenerative disc disease after years of working in a carpet mill
Social Security Disability Back Pain Case Study #12 – this case involved the claim of a 55 year old male who relies on long term pain management following unsuccessful back surgery
Failed Back Syndrome – SSDI Hearing Case Study #13 – this case involved the successful claim of a 42 year old male referred to long term pain management following 2 unsuccessful low back surgeries.