SPINAL DISORDERS & SSD BENEFITS – LISTING 1.15
SSD BENEFITS FOR SPINAL DISORDERS
Spinal disorders can keep you from working and result in SSD benefits. Do you have a spinal condition that prevents you from working? To qualify for Social Security Disability (SSD) benefits and SSI benefits, the SSA requires you to have a severe medical condition that lasts for at least one year or more.
This means that MRI’s, CT scans, or x-rays, should show show that you cannot work for over 12 months due to your spinal disorder. It also means that you will need ongoing, monthly treatment from the doctor to prove your condition to the SSA. Your treating doctor should submit all of your medical records and write a letter to the SSA stating why you cannot work. Without medical records and the support of your doctor, you will not win benefits.
Some spinal conditions don’t produce pain, even if the disc is damaged. But it is pain from a spinal condition that can keep you from working a 40 hour work week. Therefore, if you have back arthritis, but you do not have pain or limitation in your ability to function, then you are unlikely to win benefits.
Millions of people suffer from spinal disorders. It is one of the most common reasons people file for SSDI and SSI benefits. Social Security approves only the most severe cases of back pain. Likewise, they only approve claims that have medical evidence which shows you cannot work at any job. Most people who apply for benefits due to spinal conditions have already had surgery. They may be experiencing lumbar pain that radiates down their legs and prevents them from lifting, standing, walking, or sitting.
The SSA recognizes spinal conditions under Listing 1.15. Below please find a copy of the current back listing. Go here for information about the previous back listing. If you can show you have a nerve root compression, spinal arachnoiditis, or lumbar spinal stenosis, you may meet SSA’s rules to receive benefits.
TWO FORMS OF SOCIAL SECURITY BENEFITS
If you have a spinal disorder, then. there are two forms of benefits for which you can file an application: Social Security Disability benefits and Supplemental Security Income benefits. You can file an application online at the Social Security’s website. Below, you can find an explanation as to each type of benefit you can apply for:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who have worked and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history. To qualify for SSDI, you must have earned enough “work credits” to qualify. A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, you will only file for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income and assets. If you have a spouse who earns more than $4000 a month, for example, then that income will prevent you from getting SSI benefits. You cannot win SSI benefits, no matter how severe your medical condition, if you do not meet the income and asset rules for SSI.
MOST COMMON TYPES OF CHRONIC SPINAL DISORDERS
The most common type of spinal condition for which we see people filing for SSDI and SSI benefits is degenerative disc disease. There are four regions of your spine and the most common region for pain, arthritis and injury is the lumbar spine. The other three regions are the cervical spine, (which is the neck), the thoracic spine (the middle and upper back), and the sacral spine (the pelvic area). The most common cause of back pain is osteoarthritis or degenerative disc disease. Another common cause of back pain is severe scoliosis.
Back pain can be acute or it can turn into chronic back pain. Acute back pain is short term pain. It will last for a few days to a few weeks. Normally, if your spinal condition is due to overuse or moderate injury, then the pain will go away after rest, icing and heating the muscles.
Chronic spinal conditions continue for 12 weeks or longer. For example, chronic back pain results in ongoing symptoms, such as muscle spasms, limited movement, shooting pain, and numbness in your arms and legs. If the pain is due to a herniated disc that is compressing your nerves, then it might require surgery. Sometimes, your doctor will need to do a combination of these operations. Learn more information about spinal cord injury.
SSD PAYMENTS FOR BACK PAIN FALL UNDER LISTING 1.15
SSA issues rules that define how to win SSD benefits for back. For example, SSA Listing 1.15 is used to document a back condition that is causing compromise of a nerve root. When a nerve root is damaged this results in pain. It can also cause muscle spasms and loss of sensation in your arms or legs. Nerve root pain can result in being unable to sit, stand, and walk. See below for the listing the SSA uses for severe spinal conditions.
SPINAL DISORDERS UNDER LISTING 1.15
1.15 Disorders of the skeletal spine resulting in compromise of a nerve roots documented by A, B, C, and D:
A. Neuro-anatomic distribution of one or more of the following symptoms consistent with compromise of the affected nerve roots:
AND
PART B OF LISTING 1.15
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:
2. Signs of nerve root irritation, tension, or compression, consistent with compromise of the affected nerve root.
3. Sensory changes evidenced by:
b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or
4. Decreased deep tendon reflexes.
AND
PART C OF LISTING 1.15
C. Findings on imaging consistent with compromise of a nerve roots in the cervical or lumbosacral spine.
AND
PART D OF LISTING 1.15
D. Impairment related physical limits of musculoskeletal functioning that has lasted, or is expected to last, for an ongoing 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 that involves the use of both hands; or
2. Unable 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 that requires the use of the other upper extremity or a wheeled and seated mobility device that involves the use of one hand; or
3. Unable to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work related activities that involves fine and gross movements.
