Applying Specific Medical Tests To Your Case For Disability
Several medical tests, including X-rays, MRI and CAT scans, and other tests and examinations, can be used as ways to confirm that you are suffering from a disorder that is causing severe back pain and difficulty with your mobility. The SSA may order an additional medical evaluation at their expense to confirm your condition and the severity of your symptoms. The SSDI application process can be lengthy and may involve denials and appeals.
At Jan Dils, Attorneys at Law, we have more than 25 years of experience working with the SSA. We can tell you if you have a credible case and help you present it. Patients suffering from musculoskeletal conditions incur medical costs of about $240 billion per year in the United States. Medical bills and the inability to work can be financially devastating. Dont go it alone. Contact us at 877.526.3457, jandils.com, or fill our this form and we will get back to you shortly. Your first consultation is always free. Please, now more than ever, dont hesitate to contact us.
How Social Security Evaluates Your Credibility
Officially, Social Security follows the criteria in the listings and the rules regarding your RFC to determine whether you are disabled. But since your claim is probably largely based on your subjective reports of back pain, the claims examiner or judge determining the outcome of your claim is likely to try to assess how believable your symptoms are.
Social Security no longer formally assesses your “credibility” as part of a claim. But your credibilityâwhether the claims examiner and/or administrative law judge believes your pain is as bad as you say it isâis still likely to matter in chronic pain cases.
Pain complaints must be supported and consistent. Social Security will look to see whether your reports of back pain are supported by medical evidence and consistent with objective test results and other information in your application. If any test results or medical information in your file is inconsistent with your reports of how much you’re limited by your pain, Social Security may find that the extent of your limitations isn’t supported by the test results or other information. For instance, if an applicant says on his function report that his back hurts so much that he can only stand and walk a few minutes per day, Social Security would expect to see signs of muscle wasting. If the applicant’s doctor hasn’t recorded any muscle wasting, yet the applicant shows reduced muscle strength on clinical testing, Social Security might find that inconsistent.
Free Denial Letter Review By Our Long
The Law Office of Kevin J. McManus represents clients who are applying or who have been denied long-term disability benefits. We are licensed in Missouri and Kansas, and able to assist clients nationwide with ERISA LTD claimsby working with local counsel and approval by the court. Please contact our office by calling 816-203-0143 to request a free denial letter review or help with obtaining long-term disability.
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Using Your Rfc For Back Pain To Qualify For Disability
If your back pain doesn’t meet the impairment listings for any of the conditions mentioned above, the SSA will assess your residual functional capacity . Your RFC is the most that Social Security thinks you can do despite the limitations caused by your medical conditions.
To develop your RFC, Social Security will want to know whether:
- you have trouble walking
- your range of motion is limited so that you can’t stoop or bend
- you are very limited in the amount of weight you can lift and carry, and
- you need to switch positions frequently.
To learn about the RFCs that Social Security develops for each type of back condition, read one or more of the following articles:
For more information about back RFCs in general, see our article on how Social Security assesses a reduced RFC due to back problems.
Examples Of Functional Limitations
- Unable to remain seated for 6 hours in a normal workday
- Unable to stand for 2 hours a day
- Unable to walk one block without stopping
- Need to lie down during the day
- Unable to carry 10 pounds intermittently during a workday
- Must keep one or both legs elevated during the day
- Maintain Your Credibility
When you have to appeal up to a hearing, the administrative law judge may also consider your personal statements to determine if they are believable or if you seem to be exaggerating your claims. A psychiatric consultation could also be ordered for a better picture of your mental health and to assess whether your claims are inconsistent with what is expected with your particular condition.
To gauge your credibility, a hearing officer or judge may consider the following:
- Your statements
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What Should Your Medical Records Include
In order to determine whether your back condition meets the listing for disorders of the spine, Social Security will need to see all of your medical records from the various doctors you’ve seen. If you haven’t already, Social Security will require that you undergo a comprehensive spinal exam. Preferably, you have already visited an orthopedic doctor who has conducted a detailed physical exam, including testing your reflexes, sensation, muscle strength, and range of motion, as well as your ability to walk, bend, squat and rise.
When Social Security is evaluating the validity and severity of your pain, the agency will look at how often you’ve been to the doctor and what treatments you’ve tried. A longitudinal record is most helpful .
Your medical records should document the various treatments you’ve undergone , including how long the effects of treatment lasted and whether the side effects of any medication or treatment impair your ability to work or function.
