SCOLIOSIS & PROVING DISABILITY
WHAT IS SCOLIOSIS?
Scoliosis is the abnormal curvature of the spine. If the curvature is severe it can cause pain and limit your mobility. The severity of your scoliosis depends upon the amount of your spinal curvature. In order to have the diagnosis of scoliosis, your spine must curve abnormally to the side and have at least a mild curvature of 10+ degrees. However, a 10 degree curvature is mild and will not usually cause you to be unable to work.
Scoliosis curvatures range from 10+ degrees to 150 degrees. Some forms of scoliosis cause the spine to form a “C” shape. Other forms cause the spine to form an “S” shape.
Furthermore, some forms of scoliosis are rotational in nature. Scoliosis causes the sides of the body to look uneven. For example, your shoulders, waist, or hips may be uneven. Additionally, severe scoliosis can make your rib cage twist. This can damage your heart and lungs and also, make breathing difficult.
Scoliosis is one of the most common back conditions. For example, in the United States, almost 3 million cases of scoliosis are found every year. Additionally, at least 80% of scoliosis cases are idiopathic. This means that the doctors doesn’t know what is causing the condition. However, many scoliosis cases are genetic or occur because of trauma. Also, the condition can occur as a result of another disease.
FOUR TYPES OF SCOLIOSIS
Doctors define different forms of scoliosis from the cause of the condition. For example, your scoliosis may be due to genetics or it could be due to spinal trauma. These forms of scoliosis have different names, even though the end condition is the same.
1) CONGENITAL SCOLIOSIS
Congenital scoliosis is one form of scoliosis. This form of scoliosis is present at birth. It occurs because the spinal vertebra are malformed. Therefore, this form of scoliosis is usually hereditary or genetic.
If you are born with scoliosis, you may undergo surgery to correct the spinal curvature. The goal of spinal surgery is to fuse the vertebrae so the spine cannot bend. This corrects the scoliosis deformity. Or, at the very least it prevents the curve from getting worse. Your doctor will try to correct the curvature by 50 percent or more.
Depending on how much flexibility is still in the spine, scoliosis surgery can also de-rotate the abnormal spinal twisting. These changes can help your stand up straighter and reduce the rib hump in your back. A rib hump is an imbalance in rib height causing one side of the rib cage to protrude more than the other. This is due to the presence of an abnormal spinal curvature, usually along the thoracic spine.
2) NEUROMUSCULAR SCOLIOSIS
Neuromuscular scoliosis is the second form of scoliosis. This form of scoliosis is usually secondary to a disease or another medical condition. Typically, the disease or medical condition impairs your ability to control the muscles that support the spine. For example, cerebral palsy is a neurological condition that can create scoliosis. Find more information on cerebral palsy here. Another example of a disease that can cause scoliosis to occur is muscular dystrophy.
3) DEGENERATIVE SCOLIOSIS
Degenerative scoliosis is a third form of scoliosis. Degenerative scoliosis is caused by degeneration in the spine. For example, if you have arthritis in your spinal vertebrae, you may develop degenerative scoliosis. In other words, if your spine degenerates, it may start to curve. You may have a condition like Scheuermann’s disease.
Depending on the degree of spinal curvature, you may experience pain. Pain related to degenerative scoliosis can range from a dull backache to severe sciatica, which is pain down your legs. Scoliosis symptoms vary greatly, depending on factors such as your age and ongoing arthritis in your spine.
4) TRAUMATIC SCOLIOSIS
Traumatic scoliosis is the fourth form of scoliosis. This common form of scoliosis occurs when you have undergone some form of trauma to your spine. For example, over thirty years ago, this writer fell backwards out of a window (while trying to climb into the window to save her puppy who was trapped in a locked bathroom).
Unfortunately, there was a metal window well below the bathroom window and my low back landed on the side of the window well when I landed. Being young, the pain and the resulting year long bruise did not worry me too much. However, over time the injury did cause traumatic scoliosis of my lumbar spine. Every day people undergo similar injuries to their spine. Sadly, those injuries can result in scoliosis.
