Getting Disability for Spinal Cord Injury or Paralysis
Not all paraplegics and individuals with spinal cord injuries are automatically eligible for Social Security disability benefits.
The spinal cord is filled with nerves that run from the brain through the spinal cord to connect to other parts of your body. The spinal cord is responsible for sending out information to the rest of your body that allows you to move. When your spinal cord becomes injured, it can lead to a disruption of this communication channel and can lead to paralysis. While spinal cord injuries are the most common cause of paralysis, there are other causes as well. Damage to the nervous system, strokes, degenerative diseases, and some medications can also cause paralysis.
Spinal cord injuries can happen to anyone at any age. The most common causes of spinal cord injuries include car accidents, falls, sport injuries, violent acts, and diseases.
Immediately after the spinal cord is injured, it stops working completely (called “spinal shock”). Slowly, as the “spinal shock” wears off, reflexes will begin to return. Where the feeling returns to depends upon where on the spine the injury occurred and how severe the injury was. If full sensation and movement ability don't return, paralyzed individuals often find themselves unable to work.
Qualifying for Disability Benefits
Individuals who have suffered from a spinal cord injury that caused paralysis, and are unable to work as a result, are often eligible for disability benefits. To qualify for benefits, individuals can either show that they meet the requirements of an official disability listing published by Social Security or that their impairment makes it impossible to work any job.
When an Individual Meets a Listing
To meet an impairment listing, you must show that you have all of the requirements laid out in the Social Security “blue book,” which lists impairments that are so severe that an individual will automatically qualify for benefits if the listing criteria are met. There is a specific listing for those with spinal cord injuries or paralysis. The listing, Listing 1.04- Disorders of the Spine, requires you to prove the following.
- injury to the spine that has affected the spinal cord, and
- compression of the nerve root causing pain, limitations in motion, and loss of muscle strength with loss of sensation or reflexes.
If your paralysis is not caused by nerve root compression but rather a neurological impairment, such as multiple sclerosis, you may qualify for benefits under Listing 11.00, which addresses neurological impairments.
When Individuals Use Wheelchairs
While the above listing is likely easily met by those who need to use wheelchairs (particular those with quadriplegia), not all individuals who use wheelchairs may qualify for benefits through the listing (such as paraplegics).
First, in order to get to the point where Social Security will consider that your impairment may be disabling, you must first show that you are not working, or that you're working at a decreased capacity (generally, individuals earning over $1,130 per month are not considered disabled).
Second, you must also prove that your impairments interfere with your basic work-related abilities. Individuals who are confined to wheelchairs but are fully able to use their arms or hands or are able to continue to work through the use of adaptive devices may not be eligible for disability benefits. Social Security evaluates claims made by paralyzed applicants on a case-by-case basis; more on this below.
For more information, see our article on disability benefits for wheelchair users.
When the Impairment Makes It Impossible to Work
If you don't meet or "equal" a listing, you could qualify for benefits by proving that you are unable to do any job. Social Security will look at your physical, mental, and sensory abilities to determine whether or not you are able to work. The form used to assess these abilities is called the Residual Functional Capacity (RFC).
For those with spinal cord injuries and paralysis, there is a partial or total loss of movement in areas of the body, depending on where on the spinal cord the injury occurred. In addition, the effects of spinal cord injuries and paralysis go beyond the loss of feeling or movement in certain areas of the body. Additional complications can include:
- loss of bladder control (increasing the risk of urinary tract and kidney infections and kidney and bladder stones)
- loss of bowel control
- circulatory problems from low blood pressure
- respiratory problems, including difficulty breathing or coughing and increased risk of pneumonia and other lung problems
- change in muscle tone, including loss of muscle tone or tightening of the muscles
- decrease in overall fitness and wellness, which can lead to obesity and other related illnesses
- chronic pain, and
Social Security would evaluate any of the above limitations in combination with each other to see how they limit work ability. For those who have lost use of their arms, there would be severe limitations on any physical work, as even light office work may be too physical demanding. While those with loss of the use of their legs would not be able to do physical activities that involves the use of their legs (such as working while standing up or lifting, pushing, or pulling very heavy items), there would be no limitations on the ability to do physical activities that involve the upper body, including lifting or carrying items of a lesser weight or doing work with the hands.
Mental health issues, such as depression, may be an issue for those who have become paralyzed due to a spinal cord injury. Depression can affect one’s ability to begin and complete tasks, get along with others, and deal with stresses of work. Anxiety regarding physical limitations may also affect one's ability to succeed at work. Pain that does not go away after the injury is healed (to the extent that it will heal) could further decrease overall functional abilities.
For those with paralysis, sensory abilities are often affected as well. The loss of the ability to feel might require workplace adaptations (which would not itself prevent them from performing a particular job) but could cause also safety concerns in certain work environments. For those with breathing issues, the inability to work in dust or fumes can affect where an individual could work.
Social Security will take all of these limitations into account when deciding if individuals who have had spinal cord injuries can do their past job. It's likely that they cannot, but then Social Security will assess whether they can do a sit-down job that doesn't require the use of the legs or strength. For individuals who don't have any of the above complications, such as circulatory, respiratory, or urinary system problems, Social Security may find that they can do sedentary jobs. But in cases where applicants are older and a special grid rule says they are disabled, or where applicants have certain limitations that prevent them from doing sedentary work, applicants with spinal cord injuries have a good chance of receiving benefits.