Your records should also include an X-ray, MRI, CT scan, or myelogram . Because Social Security won’t solely rely on a patient’s subjective symptoms of pain as an indicator of whether you can work or not, the results of these imaging tests can be extremely important for your case.
How To Prove You Deserve Disability Benefits
Medical evidence is the most important part of your case for disability benefits for back pain.
Social Security says MRIs, X-rays, physical exams, and reports from physical therapy are all forms of medical evidence you can use to prove your case.
Your evidence must show one of the following:
- Youre suffering from nerve root compression, have a limited range of motion in your spine, and have a sensory or reflexive loss.
- Youre suffering from spinal arachnoiditis, as supported by medical imaging evidence, meaning you need to change positions or posture at least twice every two hours.
- You have a medically documented inability to move about, caused by lumbar spinal stenosis that produces leg pain, especially when standing or walking.
Our firm can help review your medical records and build you a convincing case.
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Listing 115 Nerve Root Involvement
If you have compressed nerves, Social Security will evaluate your condition under listing 1.15 for “disorders of the skeletal spine resulting in compromise of a nerve root.” To meet listing 1.15, your medical records must show that you experience pain, muscle fatigue, or burning/prickling sensation that starts in your back and travels into one or both legs. An examination by your doctor or imaging like an X-ray or MRI must also show muscle weakness and signs that something is pushing on the nerve root with one of the following:
- sensory changes, evidenced by either decreased sensation or abnormal “sensory nerve latency” on electrodiagnostic testing , or
Social Security gives several examples of back conditions that involve nerve root compression, which can cause problems from mild chronic pain to paraplegia in the worst cases:
- vertebral fracture.
What Are Va Benefits For Back Pain
First of all, although it is possible to receive benefits for pain incurred during your time in service without a diagnosis, it is not guaranteed. A current diagnosis is always recommended if possible to obtain. In addition to your current diagnosis, you will need to include a NEXUS letter and DBQ to partner with your medical evidence and in turn, prove your service-connection. Without these outside documents, you are significantly decreasing your chance of winning your VA disability for back problems claim.
In determining benefits, the VA refers to the back as the thoracolumbar spine. This is the term used to reference middle or lower back pain. The VA considers upper back pain in the same category as neck pain. Therefore, anything above middle or lower back pain will be referred to as the cervical spine and falls under a different rating system.
The thoracolumbar spine is composed of two parts of the spine the thoracic and the lumbar . These are the two areas that will be examined in order to determine benefits for any back pain.
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The Ssa Evaluation And Medical Qualifications
The SSA uses their own medical guide to evaluate disability benefits applications that they receive. This guide, known as the Blue Book, helps to determine whether or not an individual meets the criteria to be considered disabled and eligible for SSDI. There is no listing for back pain, but there are listings that apply to specific conditions that cause the pain. As an example, degenerative disc disease does not have a specific listing. You have to have severe symptoms such as requiring assistance to walk, needing to adjust your position more than every two hours, and suffer from nerve-specific problems.
Regardless of the cause of your back pain, you have to provide evidence of how it impacts your ability to work and causes your daily limitations. Your documents need to include notes from your physician about limitations you have when walking or standing, and if you have to have a cane, walker or crutches in order to be mobile. These are all considered with great weight when making a disability determination decision.
What Do You Need To Prove There Are No Jobs You Could Do
In order to prove there are no jobs you could do, you need medical documentation from your doctors of all of your medical conditions. This means you need to make an effort to get regular treatment to document your condition over time. Further, it is helpful to get statements from your doctors on how your medical condition limits your ability to work. This can include a letter from the doctor or simply having your doctor fill out a questionnaire on your condition. Doctors often do not comment on your ability to work in their office notes because theyre focused on treating you rather than commenting on your ability work. It helps to ask your doctors opinion on your ability to work. Our firm often gives our clients questionnaires to take to treating physicians to document your symptoms and how they would limit your ability to work. We have developed questionnaires over time that ask the questions we have found are helpful in proving your case.
It can be overwhelming to try to prove that you are disabled. You have to collect medical records and submit them to social security and you have to get opinions from doctors that prove your inability to work. We can help you get all this information and improve your chances of getting social security disability benefits. Our Atlanta Social Security Disability lawyers can help you prove you are entitled to Social Security Disability due to your back pain, feel free to contact us for help.
