Published on: June 15, 2017
Chronic back pain can be caused by many different spinal factors, ranging from degenerative discs to inflammatory conditions. When seeking disability benefits for chronic back pain, your application ultimately comes down to establishing a medically determinable condition, the functional limitations of your back problem and the credibility of your application.
Therefore, your application needs to be very specific on how your back condition is preventing you from doing any substantial gainful activity.This article will explore what is involved in qualifying for disability benefits with chronic back pain.
How the SSA Handles Back Pain
To qualify for disability benefits, the SSA typically requires that you have a condition that is medically determinable. Your back pain should, therefore, be identifiable to a certain medical condition of the spine or spinal canal. In addition, medical evidence such as X-rays, doctors’ notes, and MRIs need to be submitted with your application in order to prove the existence of your medical condition.
The challenge with back pain is that you may experience it often without the pain being caused by a specific medical condition. Such a situation makes it difficult for you to obtain benefits from the SSA. Because pain is subjective (it depends on the person experiencing it), medical evaluations can understate the severity of a chronic back pain condition making it difficult for you to obtain benefits.
How a Back Pain Application is Evaluated
The SSA evaluates chronic back pain applications according to 3 criteria. The first criteria they use is to evaluate the objective signs of your back pain, as well as the symptoms. This objective analysis is based on the medical evidence of your back pain condition that can be determined by a doctor.
The second criteria they use is to analyze the functional limitations of your chronic back pain; that is, how your condition prevents you from carrying out daily activities. And finally, they look at the overall credibility of your application.
Let’s look at each of these 3 criteria individually:
Objective Signs of a Back Problem
As previously mentioned, an objective evaluation by the SSA involves the ability to show a medically determinable impairment that is causing your back pain. If your back pain is being caused by a specific medical condition, you should submit the appropriate medical evidence such as:
- X-rays that show any fractured back bones
- CT scan that shows spinal defects such as stenosis
- MRI that demonstrates evidence of bone degeneration
The functional limitations involve your ability to demonstrate how the back problem is preventing you from carrying out certain activities. You should be able to demonstrate how your chronic back pain is preventing you from engaging in any substantial gainful activity and is impending your ability to work full time.
When assessing your functional limitations, the SSA will prepare what is referred to as a Residual Functional Capacity (RFC) assessment. This is an analysis of the activities that you are most able to carry out consistently, such as how long you can stand, sit or how far you can walk. The SSA uses the medical evidence that you submitted to prepare this analysis. You should also have your doctor prepare an RFC long with your application in order to strengthen your claim.
Functional Limitations Leading to Disability Benefits
There are certain functional limitations that are more likely to lead to an approved disability application than others (nothing guaranteed, though), especially if they are medically determinable. Some of these limitations include:
- Inability to bend and pick fallen items
- Inability to regularly lift more than 10lbs
- Inability to walk for a block or more without resting
- Difficulty in sitting or standing for at least 2 hours
When the SSA determines the credibility of your application, they look at many different factors. It is important to have a well-prepared claim especially when your medical documents alone are not strong enough to demonstrate your chronic back pain. A credibility assessment by the SSA involves:
- The objective medical evidence submitted
- Statements from doctors regarding your condition
- Your personal statements and statements from people close to you describing your condition
- Your daily activities
- The causes of your pain, symptoms and how long they are likely to last
The evidence of a long-standing back problem can also make your disability application more likely to be accepted. It shows that you have taken many steps to alleviate your symptoms over a period of time but they have not borne fruit.
To sum it all up, qualifying for disability benefits with chronic back pain comes down to whether your back condition is medically determinable, the functional limitations that your condition causes, and how credible your application is when demonstrating your symptoms and impairment to your daily activities.