Back surgeries and spinal fusions can be needed for many different reasons. Compression of spinal nerves caused by arthritis or scoliosis, degenerative disk disease, broken vertebrae, herniated disks, and any condition that causes spine instability may lead to the need for back surgery.
There are several different types of back surgery, with the most common type of surgery being spinal fusion. Here is a list of the various types of back surgery that can be performed:
There are risks that are associated with all back surgeries beyond the immediate risks that are present with any surgery done under anesthesia. Risks from back surgery include:
In order to receive Social Security Disability benefits, the condition of your back must match one of Social Security's disability listings for back problems or you must convince your claims examiner that your back problems limit your functioning so much that there are no jobs you can do.
There is no specific disability listing for back surgery or spinal fusion, but if the surgery did not correct your impairments, you might meet the requirements of a listing based on the ailments or impairments that led you to need back surgery or spinal fusion.
If your back surgery or spinal fusion was not successful at restoring your back, you might qualify for benefits under this listing; the underlying causes for the need for most back surgeries are covered in this listing. To qualify as disabled under this listing, you must show that you have one of the following:
Another way to receive disability benefits is to "equal" a listing. Your condition will be considered medically equivalent to a listing if you can show that you have impairments that are similar in severity and duration to a similar impairment.
This disability listing applies to surgery or fusion on weight-bearing joints, which Social Security considers to be the hip, knees, shoulder, elbow, wrist/hand, and ankle/foot. To meet the requirements of this listing, you must show that you are unable to walk effectively and that a return to normal walking did not happen after the surgery, and it is not expected to happen for at least 12 months from when its onset.
The spine is specifically not included in this listing with the other major weight-bearing joints; however, the limitations on walking that can be caused by (or not corrected by) back surgeries are the same that can occur from injuries or surgeries to the major weight-bearing joints. Therefore, it's likely that your spinal fusion could equal this listing if it did not correct difficulties you have with walking and your difficulties are just as severe and will last as long those caused by injuries or surgeries to major weight-bearing joints. Other back surgeries, including the placement of artificial disks into the spine, may be considered reconstructive surgeries and could equal this listing as well.
The medical evidence that is required to get disability benefits for back problems or back surgery includes detailed descriptions from physical examinations of the spine, descriptions of any problems with walking and limitations noted when asked to do tasks such as walking on your toes or heels, limitations in range of motion, and observations from the physician regarding any limitations seen while at the appointment (such as difficulty getting onto or off of the examination table). Laboratory findings that include x-rays, MRIs, and CAT scans are helpful.
Social Security will be looking for evidence that your disabling symptoms will last at least 12 months, if they have not already, but back impairments, especially following surgery or fusion, frequently improve over time and/or with treatment. Therefore, your medical record should cover the entire duration of your back impairments, including different treatments that were tried, when they were tried, and your body’s response to the different treatments.
Many patients who apply for disability following back surgery will not meet or equal a listing, but still get disability by showing their functioning is so limited by their back problems that there is no work they can do.
RFC assessment. If you don't meet a listing, your Social Security claims examiner is required to evaluate your ability to do any type of work by assessing your Residual Functional Capacity (RFC). To do this, the examiner will look at your ability to do physical work, called exertional limitations, and the other abilities required to do work, called nonexertional limitations.
Exertional limitations. For those who have had back surgery, including spinal fusions, the physical activities associated with work may be difficult. If there is damage to the spinal nerve, you have limitations on range of motion in the spine, or you suffer from loss of sensation, weakness, or pain in the legs, you may be unable to lift, carry, or move items. These exertional limitations would make you unfit for heavy or medium work, but are not enough for you to qualify for disability benefits.
Nonexertional limitations. You must show that you have non-exertional limitations as well, such as an inability to concentrate enough to finish a task or sit at a desk for an extended period of time. Individuals who have had back surgery may have difficulty sitting in one position without discomfort or concentrating if they have residual pain in their back or legs. Additionally, bowel and bladder issues may also increase their need to use the bathroom, which would further interrupt their ability to complete tasks.
Less than sedentary work. If your exertional and non-exertional limitations combine to make it impossible for you to do heavy or medium work requiring lifting, as well as light or sedentary work requiring sitting and concentrating (sometimes called the ability to do "less than sedentary work"), you should be approved for disability. But this is not an easy test to pass -- for more information, see our article on less than sedentary work.
The job of a vocational expert. Social Security can almost always come up with a job that you can do. Your claims examiner may consult with a vocational analyst employed by Social Security to see if they can find any jobs that someone with your limitations can do (a favorite of examiners is "surveillance system monitor," since it takes little exertional or non-exertional capacity). If the examiner and analyst come up with any job you could do (while also taking into account your prior job skills, English-language skills, and education), you will be denied benefits. But if you (or more likely, your disability lawyer) can come up with reasons that you can't do each job raised by the vocational expert (this would happen at an appeal hearing), you could be granted a medical-vocational allowance.