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Proving Va Service Connection For Your Back Condition
According to the VA, to prove a service-related back injury you must:
- Provide VA, military or private medical records related to your back pain injury claim that support when your condition began and how it has worsened over time.
- Provide military separation documents, including your DD-214
- Provide supporting statements from family members, friends, clergy members, law enforcement personnel or those you served with that can tell the VA more about your claimed condition and how and when it happened or how it got worse.
Documenting Chronic Back Pain For Long
Your doctor may perform a variety of diagnostic tests to determine the cause of your back pain. Tests may include x-rays, MRIs, and CT scans. This objective medical evidence is the most convincing evidence of chronic back pain you can submit for a long-term disability claim.
However, most LTD claims for back pain do not have clear and convincing diagnostic tests to prove the cause of the back pain. Even in cases with a precise diagnosis of a condition that generally causes chronic back pain, a person may not receive LTD benefits. The condition must be disabling. Two people could have the same condition, but one person may not suffer from disabling pain and restricted range of motion.
What To Do If You Have Chronic Back Pain And Cannot Work
See your doctor immediately for diagnosis and treatment. You need to document your condition through diagnostic testing and clinical evaluations. Make sure that you follow the prescribed treatment by your doctor. If you fail to follow your doctors treatment plan, the insurance company will use that against you.
If your back pain causes you to suffer from emotional disorders, such as anxiety or depression, you should consider seeking mental health therapy. Your mental health therapy can also be used to support your LTD claim for back pain.
LTD claims for back pain are complicated. Many claims are denied and must be appealed. Our attorney can help you take steps that improve your chances of appealing a back pain LTD claim. Our lawyers can gather evidence that helps establish your inability to work because of chronic back pain.
In some cases, our attorney may suggest seeing another physician or specialist who can provide additional evidence of your condition and your decreased ability to perform various functions required for daily living and working.
Document Your Back Condition For The Ssa
Back conditions that cause pain are one of the most common injuries on the job. It is also an impairment that can become worse over time. It is important to document any back injury or surgeries to apply for disability benefits. Applications should be made online at Social Securitys website.
Prior to making application for benefits, have a list of your doctors and their addresses. Also, have a list of all of your medications and their daily dosage. You will be asked a number of times throughout the Social Security process to list your medications. If you have any side effects or symptoms, such as fatigue or brain fog, then make sure to include those symptoms in your SSA paperwork.
Cannon Disability Law can help you apply for benefits. We have application experts who know the SSAs questions and can help you file your application. Our lawyers and staff can help you whether you live in Utah, Nevada, Idaho, California, Colorado, or any state in the Intermountain West.
Back Conditions That May Qualify For Social Security Disability
Given the important role of the spine in providing structure, flexibility, and movement throughout the entire body, certain back conditions can have a tremendous impact on your ability to work. In fact, the Social Security Administration receives more SSDI/SSI applications based upon back problems than any other disabling medical condition. For many individuals filing claims, the process is relatively straightforward because they meet an item in the SSAs Blue Book, i.e., the Listing of Impairments affecting the Musculoskeletal System.
However, many applicants will encounter substantial challenges in obtaining SSDI/SSI benefits when trying to show that their back condition equals a Blue Book listing. For this reason, it is best to retain a to assist with the claims process and ensure your application contains the essential details. You may also find it helpful to review the primary back conditions that may qualify you for disability benefits.
- One or more fractured vertebrae
- Degenerative joint disease or
Can You Get Disability Benefits For Back Pain
Weve discussed the importance of your health issue being deemed severe but how is that determination made in the first place? The short answer is that the SSA uses a document called the Listing of Impairments. If your symptoms can match or equal the symptoms given for your condition in the Listing, your medical problem may be deemed considered severe enough to merit a disability award. However, heres where it can get complicated: there is no listing devoted explicitly to back pain. Fortunately, that doesnt mean you cannot qualify it simply means you need to take a slightly different route. For example, you may be able to qualify if:
- Your back pain is attributable to another condition which is in the Listing. For example, if your back pain is related to a problem with your spine, you may qualify under Section 1.04 of Section 1.00, which is devoted to musculoskeletal disorders. It should be noted that if you are trying to qualify in this manner, you will need to match or equal the Listing criteria associated with spinal disorders, such as evidence of nerve root compression. Under Section 1.04, examples of eligible spinal disorders include:
- Spinal Stenosis
- Spinal Arachnoiditis
- Facet Arthritis
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