Does Chronic Back Pain Qualify For Disability? | DisabilitySecrets

Back pain can be caused by many different spinal conditions, many of which happen normally with age. Sit-down jobs, obesity, and strenuous sports are examples of activities and lifestyles that can make a person vulnerable to spinal stress or damage. Chronic back conditions that cause back pain include:

• bones in your spine, called vertebrae, pressing on the large nerve roots that go into your legs and arms
• compression of discs in your spine that cushion the vertebrae
• strain on muscles in your back that help keep you upright, and
• injury to bones, ligaments (tissues that hold your muscles to your bones), or joints.

If you meet the non-medical eligibility requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), claims examiners will review the documented medical conditions that cause your back pain to see whether you meet the medical definition of disability used by the Social Security Administration (SSA).

In This Article

• Can You Get Disability for Back Pain?
• When Does Chronic Back Pain Qualify for Disability?
• Can You Get Disability for Back Pain Without a Known Cause?
• Additional Information About Back Pain

Can You Get Disability for Back Pain?

While back pain can be agonizing, frustrating, and sometimes even incapacitating, Social Security doesn't hand out SSDI or SSI disability benefits readily for back pain. You'll need to show that you have a medically determinable impairment—a source of your pain, documented by X-rays, MRIs, or physical examination—that lasts for at least one year.

This durational requirement can be hard to meet for back pain caused by injuries like muscle strains, fractures, and even herniated discs. These conditions usually heal within a few months, so claims for those types of conditions aren't often successful.

When Does Chronic Back Pain Qualify for Disability?

Social Security claims examiners see many applications for disability benefits based on back pain, but only approve the most severe cases. After determining that you have a medically determinable impairment, the SSA assesses the severity of your impairment by looking at your medical records and your functional limitations.

What Chronic Back Conditions Qualify Automatically for Disability?

Social Security maintains a listing of impairments that can automatically qualify you for disability, provided your medical records match the requirements of a listing. Examples of some back disorders that might meet the criteria of a listing include:

• disc degeneration
• scoliosis and kyphosis
• spondylolisthesis or retrolisthesis
• herniated discs
• spinal stenosis
• nerve root compression
• rheumatoid arthritis
• arachnoiditis, and
• spondylitis.

Keep in mind that Social Security can't award disability benefits based on symptoms alone. So if you tell your doctor that you have back pain, but your spine doesn't show a physical impairment that normally produces pain symptoms like yours, you're unlikely to win disability benefits.

Using Your RFC for Back Pain to Qualify for Disability

If your back pain doesn't meet the impairment listings for any of the conditions mentioned above, Social Security will assess your RFC. Your RFC is a set of limitations that reflects the most that the agency thinks you can do despite your back pain. In order to develop your RFC, Social Security will review your medical records and activities of daily living to see whether:

• you have trouble walking
• your range of motion is limited so that you can't stoop or bend
• you are very limited in the amount of weight you can lift and carry, and
• you need to switch positions frequently.

Social Security will compare your RFC with the demands of your past jobs to see if you could do them now, despite your limitations. If not, then the agency will need to determine whether other jobs exist that somebody with your work history and RFC could perform. For more information about back RFCs in general, see our article on how Social Security assesses a reduced RFC due to back problems.

Can You Get Disability for Back Pain Without a Known Cause?

Social Security reviews disability applications based on back pain with an eye toward whether your self-reported symptoms of back pain are consistent with your medical records. While the agency no longer formally assesses your "credibility" as part of your disability claim (SSR 16-3p), whether a claims examiner or administrative law judge believes your pain is as bad as you say still matters in a disability determination.

As mentioned above, Social Security can't find you disabled based solely on subjective pain. Even if your doctor has diagnosed you with a specific back disorder, your complaints of pain need to be proportionate to objective findings, such as an MRI or range of motion examination.

Your Medical Record Must Support, and Be Consistent With, Your Pain Complaints

Social Security will look to see whether your reports of back pain are supported by medical evidence and consistent with objective test results and other information in your application. If any test results or medical information in your file are inconsistent with your reports of how much you're limited by your pain, Social Security may find that your limitations aren't supported by the medical evidence.

For instance, if an applicant reports that his back hurts so much that he can only stand and walk a few minutes per day, Social Security would expect to see signs of muscle wasting. If the applicant's doctor hasn't recorded any muscle wasting, yet the applicant shows reduced muscle strength on clinical testing, Social Security might find his statements inconsistent.

This works the opposite way, too. An applicant may have an MRI showing severely reduced disc height at L4-L5—generally a pretty significant indicator of lower back pain. But if the applicant says that they're regularly working on labor-intensive hobbies such as vintage car repair, Social Security isn't going to find that their MRI "overrules" their self-reported limitations (or lack thereof).

Factors That Can Support Your Complaints of Pain

In addition to whether your objective test results support your pain complaints, Social Security will consider the following factors when considering how much your back pain limits you:

• how often you've been to the doctor
• what treatments you've tried (for example, medication, physical therapy, cortisone shots)
• your doctor's opinion of your pain level and limitations
• how the pain affects your ability to do basic, everyday activities such as chores
• what factors seem to aggravate the back pain
• whether you appear to be exaggerating your level of pain, and
• how much pain is normally reported by others with your physical signs.

The agency may send you to a consultative examination (physical or mental) on their own dime if you've had trouble maintaining a regular doctor or you're reporting extreme back pain but your objective test results don't indicate that level of pain. You can learn more about how Social Security evaluates the intensity and persistence of your symptoms in our article on getting disability benefits for chronic pain.

Additional Information About Back Pain

If your back pain is the result of an injury on the job, see our articles on whether you might be entitled to workers' compensation benefits or short-term disability insurance. If your back pain is caused by a properly documented mental disorder (such as somatoform pain disorder), Social Security might also award you benefits.

Further Reading Getting Disability Benefits for Cervicalgia (Neck Pain) Disability for Nerve Root Damage and Radiculopathy Getting Disability Benefits for Ankylosing Spondylitis