Disability Benefits for Reduced Capacity Caused by Back Problems
Even if you have severe, documented back problems, it’s difficult to get approved for disability benefits by the Social Security Administration (SSA) under the SSA’s official impairment listing for spinal disorders. Fitting into the official impairment listing requires your condition to fit into a small box of symptoms and objective test results showing nerve root compression, arachnoiditis, or stenosis (for the details on the official listing, see our topic page on How to Get Disability Benefits For Back Problems).
If the SSA denies that you have a disability based on the spinal disorder listing, as the next part of the disability determination process, the SSA is required to consider the effect of your back pain and problems on your capacity to do daily activities and to function at work, and will then determine whether there is any kind of work you can do. The SSA will evaluate your treating doctor’s records and imaging tests, and in particular his or her notes on your functional limitations and restrictions, to determine if your back problems rise to the level of a disability that prevents you from working.
Residual Functional Capacity (RFC) for Back Problems
The SSA, with the help of a medical consultant, will review your doctor’s functional restrictions. (The most common doctors’ restrictions for back problems are to not lift heavy objects, bend over, or sit or stand for prolonged periods of time.) The SSA will give you a rating of the type of work it thinks you can do based on your restrictions (sedentary work, light work, medium work, or heavy work). This is called your residual functional capacity (RFC). For instance, if your doctor has limited your standing and walking to no more than four hours per day, your RFC will be for sedentary work. If your doctor has limited you to no lifting more than 20 pounds, but okays your standing or walking for six to eight hours per day, your RFC will be for light work. If your doctor has limited you to occasional bending only, your RFC will likely be for light work. If you can carry up to 50 pounds for up to one-third of the day, and up to 25 pounds for up to two-thirds of a day, your RFC will be for medium work.
Most Social Security disability claimants who apply for back problems are assigned an RFC for light or medium work. You are likely to receive an RFC for light work, or medium work at the most, if you have any of the following symptoms:
- spinal osteoporosis causing severe pain
- degenerative disc disease causing severe pain
- spondylolisthesis (the misalignment of discs, caused by arthritis or trauma) causing severe pain
- compression fracture of a vertebra of 50% or more
- fusion of lumbar or cervical vertebrae
- scoliosis with a 40º curve or more, or
- severe post-operative pain following back surgery.
If you are assigned an RFC for light or medium work and have always done heavy work, you could be approved for benefits in some cases (especially if you're older than 55). In many cases, however, you will be denied benefits if you have an RFC of medium or light work, as you'll see below.
How Your RFC Translates to What Jobs You Can Do
The lower your RFC (sedentary work being low, heavy work being high), the fewer types of jobs you can do. The SSA will take your RFC and look at your age, education, and past job experience to see what kind of work you can do or could learn to do. The SSA has a grid that sets out whether a claimant will be considered disabled based on the claimant’s RFC, age, education, and prior experience (to see the grid and explanations of it, check out Nolo’s Guide to Social Security Disability, by David Morton).
For example, if you can do medium work, you won’t be considered disabled unless you’re older than 55 and have less than a 6th grade education. In this case, you’ll likely be granted disability benefits under what’s called a “medical-vocational allowance.” In most other cases, if you can do medium work, the SSA will presume that you can learn a new job. If you can do only sedentary work, but you are 55, never graduated high school, and worked heavy jobs all your life, you’ll likely be approved for benefits. But if you limited to sedentary work, you are 30 years old, and you have a college education or transferable skills, the SSA will probably say that there are jobs you can do or learn to do (even if you’ve never done sedentary work), and the SSA will deny you benefits.
Obviously it’s in your best interests to prove that you can do only sedentary work -- or even less than sedentary work -- because of your back problems. You can get a sedentary RFC if your doctor says you can’t stand or walk at least six hours per day. A sedentary RFC means that it’s less likely the SSA will say there are jobs you can do, depending on your age, education, and experience.
In addition, you won’t be able to do most sedentary jobs, meaning you may be able to get a less than sedentary RFC, if any of the following apply:
- You can’t sit for more than a couple of hours at a time.
- You need to alternate between sitting and standing because of severe back pain (though the SSA may say there are jobs you can do that allow you to alternate between sitting and standing).
- Your pain medication makes it too difficult to concentrate or focus.
A less than sedentary RFC is likely to get you a medical-vocational allowance regardless of your age, education, or past experience; however, getting less than sedentary RFC is fairly rare, and would require objective medical evidence of a severe back problem.
Because Social Security disability benefits (SSDI and SSI) aren’t easy to get for back problems unless you meet the SSA’s official impairment listing, you may want to hire an attorney to help you. Especially if you are initially denied benefits, it makes sense to hire an attorney with experience with back cases. For instance, if your doctor agrees that you should have serious functional restrictions on what you can do because of your back problems, the attorney will know what questions to ask your doctor to get a low RFC for you.