How Does Social Security View Disability Claims for Back Pain?
Disability claims focusing on back pain often come down to your credibility and whether your complaints of pain are believed.
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Back pain can be caused by many different spinal conditions, many of which happen normally with age. Chronic conditions causing back pain include degenerative discs (created by wear and tear, or osteoarthritis); inflammatory conditions like rheumatoid arthritis, arachnoiditis, and spondylitis; and problems involving the nerves in the back: spinal stenosis, nerve root compression, herniated discs, scoliosis, or spondylolisthesis.
You can visit the above links for specific discussions of getting disability for those conditions, but this article will focus on how Social Security views the symptom of pain and why your credibility is so important with back disability claims.
Can You Get Disability for Back Pain?
While back pain can be agonizing and frustrating, and sometimes incapacitating (especially lumbar pain), Social Security does not hand out SSDI or SSI disability benefits readily for back pain.
To qualify disability benefits, Social Security requires you to have a “medically determinable” impairment that lasts for at least one year. This means that x-rays, MRIs, or at least your doctor's notes after a physical examination must show that your back pain is caused by some physical abnormality of the spine or spinal canal. If you have back pain without a physical impairment that normally produces pain symptoms like yours, you're unlikely to win disability benefits.
(But note that back pain caused by obvious injuries like muscle strains and fractures usually heal within a few weeks or months, so won't qualify for Social Security disability or SSI.)
How Social Security Evaluates the Severity of Your Back Pain
Social Security sees many, many disability claims for back pain, but only approves a few of the most severe cases; Social Security expects most others to be able to work through their back pain. So Social Security's job is to determine which claims for back pain are the most serious. The agency does this by looking at:
- your objective symptoms, to see whether they match the requirements in Social Security's impairment listing for spinal disorders (the listed conditions can be found in our section on spinal disorders)
- your functional limitations (for example, your range of motion is limited so that you can't stoop or bend, you have trouble walking, or you need to switch positions frequently) to see what type of work you could do (see our section on how Social Security determines disability using functional limitations, and
- your credibility, since most of your claim is based on your subjective reports of back pain.
How Social Security Evaluates Your Credibility
Your credibility -- whether the claims examiner and/or administrative law judge believes your pain is as bad as you say it is – is key in chronic pain cases. To evaluate your credibility, Social Security will consider some or all of the following factors (in addition to whether your objective test results support your pain complaints):
- how often you have been to the doctor
- what treatments you have tried (for example, medication, therapy, cortisone shots)
- your doctor's opinion of your pain level and limitations
- how the pain affects your activities of daily living
- whether you appear to be exaggerating your level of pain, and
- how much pain is normally reported by others with your physical findings.
If you say you have extreme back pain but your objective test results don't indicate that your pain should be so severe, Social Security might ask you to see a psychiatrist for a consultative exam.