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Social Security Disability Benefits For Spinal Stenosis
I have been diagnosed with spinal stenosis. Can I get Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?
If you have a diagnosis of spinal stenosis, it can be the start of your Social Security disability claim. However, the main focus in a claim is usually the symptoms you experience from spinal stenosis and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week.
Within the human spine, there is a channel or space occupied by the spinal nerves and spinal cord. The abnormal narrowing of this channel is called stenosis. When spinal stenosis occurs, it can put pressure on the nerves and consequently cause pain, numbness, tingling, and muscle weakness, which may all worsen over time.
Can you get disability for cervical spinal stenosis?
There are two types of spinal stenosis: cervical stenosis, which occurs near the neck, and lumbar stenosis, which is in the lower back. Most cases of spinal stenosis are a product of aging or age-related conditions such as overgrowth of bone and thickened ligaments. However, some cases are caused by tumors and spinal injuries. There are also people who are born with an abnormally narrow spinal canal.
To confirm that you are disabled, there is a five-step process that the Social Security Administration (SSA) uses.
Step 1. Do you have a gainful activity?
To start, the SSA considers your work activity. If you are engaged in Substantial Gainful Activity (SGA), you will not be found 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 stenosis is more closely evaluated.
Step 2. Does your illness qualify as “severe”?
The SSA wants to see that your medical condition significantly limits 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.
For the SSA to consider 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, SSA goes to Step 3.
Step 3. Does your illness match a “Listing”?
There is an important list that the Social Security Administration maintains, containing 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 stenosis can be found here.
If your medical impairment does not meet or equal one of the listings, or if the duration requirement is not met, the SSA moves on to see what you’re capable of doing despite your impairments. This is your Residual Functional Capacity (RFC).
To determine the RFC, the SSA does 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. In short, it is an evaluation of your capacity for full-time work.
Step 4. Can you still do any of the work you’ve done in the past fifteen (15) years?
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 the 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.
Here at Step 4, you have what is called the “burden of proof” or the requirement to present proof. 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.
Here are some types of objective medical evidence that can support a claim for disability based upon spinal stenosis:
- General clinical records
- Documentation of medically prescribed treatment and response
- Imaging results (MRI, CT scan, or x-ray)
- Clinical notes of specialists, such as those describing decreased range of motion and reduced muscular strength
Doctors who specialize in treating spinal stenosis include:
- Orthopedists/Orthopedic surgeons – They focus on the musculoskeletal system (bones, muscles, nerves, joints, tendons, ligaments, and skin).
- Neurosurgeons (spine surgeons) – They focus on surgical and nonsurgical treatments for the nervous system.
- Rheumatologists – They specialize on conditions affecting the joints.
- Physiatrists (Physical Medicine and Rehabilitation physicians) – They treat medical conditions of the brain and musculoskeletal system.
Bear in mind that if you are only treating with your family doctor or a primary care doctor for your spinal stenosis, the SSA may believe 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. Are you able to do other work?
At this point, the “burden of proof” shifts to the SSA. If you cannot do your past relevant work, the 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, the SSA will find you disabled.
If you are over 50 years old, 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.
Is severe spinal stenosis a disability?
Many people suffer from spinal stenosis, but unfortunately, not every one of them has been approved for disability benefits. In fact, about two-thirds of all initial disability claims get rejected.
Contact Gillette Law Group
Don’t let this discourage you. It is not easy to have your life restricted by the pain you are experiencing, and you may truly deserve assistance. You have a great chance to succeed in your application if you let us at Gillette Law Firm help you. We are experienced and proven effective in Social Security disability applications, both initial claims and appeals.
Let’s get started on your claim. Your consultation with us is free, so call us today at (855) 873-2604.