Disability for Spinal Stenosis: Social Security Benefits and SSI

Spinal stenosis is a condition that causes a narrowing of the spinal canal and compression of the spinal cord and nerves. Stenosis is usually the result of the aging process (and the accompanying thickening of ligaments and growth of bone spurs), but a bulging or ruptured disc can also cause it. Spinal stenosis usually affects individuals above 50 years of age or older, and it affects both women and men.

Types of Spinal Stenosis That Qualify for Disability

Spinal stenosis can occur in the cervical (neck) and lumbar (lower back) areas of the spine. Lumbar stenosis commonly causes "neurogenic claudication," or "pseudoclaudication," which refers to leg pain and weakness, and often difficulty walking, caused by compression of the spinal nerves.

"Foraminal stenosis" is a specific type of spinal stenosis where the "foramina" (openings on the sides of the vertebrae) get smaller, causing the nerves passing through to get pinched. Stenosis or "encroachment of a foramen" can be caused by any of the following:

• deterioration of the spine (spondylosis)
• enlargement of the facet joints (facet hypertrophy)
• arthritic changes to the facet joints (facet arthropathy), or
• the growth of bone spurs, which are in turn caused by osteoarthritis (called facet joint arthritis).

Severe cases of lumbar stenosis can progress to affect the "cauda equina" nerves (a bundle of nerve roots that descends from the end of the spinal cord). Stenosis can compress the cauda equina, causing muscle weakness and pain or cramping extending from the buttocks down through the leg that may affect your ability to stand or walk. It can also cause bladder and bowel issues.

Symptoms and Treatment of Stenosis

Symptoms of lumbar stenosis include pain in the lower back, sciatica (pain that extends down the leg), numbness or tingling in the legs or feet, weakness in the thighs or calves (caused by pseudoclaudication), and loss of deep tendon reflexes (DTR). Walking and standing for long periods can aggravate the pain caused by lumbar stenosis. Sitting often relieves the discomfort from stenosis, in contrast with other causes of back pain.

Symptoms of cervical (neck) stenosis can include neck pain, numbness or tingling in the arms or hands, weakness of the upper or lower limbs, and problems with walking and balance.

Treatment for spinal stenosis, either lumbar or cervical, depends upon the area affected; surgery, however, is an option for both types of spinal stenosis.

Does Stenosis Qualify for Disability Benefits?

Social Security does have an official listing for lumbar spinal stenosis in its listing of impairments. If you meet the requirements in the stenosis listing, you can automatically qualify for disability benefits. Beware, this listing is complicated; you'll likely need your doctor's help to read through it and determine whether you might meet the requirements of the listing.

To qualify as disabled under this listing, you must have all of the following:

• at least one sign of neurological compromise in the cauda equina:
  • nonradicular (nonradiating) distribution of pain in a leg or foot
  • nonradicular distribution of sensory loss in a leg or foot, or
  • pseudoclaudication.
• a diagnostic test or clinical exam showing nonradicular neurological signs of muscle weakness and sensory changes evidenced by one of the following:
  • decreased sensation
  • sensory nerve deficit on electrodiagnostic testing
  • lack of reflexes, trophic ulceration, or bladder or bowel incontinence, or
  • decreased deep tendon reflexes in one or both lower extremities.
• an MRI, CT scan, or other imaging showing compromise of the cauda equina with stenosis, and
• a resulting physical limitation, with medical documentation, that makes one of the following true:
  • you need a walker, bilateral canes or crutches, or a wheelchair or scooter that requires both hands, or
  • you can't use one hand, and you need the other to operate a one-handed wheelchair, cane, crutch, or other device.

The four required symptoms or tests above must be present simultaneously, or within a "close proximity of time." Social Security generally defines close proximity as being within four months of each other. So if you had an MRI showing stenosis last year and the other three symptoms or tests last month, Social Security might not count the MRI (unless, in a doctor's opinion, the MRI findings could be reasonably expected to have been present when the stenosis began).

What Your Medical Records Should Include

When you apply, notes from a detailed physical exam with your doctor should be in your medical records, including the results of testing your reflexes and muscle strength. Your doctor should also note any limitations you have, such as whether you need a walker, cane, or other "assistive device" and how long you can sit without changing position.

These limitations and functional restrictions will be helpful when Social Security assesses your residual functional capacity (RFC). If you are able to walk and get around without the assistance of assistive devices or people, you won't qualify for benefits automatically under the above listing, but Social Security will give you an RFC and use it to determine if there are any jobs you can do. Similarly, if you have cervical stenosis, Social Security will not use the above listing, but will instead evaluate your RFC. (For more information, see how Social Security uses RFCs for back problems.)

Your medical records should also include the medications you are taking, any negative side effects, and the treatments you have had, such as physical therapy, spinal decompression, or steroid injections. You should also have the results of an MRI or CT scan supporting a diagnosis of stenosis.

How to Apply for Disability Based on Spinal Stenosis

If you're applying for Social Security disability insurance (SSDI), you can file your entire claim online on Social Security's website. Most individuals filing for SSI only cannot file the whole application online, but they can get started on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim. For more information, see our article on applying for Social Security disability benefits.

If you'd like help with your application, or you just can't get started, think about working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Unless you have lumbar stenosis so severe that you need assistance walking, you probably won't get disability benefits automatically. You'll need to rely on your doctor to document your functional restrictions and provide objective medical evidence to back them up. The doctor needs to submit this information to Social Security so that the agency can create an accurate RFC for you.

A legal professional or disability firm can help you line this up, and they know the questions to ask your doctor regarding your stenosis and your limitations. Consider having a free case evaluation with a legal professional to determine whether your spinal stenosis is severe enough to qualify for benefits.

_{Updated April 21, 2022}