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Social Security Disability Benefits For Spinal Arachnoiditis

I have been diagnosed with spinal arachnoiditis. Can I apply for Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

Have you received a diagnosis of spinal arachnoiditis? This is just the start. The main focus in a Social Security disability claim is usually on the symptoms you experience from spinal arachnoiditis and how those symptoms affect your ability to engage in physical and mental work-related activities full-time – that is, eight (8) hours per day, five (5) days per week.

Within your spinal cord, there are membranes that protect the nerves. One of these membranes is called the arachnoid, and when it is inflamed, the disorder is called arachnoiditis. Various things can cause arachnoid inflammation, including spine injury, infection, spinal surgery complications, and even some medical chemicals.

Arachnoiditis has no consistent symptoms, but the most common sign is pain in the lower back and legs. Also watch out for severe stinging sensations, leg weakness and/or numbness, severe shooting pain, muscle cramps and/or twitching, and even bladder problems. Some patients also experience sensations of insects crawling or water trickling along the leg.

Is arachnoiditis a disability?

The danger with spinal arachnoiditis is that its symptoms can worsen and become permanent over time. Many patients with this condition end up suffering from significant disability because of the pain.

To confirm that spinal arachnoiditis has disabled you, the Social Security Administration (SSA) uses a 5-step process.

Step 1. Do you have work that is a gainful activity?

The first step is for the SSA to consider your work activity. If you are engaged in Substantial Gainful Activity (SGA) you will not be found to be disabled.  The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled.  If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your spinal arachnoiditis is evaluated more closely.

Step 2. Can your illness be considered “severe”?

The SSA’s definition of disability entails that your medical condition must significantly limit your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.

Specifically, for the SSA to find you disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits. If your condition is that severe, the SSA goes to Step 3.

Step 3. Does your illness match a “listing” of the SSA?

The Social Security Administration has a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them. The Adult Listing for spinal arachnoiditis can be found here.

If none of your impairments meets or equals one of the listings, or the duration requirement is not met, the SSA determines your Residual Functional Capacity (RFC).

In a nutshell, the RFC is what you’re capable of doing despite your impairments. It involves a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments.

Step 4. Can you still perform any of the jobs you’ve had in the past fifteen (15) years?

At this point, the SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity (SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, SSA goes on to Step 5.

You have the “burden of proof” at Step 4. In other words, you are required to present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.

For disability based upon spinal arachnoiditis, some types of objective medical evidence that can support a claim include:

  • General clinical records
  • Documentation of medically prescribed treatment and response
  • Imaging results (MRI, CT scan, or x-ray)
  • Clinical notes of specialists

Doctors who specialize in treating spinal arachnoiditis include:

  • Orthopedists/Orthopedic surgeons – These doctors specialize on the musculoskeletal system (bones, muscles, nerves, joints, tendons, ligaments, and skin).
  • Neurologists/Neurosurgeons (spine surgeons) – Their specialty is on the nervous system.
  • Physiatrists (Physical Medicine and Rehabilitation physicians) – These doctors treat medical conditions of the brain and musculoskeletal system.

Note that if you are only treating with your family doctor or primary care doctor for your spinal arachnoiditis, the SSA may think that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).

Step 5. Is there other type of work you can do?

Here, the “burden of proof” is on the SSA. If you cannot do your past relevant work, SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, the SSA will determine you are not disabled. If you cannot do other work, SSA will find you disabled.

Are you older than 50? There are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.

It is unfortunate that spinal arachnoiditis is commonly considered in the medical community as incurable as of now. However, the good news is that you may experience a form of relief if you are approved to receive disability benefits.

Contact Gillette Law Group

Your best chance to successfully apply for these benefits is to enlist our team at the Gillette Law Group. For years now, we have been helping applicants like you in pursuing an effective disability application, regardless if they’re first-time claimants or appealing their previously-denied claim. With our extensive experience, we can help you develop a claim that the SSA is much more likely to approve.

Please don’t hesitate to talk to us for any concern regarding your disability claim. Your consultation with us is free. Call us today at (855) 873-2604.

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