SIGNS AND SYMPTOMS OF SCOLIOSIS
Common symptoms and signs of scoliosis include:
- One shoulder blade appearing more prominent than the other shoulder blade
- Uneven shoulders
- An uneven waist
- One hip that is higher than the other hip
- The side of the rib cage extends out in front
- A visibly curved spine
Scoliosis disability occurs when the curvature of the spine is so severe that it results in nerve compression of the nerves close to the spine. People who have a spinal curvature that is less than 20 degrees have a “mild” curvature. Those who have a spinal curvature between 25 and 40 degrees have a “moderate” curvature. Finally, people who have a spinal curvature that is more than 50 degrees have a “severe” curvature.
SCOLIOSIS CAN PREVENT YOU FROM WORKING
The Social Security Administration (SSA) recognizes that if your scoliosis symptoms are severe, you may not be able to work a full time job. If you are unable to work full time for at least 12 months due to your scoliosis, then it is possible for you to qualify for SSDI and SSI benefits.
There are two types of Social Security benefits. The first type is Social Security Disability benefits (SSDI). This benefit requires you to have years of working a job and paying your taxes. The second type of benefit is Supplemental Security Income (SSI).This benefit acts as a supplement to SSD benefits. Additionally, it is for people who have never worked or who have earned low wages.
Spinal disorders, like scoliosis, are one of the main reasons that people file for SSDI and SSI benefits. The SSA awards benefits to those whose scoliosis symptoms prevent them from working and doing activities of daily living.
MEDICAL EVIDENCE THAT PROVES YOU DESERVE BENEFITS
When you apply for SSDI and SSI benefits, the SSA will first look to your medical records to determine if your scoliosis is a disabling impairment. Medical records are crucial to obtaining benefits. Find out more about the importance to medical records in your SSD case.
The SSA obtains your medical records. Next, a claims worker at Disability Determination Services (DDS) reviews your records. The claims examiner will be looking for objective medical evidence that documents your scoliosis. For example, the SSA will look for the following items:
- medical imaging, such as MRI, CT scan, or X-ray that shows spinal curvatures
- physical exam notes or progress notes from your doctor that shows pain, numbness, sciatica, muscle weakness, and reduced range of motion from your scoliosis
- a record of your medications for pain and any side effects you may be experiencing from your medications
- the medical opinion of an expert in spinal conditions, like an orthopedic surgeon or neurologist
- physical therapy records that help show your attempts to help your pain and improve your spinal restrictions
- nerve conduction studies showing the nerve compression
- records which show you use an assistive device, like a back brace, cane, walker, or wheelchair
- reports of any back operation for scoliosis or other degenerative spinal condition.
Remember, it your responsibility to supply your medical records to the SSA. You should ask your treating doctor to write a letter to the SSA that states you cannot work due to your scoliosis. The burden to prove that you deserve benefits is on you.
OBTAIN MEDICAL EVIDENCE FOR FREE OR LOW COST
If you are missing medical information, then you can make an appointment with your doctor. Your doctor can order tests, like an MRI or CT scan. This evidence helps you win your case. However, if you can’t afford to see a doctor, then you still have options.
For those who live in Utah, we have a list of free and low cost health resources you can contact for scoliosis treatment. Likewise, if you live in Nevada, we provide a list of Nevada’s free and low cost health resources to help you find a doctor.
Additionally, if you cannot afford treatment, you can request that SSA send you to one of their doctors. This is a consultative examination. You can visit one of SSA’s doctors for free. They will write a report about your scoliosis. Further information about consultative exams can be found on on this website. Also, more information is written below on this blog.
DOES SCOLIOSIS MEET SSA’S LISTING FOR BENEFITS?
In order for the SSA to pay you benefits for your spinal condition, they first decide if you meet the SSA’s rules:
- Your scoliosis must prevent you from doing the work you did before
- Next, it must prevent you from doing other similar work
- Finally, your scoliosis must last or be expected to last at least one year. Or, it must be expected to result in death.
Additionally, you may be found disabled by meeting or equalling an SSA listing. Sometimes, the SSA’s list of disabilities is called the “Blue Book.” SSA’s listing, unfortunately, does not contain a specific listing for scoliosis.
Nevertheless, the SSA will evaluate your scoliosis under the musculoskeletal listing 1.15. See the Musculoskeletal Listings under SSA’s description of Disorders of the Spine. If you are claiming benefits for childhood scoliosis, then the SSA will evaluate the child’s condition under listing 101.15.
