Qualifying For Disability With Back Pain

Many of us live with some form of back pain or arthritis.  Although at times uncomfortable, most of us are able to continue to work despite our limitations.  Back pain alone will not qualify a claimant for disability benefits.

To qualify for benefits, your claim will be evaluated under the Social Security Administation (SSA) five step sequential evaluation process.  First, you must show that you are not engaging in substantial gainful activity and that your back condition is a severe impairment. Your condition must be supported by medical tests and documentation such as x-rays, magnetic resonance imaging (MRI), treatment notes , chiropractic care, physical therapy and/or pain management.

At step 3, SSA will evaluate your claim to determine if you meet or equal a listing for your back condition.  The applicable listing for back injuries is found at Listing 1.04.

1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:

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What Is a Medical-Vocational Allowance In Social Security Disability?

A medical vocational allowance is the term used by Social Security (SSA) when your condition does not meet the criteria in SSA’s listings but it is determined that you are still unable to work.

To be approved for Social Security disability benefits, SSA will evaluate your claim using the five step sequential evaluation process.  At steps 1 and 2, SSA addresses whether you are performing substantial gainful activity and if  you have a severe impairment.  At step 3, SSA evaluates your claim to determine if you meet a listing.  To meet a listing, you must meet specific criteria to be found disabled.  The criteria is different  for each listing as it applies  to different conditions and, unfortunately, most claimants do not meet a listing.

If you do not meet a listing, SSA will further evaluate your claim under steps 4 and 5  to determine the impact your disability has on your ability to work.  SSA will examine your illness, conditions and limitations to determine if you can do your past work, and if not, if there are any other jobs that you could still perform based upon your age, education and work history.  This is called your residual functional capacity.  If it is determined that there are no jobs that you could perform based on your residual functional capacity, then your claim will be approved under a medical vocational allowance.

Medical Source Statements In Disability Cases

Medical Source Statements are very important in your disability case.  A Medical Source Statement is a statement or opinion by a physician or other medical provider detailing the functional capacity of a disability claimant.  While your medical records will document diagnoses, tests, medications and communication or statements between you and your doctor, most likely your medical records will be lacking as to how your disability affects your ability to work on a sustained basis.  These statements are most effective if they are carefully drafted to meet or satisfy the applicable regulation specific to your medical condition.  Even persons with the same condition/disability may need different medical source statements edited to their specific needs.  This should be done on a case-by-case basis.   Please contact my office to discuss medical source statements in further detail.

Am I Eligible For Social Security Disability – Part 5

In our final part of our 5 part series, we are discussing the process you must go through to be approved for social security disability benefits.  We’ve already discussed the first four steps, which address working, the severity of your impairment, if your medical condition meets or equals a listed impairment by the Social Security Administration, and whether you can perform your past work.  In this series, we will discuss step 5 of the sequential evaluation process which addresses if you can perform any other type of work.  The 5 step sequential evaluation process is noted below for reference:

  1. Are you currently working?  Does your impairment prevent you from performing substantial gainful activity?
  2. Is your condition severe?
  3. Does your medical condition meet or equal a listed impairment?
  4. Can you perform your past work?
  5. Can you do any other type of work?

Step 5

Step 5 of the sequential evaluation process analyzes whether you are able to adjust to other types of work.  The work must be of the type that exists in significant number in the national economy.  The analysis will factor in your past work, your age, remaining work capacity and education level.  If the SSA finds that you cannot adjust and take on other types of work, the SSA will likely find that you are disabled.  If you were denied at any step, please contact Sharry Law Office for a free case evaluation and discuss your appeal.

Evaluating Functional Equivalence In Childhood Disability

In children’s disability cases, if the child’s impairment is not severe enough to meet a Social Security “listing”, meaning an approval for disability benefits, then an assessment must be done to determine if the impairment functionally equals a listing.  For functional equivalence, the child must have one “extreme” or two “marked” limitations in the six domains of functioning. 

The six domains of functioning are:

  1. Acquiring and using information
  2. Attending and completing tasks
  3. Interacting and relating with others
  4. Moving about and manipulating objects
  5. Caring for oneself, and
  6. Health and physical well-being.

The evaluation of how functioning is affected will be done during all of the child’s activities; meaning activities done at home, at school, and in the community.   First, Social Security will identify which of the child’s activities are limited, and which domains are involved in those activities.  They will then determine whether the child’s impairment(s) could affect those domains and account for the limitations.  Second, Social Security will then rate the severity of the limitations in each affected domain(s).  If SSA finds one extreme limitation, or two marked limitations, the child will be approved for disability benefits.

Am I Eligible For Social Security Disability – Part 4

In part 4 of our 5 part series, we are discussing the process you must go through to be approved for social security disability benefits.  We’ve already discussed the first three steps, which address working, the severity of your impairment, and if your medical condition meets or equals a listed impairment by the Social Security Administration.  In this series, we will discuss step 4 of the sequential evaluation process which addresses if you can perform your past work.  The 5 step sequential evaluation process is noted below for reference:

  1. Are you currently working?  Does your impairment prevent you from performing substantial gainful activity?
  2. Is your condition severe?
  3. Does your medical condition meet or equal a listed impairment?
  4. Can you perform your past work?
  5. Can you do any other type of work?

Step 4

Step 4 of the sequential evaluation process evaluates your past relevant work.  Generally speaking, past relevant is described as work you performed in the last 15 years.  Only work that was performed at the SGA (substantial gainful activity) should be factored into your past relevant work.  In order to figure out whether you can perform past relevant work, the SSA will examine the physical and mental requirements of your former job in conjunction with your current residual functional capacity. If you are able to perform past relevant work, you will not be considered disabled for purposed of social security disability benefits.  If SSA decides that you can no longer perform your past job, your case will be evaluated at step 5 to determine if you can do any other type of work.  To simplify the analysis, take the least-taxing job you performed in the previous 15 years and argue as to why you can no longer do that job.

In the next series, we will discuss step 5, “Can you do any other type of work?”

Am I Eligible For Social Security Disability – Part 2

In the first part of this five part series, we discussed substantial gainful activity at step 1 of the sequential evaluation process and how working affects eligibility to social security disability.  In this series, we will discuss how the severity of your medical condition factors in to the eligibility process.

To recap, the Social Security Administration uses the five step sequential evaluation to determine eligibility.  If you fail at any step, your claim will be denied.

  • Step 1 – Are you currently working?
  • Step 2 – Is your condition severe?
  • Step 3 – Does your medical condition meet or equal a listed impairment?
  • Step 4 – Can you perform past work?
  • Step 5 – Can you do any other type of work?

Step 2

If  you are not working, or are working below the subtantial gainful activity level, you will pass step 1 to be evaluated at step 2.  At step 2, your condition must prevent you from performing basic work activities for at least twelve (12) months to qualify for activities.  If your condition will prevent you from working for less than a year, you will be denied.  Private short-term and long-term disability insurance benefits may be available in those situations.  The timing of your application may affect the outcome of your claim in some cases.  Therefore, it may be wise to consult with a disability attorney to determine when you should apply.

In the next series, we will discuss step 3, “Does your medical condition meet or equal a listed impairment?”