SSDI Eligibility Guidelines: Spinal Disorders
Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,170 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
Conclude the spinal disorder disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
Disorders of the spine are listed under the category of impairments known as Musculoskeletal System – Medical Listing 1.04. Disorders of the spine such as herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture, result in limitations because of distortion of the bony and ligamentous architecture of the spine and associated impingement on nerve roots (including the cauda equina) or spinal cord. The following criteria have been established indicative of the inability to engage in any substantial gainful activity, i.e., if one has a diagnosis of a disorder of the spine and one of the following, a finding of disabled under the Social Security Act is warranted:
- Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine).
- Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours.
- Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively.
Explore the ability of an individual to perform work they have done in the past despite their spinal disorder. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine spinal disorder disability, the SSA enlists medical-vocational rules, which vary according to age.
Social Security Rulings 85-15 and SSR 96-9p both describe how an individual must, on a sustained basis, be able to understand, remember and carry out simple instructions; make simple work-related decisions; respond appropriately to supervision, co-workers, usual work situations and to deal with changes in a routine work setting.
A substantial loss of ability to meet any one of these basic work related activities would severely limit the potential occupational base for all age groups and justify a finding of disabled. A person who has a medically determinable severe impairment of spinal disorder and is unable to understand, remember or carry out simple instructions would be found disabled based on his/her mental residual function capacity.
SSDI & Spinal Disorders: A Personal Story
Read how one person’s journey to approval was made easier with True Help.
Her Home & Health Hung in the Balance
Tucson, Arizona –Her dire financial straits forced Lynn Eddins to put her house on the line. To cover medical bills while she awaited approval of her disability claim…
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