Likewise, if a curvature of the child’s skeletal spine is under continuing surgical management, the SSA will look at it under SSA listing 101.21. Because scoliosis does not meet a listing, the SSA looks at the condition under equalling the listing. See the Code of Federal Regulations under 20 C.F.R. § 416.926 for an explanation of what “equalling the listing” means.
DOES YOUR SCOLIOSIS EQUAL LISTING 1.15 ?
The SSA uses listing 1.15 to evaluate whether or not your scoliosis “equals” a listing. However, other listings can also be used to evaluate scoliosis. For example, the SSA can pay you benefits under its listing for inflammatory arthritis if you have degenerative scoliosis.
1.15 Disorders of the skeletal spine resulting in compromise of a nerve root, 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 root(s):
AND
B. Radicular distribution of neurological signs present during physical exam 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
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 records 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 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.
ANOTHER OPTION FOR SCOLIOSIS UNDER SSA’S LISTINGS
Under SSA’s listing for inflammatory arthritis, which is listing 14.09, there is an argument to be made for equalling listing 14.09. Part C of 14.09 states that ankylosing spondylitis can be disabling if the spinal curvature reaches certain degrees of severity. Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the bones in the spine to fuse together. This fusion makes the spine less flexible and can result in a hunched posture. This is similar to scoliosis and your attorney can use this listing to argue that the SSA should pay you benefits. See below:
Listing 14.09 Part C. Ankylosing spondylitis or other spondyloarthropathies, with:
1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45° or more of flexion from the vertical position (zero degrees); or
2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical exam at 30° or more of flexion (but less than 45°) measured from the vertical position (zero degrees), and involvement of two or more organs or body systems with one of the organs or body systems involved to at least a moderate level of severity.
SCOLIOSIS AND YOUR RESIDUAL FUNCTIONAL CAPACITY
Even if Social Security thinks that your scoliosis doesn’t meet or equal one of their listings, then they can still find you should be paid benefits. But, you must prove you cannot work due to your condition. The way the SSA decides whether or not you can work is by looking at your residual functional capacity (RFC).
Your RFC is the medical finding of what you can physically and mentally do in a work setting, after taking into account all of your symptoms.
The RFC includes both your physical and mental limits. For example, the SSA will define your ability to sit, stand, walk, and lift, taking into consideration your symptoms. They will also determine how long you can perform these activities during the course of an 8 hour workday. Likewise, the SSA will include your ability to carry, pull, and push. Find out more about how the SSA defines work here.
WHAT EVIDENCE PROVES YOUR RFC FOR SCOLIOSIS?
In order to figure out your physical RFC, the SSA will examine your medical records. They will take into account what your doctor states in your medical records. Also, the SSA will review any statements from your doctors and from the SSA consultative examiners.
You have the option to have a Residual Functional Capacity form filled out by your treating doctor. Your treating doctor knows more than anyone about your scoliosis and the impact it is having on your ability to work.
The SSA will also consider descriptions about your limits from you, your family, neighbors and friends. For example, your family or friends could write a statement about your physical symptoms. Find out more here about RFC and your age work together to show you cannot work. Also, find out more about SSA’s Medical Vocational Guidelines here.
REQUEST A CONSULTATIVE EXAM TO DOCUMENT YOUR SCOLIOSIS
When you are at the initial level or the reconsideration level of your case, the SSA may decide to schedule you for a consultative examination with one of their doctors. You need to go to the exam.
You do not have to pay for the Consultative Exam. So, you will not have to pay to see the medical doctor who looks at your scoliosis. Additionally, you will not be charged a copay any other fee at the exam. The SSA is paying for your doctor visit.
However, if you don’t go to the exam, the SSA will automatically deny your case. You don’t want that to happen. Use the exam to tell the doctor how your scoliosis is making it impossible for you to do full time work.
The SSA will send you a written notice in the mail about your consultative exam. It will have the name of the doctor, the address you need to go to, and the date and time of the exam.
If you cannot attend the exam, you must call the SSA and inform them that you have a conflict. Usually, they will give you a new appointment time so that you can attend. Whatever you do, do not miss the exam. They will not give you a new exam time if you miss it without explanation.
