If your doctor mentions spondylosis when discussing your problems with chronic back pain, you might feel worried. However, spondylosis is just a medical term that describes the pain and other related symptoms that come from spinal arthritis. In fact, it affects about 4 in every 5 people aged 60 and older, mostly for age-related reasons. But can you qualify for Social Security disability (SSD) benefits if you have this common back issue? Below, we’ll explain what may help you get disability for spondylosis.
Getting Social Security Disability for Spondylosis: Key Takeaways
- Spondylosis significantly impairs your ability to work and can qualify you for Social Security Disability benefits.
- The Social Security Administration (SSA) needs specific medical evidence and documentation to approve disability claims.
- Chronic pain, limited mobility, and nerve root compression are key to showing how bad your condition is.
- Working with a disability lawyer will increase your chances of winning a disability claim by getting the right documentation and guidance throughout the process.
What is Spondylosis? Symptoms and Side Effects
Spondylosis is a degenerative condition where the spinal discs wear out over time and can cause osteoarthritis and bone spurs. It most commonly affects people over 60, though younger individuals with bone conditions may also be impacted.
Symptoms can vary but often include pain and stiffness, especially in the neck (cervical spondylosis) or lower back (lumbar spondylosis). Multilevel spondylosis, where the degeneration is at multiple levels of the spine, can cause more severe symptoms by compounding the symptoms. In severe cases, it can cause pinched nerves, which can cause tingling, numbness, weakness, difficulty walking, and loss of bladder or bowel control. Regular medical attention and treatment, such as anti-inflammatory medications and physical therapy is key to managing symptoms and preventing complications.
Common Types of Spondylosis
- Cervical Spondylosis: This type of spondylosis affects the neck region of the spine. It’s very common, especially among older adults, with over 85% of people 60 and older having some form of cervical spondylosis. Symptoms include neck pain and stiffness which is often worse after sitting or standing for a long time. In severe cases it can cause tingling, numbness or weakness in the arms and hands, lack of coordination and difficulty walking.
- Lumbar Spondylosis: This type of spondylosis affects the lower back. Like cervical spondylosis, lumbar spondylosis is usually age-related and caused by wear and tear on the spine. Symptoms often include chronic lower back pain and stiffness. If the condition progresses it can cause nerve root compression which can cause symptoms like pain radiating down the legs (sciatica), muscle weakness and sensory loss. People with lumbar spondylosis may find it difficult to stand or walk for extended periods.
- Multilevel Spondylosis: This type involves degeneration at multiple levels of the spine, which can cause a combination of symptoms from both cervical and lumbar spondylosis. It can cause more severe pain and greater disability due to the extensive involvement of the spine. Symptoms may include widespread pain, significant mobility issues, and neurological deficits like numbness, tingling, or weakness in different parts of the body. Managing multilevel spondylosis often requires a comprehensive treatment approach to address the various affected areas.
SSI & SSDI Disability Criteria From the SSA
The Social Security Administration (SSA) has specific criteria for disability benefits for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). For SSDI you need to have sufficient work credits, typically 40 credits, with 20 in the last 10 years. In 2024, one credit is earned for every 1,730 in wages, with a maximum of 4 credits per year. Your disability must prevent substantial gainful activity (SGA) which is earning more than $1,550 per month ($2,590 for blind individuals) and lasting at least 12 months or resulting in death.
SSI is a need-based program with income and asset limits, but lacking the work requirements of SSDI. In 2024, the federal benefit rate is $943 for an individual and $1,415 for a couple. Countable income includes wages and pensions but excludes the first $20 of most income and the first $65 of earnings. Asset limits are $2,000 for an individual and $3,000 for a couple, excluding your home, one vehicle, and certain other resources. Medical criteria for both programs require comprehensive evidence of the severity and duration of your condition.
Applicants must be U.S. citizens or certain non-citizens and must provide detailed medical documentation including doctor’s reports and test results. Understanding and meeting these criteria is key to getting disability benefits and increasing the chances of a successful claim.
Does Spondylosis Qualify for Disability Benefits?
The Social Security Administration (SSA) considers spondylosis as a disability if it severely limits your ability to work. Spondylosis is listed in the SSA’s Blue Book under musculoskeletal disorders, Section 1.04 for disorders of the spine. To qualify your condition must meet or equal the criteria which usually involves severe nerve root compression, limited spinal movement, motor loss, and sensory or reflex loss.
SSA Disability Requirements for Spinal Disorders
To meet the SSA’s criteria for spinal disorders your medical evidence must show:
- Nerve root compression causing pain, limited spinal movement, and motor loss.
- Positive straight-leg raising tests for lower back issues.
- Detailed medical imaging (MRI, CT scans) to support the diagnosis.
- Consistent medical records documenting the severity and impact of your condition.
Does Your RFC Mean You Can’t Work?
