SSA CHANGES DISABILITY LISTINGS FOR BACK CONDITIONS
Back disability benefits are, once again, going through changes by the SSA. The SSA changed their listing of medical conditions for people with a back disability. This change should concern to all lawyers and people who are seeking SSD and SSI benefits.
When the SSA changes the medical criteria for benefits, it effects million of people. Especially in this instance, because every year there are millions of SSD and SSI claims for back conditions. The new rules, including the new preamble, start on April 2, 2021.
Prior to filing an application for SSD benefits, you should read the rules that apply to your medical condition. That way, you will know what medical evidence you need to submit to prove to the SSA that you deserve benefits. Also, prior to a hearing with an SSA judge, you should review SSA’s rules. Because the judge is comparing your back condition to the listing.
WHEN WILL THE NEW RULES FOR BACK DISABILITY BENEFITS APPLY?
The current rules, which have been in place for a number of years, will continue to apply until April 2, 2021. However, the new rules, valid on April 2, 2021, will apply to new applications filed on or after April 2, 2021. Most importantly, the new rules will also apply to claims that are still pending on or after April 2, 2021.
What this means is if you had a hearing a few months ago and are claiming you cannot work based on back impairments, then the new rules will apply to you. They will apply to your case and the judge will use them in her decision, even if your hearing was before April 2, 2021. If the judge has not yet issued a decision in your case, then the new rules will apply.
It is important to understand the new rules, so that you can provide the correct medical evidence to the SSA. As always, the medical information that the judge sees is what wins the case. If you do not have the correct medical evidence, then you cannot win your case. This post applies specifically to the changes for back disorders that previously fell under listing 1.02.
NEW LISTING FOR BACK DISABILITY AND NERVE ROOT IMPINGEMENT – LISTING 1.15
The new SSA listing, which you can read below, replaces the old listing. Under the Social Security Administration’s listing you must show you have a severe medical condition. Also, you can refer to the Federal Register and read about the SSA’s reasoning in changing the back listing.
This listing still applies to those with a herniated spinal disc and neuropathy. You may have also heard that your back pain be called a ruptured disc, slipped disc, or degenerative disc disease. Herniated discs can cause sciatica. Likewise, sciatica or neuropathy occurs when pain radiates down the long sciatic nerve running from the lower back into the lower legs. The SSA rules contain all of these medical conditions.
In order to meet the listing, all of the symptoms under each element must be in your medical records and occur at the same time. The listing is long. Pay attention to the words “and” and “or.” If the word “and” is used, that means both elements are needed to meet the listing.
If the word “or” is listed, then only one element out of two is necessary. Please also note that the SSA requires the “bilateral” use of canes or assistive devices. Using a cane in one hand, for example, does not meet the listing. Meeting the listing requires having all of the elements on the list. Equaling the listing means you have a combination of medical conditions that are as severe as meeting the listing.
Musculoskeletal Disorders
1.15 Disorders of the skeletal spine resulting in compromise of a nerve roots documented by A, B, C, and D:
A. Neuro-anatomic (radicular) distribution of one or more of the following symptoms consistent with compromise of the affected nerve roots:
1. Pain; or
2. Paresthesia; or
3. Muscle fatigue.
AND
B. Radicular distribution of neurological signs present during physical examination or on a diagnostic test and evidenced by 1, 2, and either 3 or 4:
1. Muscle weakness; and
2. Signs of nerve root irritation, tension, or compression, consistent with compromise of the affected nerve root
3. Sensory changes evidenced by:
a. Decreased sensation; or
b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or
4. Decreased deep tendon reflexes.
AND
BACK DISABILITY – THE PART C CRITERIA FOR THE SSA LISTINGS
C. Findings on imaging consistent with compromise of a nerve roots in the cervical or lumbosacral spine.
AND
D. Impairment-related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following:
1. A documented medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device involving the use of both hands; or
2. An inability to use one upper extremity to independently initiate, sustain, and complete work related activities involving fine and gross movements, and a documented medical need for a one handed, hand held assistive device (cane) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand; or
3. An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work related activities involving fine and gross movements.
MEDICAL EVIDENCE THAT HELPS YOU WIN BENEFITS FOR YOUR BACK DISABILITY
Medical record evidence is the single most important part of your Social Security case. Building that medical evidence is the best thing you can do to help yourself win SSD and SSI benefits.
At Cannon Disability Law, we can help you build your case with medical records. Many people who apply for benefits think they can explain their back pain to a judge and their explanation will win the case. Nothing could be further from the truth.
The law requires the judge to find medical evidence of your back condition and how it limits you in your medical records. The judge must determine if you have a “severe impairment.” Next, the judge must determine if your back condition keeps you from working.
We have resources on this website that can help you find a low cost doctor or a free doctor in Nevada and a free or low cost doctor in Utah. We also have information about how to obtain your medical records for free. If you have medical insurance, use it. Visit your doctor. Tell your doctor what is wrong with your back. Then, get treatment and follow it. None of our resources will do you any good if you don’t also go to the doctor on a regular basis.
Another thing that is very important is building a relationship with your doctor. You cannot do this unless you visit the doctor on at least a monthly basis. Additionally, your doctor will usually prescribe medication for you if you have a pain from your back condition. Follow the treatment. Then, send your records to the SSA.
WHAT TO DO IF YOU DO NOT MEET OR EQUAL THE NEW BACK LISTING
If your back disability does not meet or equal the listing, there is another way to win benefits. You can obtain SSD & SSI benefits by proving your residual functional capacity (RFC) eliminates your ability to sustain full-time work at any job. Your RFC is a determination of what you are physically capable of doing in an eight hour workday. Another way to think of it is having your doctor outline your physical and mental conditions. The outline needs to be specific.
For example, it will be helpful to your case if your doctor writes in your medical record that due to your back condition, you are not able to lift more than 10 pounds. Also, your doctor could write that you cannot stand for more than 2 hours in an 8 hour day. These two limitations will prevent you from performing many types of work.
You would not be able, for example, to perform medium or light work. Both of which require the ability to lift more than 20 pounds and stand for up to 6 hours in an 8 hour workday. For instance, you couldn’t be a cashier or work at a warehouse, because you couldn’t physically perform that duties of that work.
If you do not have this kind of evidence, then you should request an exam by the SSA doctor. The SSA sends people to physical and mental doctors at no cost to you. These doctors can examine you and they will write a report to the SSA about your physical limits.
CANNON DISABILITY CAN HELP YOU WIN BENEFITS
As you can see, the SSA back listing is complicated. It is best to hire an experienced attorney to present your case. When you hire us, we will help you file your application. Also, we will help you complete SSA’s paperwork. The SSA will probably deny your case, because the SSA denies most cases. However, we will appeal for you. If you need to go to a hearing with a judge, then you should not go alone. Experience counts. Hire an experienced attorney to present your case to the judge.
Remember, if you hire us to represent you and we do not win your case, then you do not owe an attorney fee. Do your research. Find out how many cases your attorney has done. Then, hire the legal team with the most experience.
If you want to find out more about our legal team, then call our office. You can also read About Us. Dianna Cannon has 30 years of experience winning SSDI and SSI cases. Andria Summers has 20 years of experience helping our client on appeal and in court. Brett Bunkall has won hundreds of SSD cases in Utah, Nevada, Idaho, and California.
Our legal team understands Social Security law and knows how hard it can be to go through this application process. You should leave it up to us. We have won over $100 million in ongoing and back due SSD benefits for our clients. Although we can’t guarantee we will win your case, we will do our very best to help you through the Social Security process. Therefore, contact us today. Hire an SSDI attorney with the experience to deal with the SSA.