HOW TO MEET LISTING 1.15 AND WIN BENEFITS
In order to win SSDI and SSI benefits, you must have a spinal condition that meets all of the elements found in listing 1.15. Sometimes, the listing is also called the “Blue Book.”
The SSA reviews your medical records and compares your symptoms to those in the listing. If you have all of the symptoms and elements on the listing, then you “meet” the listing. Meeting the listing is difficult to do. But, if your medical condition does meet the listing, then you will be paid SSDI and SSI benefits. Learn more about what it takes to meet the SSA listing.
It is also possible to “equal” the listing and win benefits. In order for the SSA to find that you have a medical condition that is equal to a listing, your back symptoms must be equal in severity and duration to a medical condition on SSA’s list. To understand this idea, think of not having all of the symptoms you need to meet a listing, but perhaps you have two severe medical conditions. Those two conditions, when combined, can “equal” the severity of one listing. For example, perhaps you have a spinal condition and ankle arthritis. Together, those two conditions may equal a listing.
SPINAL DISORDERS THAT QUALIFY FOR SSD BENEFITS
Most people with back pain will have seen a doctor and a surgeon. First, your pain will be so severe that you will have trouble standing, sitting, and walking. Usually, if you have lower back pain, the pain will radiate from your low back down into one of your legs. Sometimes, pain can go down both legs. This pain is called sciatica. The causes of it is usually a pinched nerve. This can occur from a disc bulge or herniation. Sciatica and back pain impairs your ability to walk, sit, stand and lift.
Likewise, you can also have neck pain. Arthritis in the upper back and neck can cause radiating pain down your arms and headaches. For instance, if one of the discs in your neck degenerates, it might pinch a nerve that goes into your arm. Your arm will feel numb, like when you arm falls asleep. Also, you might have pain and be unable to use your fingers to perform tasks, like picking up coins. Read here, to learn more information about SSD benefits for neck pain.
TREATMENT FOR CHRONIC SPINAL DISORDERS
Treatment for chronic back and nerve pain usually requires physical therapy, medications, and epidural steroid injections. If this type of conservative treatment does not work, then your doctor will normally recommend surgery. Before having surgery, make sure you find a surgeon who has an excellent reputation. Also, try everything you can to help cure your back pain before having surgery. Only have surgery if you fail more conservative measures.
For example, you should try physical therapy and pain medications. Also, try acupuncture, yoga, and chiropractic care. If you try all of these treatments, you will know if anything makes your pain go away. If it does not, then surgery may be your only remaining option. Once you have surgery, you may be able to return to work. If not, then you may be told you have a failed back surgery. If you have failed back surgery, you need to apply for SSD and SSI benefits.
APPLY FOR SSD AND SSI BENEFITS IF YOU CANNOT WORK
Many people wait to apply for SSD benefits because they think they are going to get better. For example, you may have hurt your back at work. After physical therapy and other treatment, your doctor might decide you need surgery. Perhaps you believe that once you have back surgery you will be able to return to work. Unfortunately, there are times when surgery does not work.
If you wait to apply for benefits until long after back surgery, you may miss out on months or years of SSD benefits. This is money that you need to support yourself while you are not working. Benefits can also provide Medicare or Medicaid, which is health insurance that you need to obtain surgery or get ongoing treatment for back pain.
If you have severe back pain and cannot work, you should apply for SSD benefits. You should not wait to apply until you get better or until you think you will no longer have back pain. Social Security Disability benefits are based upon the number of years you work and the amount of money you earn. The amount of the monthly benefit is different for everyone. If you have not been able to recover after a back operation, are still using a cane or walker and suffer from severe pain, you can probably win benefits.
WE CAN WIN SSD BENEFITS FOR SPINAL DISORDERS
Contact Cannon Disability Law today to see if you qualify for SSD benefits or Supplemental Security Income. We can often tell you over the phone if you have a good case. Please call us and tell us why you cannot work. We also need to know who your doctors are and if you have already sent in an application for benefits. We have won over 20,000 SSDI and SSI claims for our clients.
Our attorneys practice in Utah, Nevada, Idaho, and California. Our main office is in Salt Lake City, Utah. However, we can represent you where you live. Likewise, we practice in Nevada and Idaho on a routine basis. Also, we have attorneys that are members of the bar in those states.
Additionally, Dianna Cannon is a member of the bar in California. Don’t wait to contact our law firm today, because your monthly benefit doesn’t start until you apply. Therefore, every day you wait to apply is a day you lose benefits. Call now and start the process to win SSDI and SSI benefits for your spinal disorder.