Residual Functional Capacity (RFC) assessments are key in disability evaluations. The SSA uses your RFC to determine if your condition prevents you from working. A thorough RFC assessment includes detailed descriptions of your pain, physical limitations, and how they affect your daily activities and job tasks. Clear, objective documentation from your treating physician helps your claim.
Chronic Pain and Proving Back Disabilities
Proving chronic pain and back disabilities to the SSA requires medical documentation. Specific, consistent descriptions of your pain and how it affects your ability to function is key. Regular medical visits and detailed records help establish the severity of your condition and increase the chances of your claim being approved.
How Hard Is It to Get Disability Benefits for Spondylosis?
Getting disability for spondylosis is tough because of the SSA’s strict requirements. The process involves multiple steps and each step requires medical documentation and clear evidence of how your condition affects your ability to work. Although spinal disorders are one of the most common claims, approval rates vary greatly based on the severity of symptoms and the quality of evidence.
Evaluation Process
The SSA uses a five-step sequential evaluation process to determine disability:
- Non-Medical Criteria: You must not be engaged in substantial gainful activity (SGA). In 2024, SGA is defined as earning more than $1,550 per month ($2,590 for blind individuals).
- Severity of Impairment: Your condition must be severe enough to significantly limit your ability to perform basic work activities.
- Medical Listings: Your condition must meet or equal one of the medical listings in the SSA’s Blue Book, specifically Listing 1.04 for disorders of the spine.
- Past Work: The SSA evaluates whether you can perform any of your past work.
- Other Work: If you cannot perform past work, the SSA considers whether you can do any other work based on your age, education, and work experience.
Success Rates and Common Challenges
According to SSA statistics, about 22% of initial disability claims are approved. However, success rates improve significantly with appeals, where about 47% of cases are approved at the hearing level. Key challenges include providing comprehensive and consistent medical records, demonstrating the severity of the condition, and proving that it significantly impairs your ability to work.
Importance of Legal Assistance
Given the complexity of the application process and the high rate of initial denials, many applicants benefit from legal assistance. Disability lawyers can help gather and present medical evidence effectively, ensuring all documentation meets SSA requirements. Legal representation can improve the chances of a successful claim, especially during the appeals process.
Medical Evidence You’ll Need for Your Spondylosis Disability Claim
Proper documentation is crucial when applying for disability benefits for spondylosis. The SSA requires comprehensive medical evidence to support your claim, demonstrating the severity and impact of your condition.
Medical Records
Regular visits to your healthcare provider are essential. Detailed records from these visits should include:
- Diagnosis: Specific diagnosis of spondylosis, including affected spinal regions (cervical, lumbar, or multilevel).
- Symptoms: Detailed descriptions of pain, stiffness, numbness, and other related symptoms.
- Treatments: Documentation of treatments such as medications, physical therapy, and any surgical interventions.
Medical Evidence
The SSA relies heavily on objective medical evidence to assess the severity of your condition:
- Imaging Studies: MRI, CT scans, and X-rays showing the extent of spinal degeneration and nerve root compression.
- Test Results: Positive straight-leg raising tests and other functional assessments that demonstrate limitations in movement and motor function.
- Doctor’s Notes: Comprehensive notes from your treating physician detailing the impact of spondylosis on your daily activities and work capabilities.
Evidence that Work Triggers Your Symptoms
Your medical records should include documentation showing that work activities exacerbate your symptoms:
- Pain Levels: Consistent reports of pain during or after work-related tasks.
- Functional Limitations: Specific limitations on your ability to sit, stand, walk, lift, or carry out other work-related activities.
Proof of Other Conditions
If you have additional medical conditions that contribute to your disability, include evidence of these as well:
- Comorbid Conditions: Documentation of related conditions like ankylosing spondylitis, arthritis, or degenerative disc disease.
- Impact on Function: Detailed descriptions of how these conditions further limit your ability to work.
How to Get Approved for Spondylosis Disability Benefits: 3 Crucial Steps
Many people focus solely on their medical issues when applying for Social Security disability benefits. It’s important to understand that even severe medical conditions won’t qualify you for benefits if you don’t meet the technical requirements. Before applying, ensure you have the necessary work history, are not already receiving certain Social Security benefits, and are not earning above the substantial gainful activity (SGA) limit of $1,550 per month. Here’s a look at the steps you need to follow to get approved for SSI and SSDI:
Step 1: Make Sure You Pass All Technical Requirements to get Disability for Spondylosis
Many people only think about their medical issues when applying for Social Security disability. We get emails all the time asking if certain health problems qualify for benefits. You should know that it’s impossible to get disability benefits if you aren’t technically eligible. That means even with terminal cancer, some people get denied SSD benefits for technical reasons. Before you apply for benefits, answer these questions:
- Did you work at least 5 in the last 10 years full time for jobs where you paid Social Security/FICA taxes? If yes, move on to question #2. If no, stop here – you cannot qualify for SSD benefits.
- Do you currently receive any Social Security benefits on your own work record, including early retirement? If yes, stop here – you cannot qualify for SSD benefits. If no, move on to question #3.
