May 3, 2016
Applicants for disability caused by spinal disorders are subject to the Social Security Administration’s extremely specific requirements, and often do not qualify, even if their back pain is severe. The lawyers at Disability Associates, LLC share suggestions on how to navigate alternative pathways to disability benefits when back problems prevent normal work.
The Social Security Administration (SSA) classifies back conditions, injuries and pain under the category of ‘spinal disorders.’ In general, it has been described as difficult to qualify for disability benefits for back injuries or pain under this category. Applicants must submit medical records containing one or several conditions on this short list: nerve root compression, arachnoiditis, or stenosis, all of which are accompanied by severe pain.
If your disability claim for a spinal disorder is denied, the SSA is required to take into account your ability to work and perform the tasks of daily life with the back condition your application describes. The SSA also evaluates whether you are able to work at all, based on your medical records as well as several other factors.
The initial information the SSA uses to evaluate each applicant are his or her medical records, including medical test records and doctor’s notes. The SSA will then issue each applicant a Residual Functional Capacity, or RFC, rating based on the information in the medical records.
In order for you to qualify for RFC, your doctor’s notes must describe your spinal range of motion in detail. Often, doctor recommendations also include restrictions on heavy lifting, bending down at the waist, and sitting or standing for several hours at a time.
RFC ratings are the SSA’s interpretation of what amount of work the applicant is able to do during a normal work day. The most limiting back conditions should yield a score of sedentary work, light work and medium work are scores for conditions that have fewer movement restrictions, and heavy work is the restriction requiring the little or no modification to the applicant’s normal work day due to back problems. Sedentary work is considered a low RFC rating, while heavy work is categorized as a high RFC rating.
Most applicants for disability as a result of back problems are assigned an RFC of either light or medium work. Applicants with spinal osteoporosis, scoliosis with a spinal curve of 40 or more degrees, fusion of the lumbar or cervical vertebrae, postoperative pain from back surgery, degenerative disc disease, spondylolisthesis, or a vertebral compression fracture of 50% or more will most likely be assigned the light or medium work RFC rating.
In rare cases, applicants who have done heavy work jobs for most of their careers and receive RFC ratings of light or medium work will receive full disability benefits. Usually, however, this is not the case.
RFC Determines What Jobs You Can Do
Applicants who receive a low RFC rating will find that they qualify for very few jobs. The SSA will suggest possible jobs based on each applicant’s work history, age, and education. These demographic factors, combined with each applicant’s RFC rating, also allow the SSA to determine whether those who have been denied disability benefits initially for spinal disorders may still qualify based on other factors.
A rating of medium work will only result in the approval of disability benefits if the applicant is 55 or older, and whose highest level of education is 6th grade or lower. If awarded disability with a rating of medium work, the applicant is also entitled to a medical-vocational allowance. If you receive an RFC medium work rating and do not qualify for disability benefits, you will likely need to prepare to return to work at a different job that will cause less strain on your back.
Applicants who are 55 or older and receive an RFC rating of sedentary work will receive disability, while 30 year olds who have graduated from college or have well-developed job skills will not receive disability benefits. The SSA in this case assumes that a person with this amount of previous experience will not have trouble learning skills for new positions.
Receiving an RFC rating of sedentary work, or lower, provides you with the best chance of receiving disability benefits, no matter the age or level of education. Sedentary work limits applicants to jobs that do not require workers to stand or walk for more than 6 hours each day. You will likely receive a rating of sedentary work or less if your doctor recommends that you avoid sitting for 2 or more hours at a time, or if you are required to alternate between sitting and standing in order to reduce your back pain. Pain medicine also factors into RFC scores, as they have been proven to make concentration more difficult.
If you are unsure of whether you meet the SSA standards, the advice of an attorney can be helpful. An attorney with vast Social Security disability experience can help you understand the best questions to ask your doctor as to have a greater chance of receiving a low enough RFC rating to qualify for disability benefits. For more information on SSA standards and medical back issues, contact Disability Associates, LLC today.