Back pain can be caused by many different spinal conditions, many of which happen normally with age. Chronic back conditions that cause back pain include:
This article focuses on how the Social Security Administration (SSA) views symptoms of back pain and how the consistency between your medical records and your statements about your symptoms and pain (in other words, your credibility) can affect the success of your back disability claim.
While back pain can be agonizing and frustrating, and sometimes incapacitating (especially lower back pain), Social Security doesn't hand out SSDI or SSI disability benefits readily for back pain.
To qualify for disability benefits, first, Social Security requires you to have a "medically determinable" impairment (MDI) that lasts for at least one year. The duration 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 often won't qualify for Social Security disability or SSI.
Social Security sees many disability claims for back pain, but approves a only 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 and truly prevent the claimant from being able to do any kind of work.
After determining that you have an MDI (medically determinable impairment), the SSA assesses the severity of your impairment by looking at:
The SSA maintains a listing of impairments that can automatically qualify for disability. If your condition matches the requirements of any of the following listings, you could qualify automatically for disability. To learn about the criteria for each listing read our articles on the following types of back problems:
If your back pain doesn't meet the impairment listings for any of the conditions mentioned above, the SSA will assess your residual functional capacity (RFC). Your RFC is the most that Social Security thinks you can do despite the limitations caused by your medical conditions.
To develop your RFC, Social Security will want to know whether:
To learn about the RFCs that Social Security develops for each type of back condition, read one or more of the following articles:
For more information about back RFCs in general, see our article on how Social Security assesses a reduced RFC due to back problems.
Officially, Social Security follows the criteria in the listings and the rules regarding your RFC to determine whether you are disabled. But since your claim is probably largely based on your subjective reports of back pain, the claims examiner or judge determining the outcome of your claim is likely to try to assess how believable your symptoms are.
Social Security no longer formally assesses your "credibility" as part of a claim. But your credibility—whether the claims examiner and/or administrative law judge believes your pain is as bad as you say it is—is still likely to matter in chronic pain cases.
Pain complaints must be supported and consistent. 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 is inconsistent with your reports of how much you're limited by your pain, Social Security may find that the extent of your limitations isn't supported by the test results or other information. For instance, if an applicant says on his function report 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 that inconsistent.
Factors that can support your complaints of pain. In considering how much your pain limits you, Social Security will consider some or all of the following factors (in addition to whether your objective test results support your pain complaints):
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 even ask you to see a psychiatrist for a consultative exam.
To learn more about how Social Security evaluates the intensity and persistence of your symptoms, see our articles on how Social Security evaluates your credibility and getting disability benefits for chronic pain.
Updated May 25, 2022