- Are you currently working and earning more than $1,550 each month? If yes, stop here – you cannot qualify for Social Security disability. If no, then congratulations! You likely meet all technical requirements to qualify for benefits.
Step 2: Write Down All Your Related Health Problems & Spondylosis Symptoms
Remember, spondylosis is an umbrella term doctors use to describe your back pain and related symptoms. The Social Security Administration’s Blue Book does not specifically mention disability for spondylosis because it’s a symptom and not a condition. It’s closer to saying you have nausea, for example, because many different things may cause it. First, you need to find out the source(s) and gather all related medical records from your doctor. These health issues can cause you to develop painful spondylosis symptoms as you age:
- Facet joint arthritis, so your pain’s usually worse after sitting or lying down for longer periods or when you’re most physically active.
- Degenerative disc disease, which means you’re more likely to have lower back, neck, arm, or leg pain from spinal degeneration.
- Spinal stenosis, which means your leg(s) experience burning nerve pain when you walk.
- Spinal arachnoiditis, which the SSA says counts only if your doctor says you must change your posture, lie down, stand, or sit every two hours to relieve severe burning, pain, or itching.
- Obesity (even carrying 10 extra pounds can increase your risk for developing spine problems if you’re sedentary or rarely exercise).
- Osteoporosis, which can cause the bones in your spine to collapse and then rub together.
- Scoliosis.
- Cervical radiculopathy, which pinches your spinal nerves and causes shooting pain, numbness, and even hypersensitivity.
- Osteoarthritis, which may start after age 45 or come from surgery or a traumatic injury (i.e., a broken ankle).
- Cervical spondylotic myelopathy, which means your limbs go numb, you may have trouble walking or standing, maintaining balance, or controlling your bladder.
About 62% of approved SSD applicants in recent years listed 2-5 conditions on their claim forms.
Step 3: Pull Together Key Medical Documents That Support Your Disability for Spondylosis Claim
Next, you’ll want to visit your pharmacy. Ask the pharmacist to print out a list of every prescription you filled in the last year. (Any drug store should provide this to you free of charge.) The SSA wants to see your medication dosages, how often you take each one, cost, and side effects. If you stopped taking a specific medication or changed drugs in the past year, explain why. Maybe your doctor put you on a time-release pain medication to control your spondylosis symptoms, for example. Other medical evidence that best supports your SSD claim may include:
- Spinal scans taken within the past 12 months (i.e., x-rays, MRIs, CT scans, etc.).
- Lab tests, including recent blood work.
- Hospitalization or surgery dates, along with detailed receipts from those procedures.
- Physical therapy dates within the past year, if applicable.
- Records/receipts showing how often you require steroid shots, massage therapy, acupuncture, or chiropractor visits to manage your symptoms.
- Detailed treatment notes from your doctor showing how often you receive treatment for your spondylosis symptoms and how well you respond.
You should also keep a symptom diary for at least 30 days tracking how spondylosis affects your daily life. Basically, the SSA wants to know how much your health limits your ability to work. If you can show you struggle with basic daily living tasks, that may help get you disability for spondylosis.
For example: Can you do laundry, clean your home or pick up groceries by yourself? If you drop a pencil on the floor, can you pick it back up again? Can you stand up and walk across the room without help? If not, then you likely do qualify for SSD benefits.
Work With a Disability Lawyer to Improve Your Odds of Approval
Applying for Social Security disability benefits for spondylosis can be a complex and challenging process. Many initial applications are denied due to insufficient evidence or errors in the application. Working with a disability lawyer can significantly improve your chances of approval by ensuring that your application is thorough and accurately represents the severity of your condition.
Benefits of Legal Assistance
- Expert Guidance: Disability lawyers are familiar with SSA regulations and requirements. They can help you gather and present the necessary medical evidence effectively.
- Documentation Support: Lawyers assist in obtaining detailed medical records, imaging studies, and other critical documentation needed to support your claim.
- Application Accuracy: Ensuring your application is complete and free of errors reduces the risk of denial due to technical issues.
- Appeals Process: If your initial application is denied, a lawyer can guide you through the appeals process, increasing your chances of a successful outcome.
Increasing Approval Odds
Studies show that applicants represented by legal professionals are more likely to have their disability claims approved. Lawyers can:
- Prepare Thorough Applications: Ensuring all medical evidence and documentation is accurately compiled and submitted.
- Represent You at Hearings: Advocating on your behalf during hearings and appeals, presenting your case effectively to the Administrative Law Judge.
Securing Disability Benefits for Spondylosis
Securing disability benefits for spondylosis can significantly improve your quality of life and financial stability. Recognizing how conditions like cervical and lumbar spondylosis qualify for these benefits ensures you receive the necessary support. Understanding the criteria and steps involved in the application process is vital for a successful claim. Addressing the challenges of multilevel spondylosis through disability benefits helps manage the condition more effectively.
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Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.