WHAT WILL THE DOCTOR SAY ABOUT YOUR SCOLIOSIS?
If you have a back impairment like scoliosis, SSA’s doctor will be watching how you walk into the office. Also, they will watch you in the waiting room to see if you have pain behavior. The doctor will discuss how you move, bend, sit, stand, and walk. They will write down if you are able to get onto the exam table. The doctor will also write down your complaints and if he or she can document those symptoms on exam.
The SSA pays the doctor who is doing your exam. The doctor at the exam is not your doctor. The doctor is not on your side. You should not assume they are in support of you winning benefits. However, if you have scoliosis, ask them to measure the curvature in your spine.
BRING COPIES OF YOUR MEDICAL RECORDS TO THE EXAM
If you are sent to an exam for your physical condition, you need to bring copies of your medical tests and records with you. Find out more here about how to obtain a copy of your medical records.
For example, if you have an MRI, X-ray, CT scan, or operative report, bring it with you to the exam. Give a copy of your records to the doctor. The reports provide medical evidence of your scoliosis and the degree of the curvature in your spine. Your medical records should contain the opinion of your treating doctor about why you cannot work. This opinion is good for the SSA’s doctor to see. If you need to learn more about the importance of medical records in your SSDI claim, read here.
Once you have gone to the exam, the doctor hired by the SSA will write a report. Then the doctor will submit their report to the SSA. Hopefully, the report will document the problems your medical conidtion causes in your ability to sit, stand, walk, climb stairs, etc.. Additionally, the report will state whether or not your scoliosis prevents you from working.
CANNON DISABILITY LAW’S ATTORNEYS & STAFF
If you need help with your benefits claim for scoliosis, you have found the right law firm. You can learn more about the attorneys at Cannon Disability Law on our About Us page.
For example, you may want to know that Dianna Cannon has been helping her clients win Social Security cases for over thirty years. Additionally, Brett Bunkall and Andria Summers have also won thousands of SSDI and SSI cases.
In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our experts can help you file for SSI benefits using the SSA’s website. However, we will need your help to apply for SSI benefits. Why? Because only you know your personal financial information. SSI benefits require you to have minimal assets and monthly income.
Likewise, if you need an appeal, we can help you do that too. There are also many forms that will need to be filled out. Don’t worry. If you have questions about these forms, we will answer them. You can learn more about SSA’s appeal forms here. Call us today for help with your scoliosis case.
WHAT DOES OUR LAW FIRM DO FOR YOU
You do not have to obtain benefits on your own. We can help file your SSD application. Also, we can help you through each of the appeal stages of the Social Security process.
When you leave that up to us, you can focus on your health. Our attorneys and staff can:
- Help you file your application for SSD and SSI benefits
- File an appeal if you receive an initial denial from Disability Determination Services
- Collect your medical records
- Help you confirm your Consultative Exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to be a good witness at your Social Security hearing
- Represent you at your hearing and question the expert witnesses.
- Read more about vocational experts here.
- Learn more about medical expert testimony here.
- Request review of an decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your SSD application online at Social Security’s website, then you have 6 months to complete the application. It is best to complete the application quickly. You don’t want to run out the 6 month time limit.
HIRE US TO HELP YOU WIN YOUR SCOLIOSIS BENEFITS
June is scoliosis awareness month. At Cannon Disability Law, we want to make people more aware of scoliosis as a severe medical condition. If you have a spinal condition that keeps you from working, we can help you win benefits.
Here are some tips. When you file your online application for scoliosis, the SSA may send you a written summary of your online application. If you receive the written summary, then you need to sign it and send it back to the SSA in the envelop they provide. Do it quickly.
Additionally, once you receive a denial from the SSA, you only have 60 days to file an appeal. You should appeal every negative decision the SSA makes. However, you must not fail to meet the time limits set by the SSA. Our advice is simple. Appeal early. Appeal often. Never give up.
As Social Security experts, our attorneys will properly present your case to the SSA. Contact us today. Take advantage of our free review of your case. If you call, then we can answer your questions. Remember, we are experts in SSI and SSD benefits. We will do our best to win your benefits for scoliosis. Call today.
