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SSA CHANGES RULES FOR THOSE WITH BACK DISABILITIES

Once again, the SSA is changing the criteria for people with a back disability. This change should be of concern to all lawyers and claimants who are seeking disability benefits, because every year there are millions of disability claims filed for back impairments. The new rules, including the new preamble, will be effective on April 2, 2021.

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 disability 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 his or 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 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, you cannot win your case. This post applies specifically to the changes for back disorders that previously fell under listing 1.02.

back disability and pain

 

NEW LISTING FOR BACK DISABILITY AND NERVE ROOT IMPINGEMENT – LISTING 1.15

The new listing, which you can read below, replaces the old listing. You can also go to the Federal Register and read about the SSA’s reasoning in changing the back listing here. This listing is still designed to apply 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. Sciatica or neuropathy occurs when pain radiates down the long sciatic nerve running from the lower back into the lower legs.

All of the symptoms listed in each element must be documented 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.

Musculoskeletal Disorders

1.15 Disorders of the skeletal spine resulting in compromise of a nerve root(s) (see 1.00F), 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):

1. Pain; or

2. Paresthesia; or

3. Muscle fatigue.

AND

B. Radicular distribution of neurological signs present during physical examination (see 1.00C2) or on a diagnostic test (see 1.00C3) and evidenced by 1, 2, and either 3 or 4:

1. Muscle weakness; and

2. Sign(s) of nerve root irritation, tension, or compression, consistent with compromise of the affected nerve root (see 1.00F2)

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

C. Findings on imaging (see 1.00C3) consistent with compromise of a nerve root(s) 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 (see 1.00C6) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i)); or

2. An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 1.00E4), and a documented medical need (see 1.00C6a) for a one-handed, hand-held assistive device (see 1.00C6d) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii)); 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 (see 1.00E4).

CANNON DISABILITY CAN HELP YOU WIN BENEFITS FOR BACK IMPAIRMENT

As you can see, the back listing for disability benefits 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 the majority of cases, but we will appeal for you. If you need to go to a hearing with a judge, you should not go alone. Experience counts. Hire an experienced representative to present your case to the judge.

Remember, if you hire us to represent you and we do not win your case, you do not owe us an attorney fee. Do your research and hire the legal team with the most experience. If you want to find out more about our legal team, you can call our office and read our website. Dianna Cannon has 30 years of experience practicing disability law.  Andria Summers has 20 years of experience representing claimants on appeal and in court. Brett Bunkall has won hundreds of disability cases in Utah, Nevada, Idaho, and California. Our legal team understand the law and knows the difficulties you are facing. We have won over $100 million in disability 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 disability process. Contact us today to hire a disability attorney with the experience to deal with the SSA.

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