Degenerative disc disease (DDD) is one of the most common impairments for which people apply for disability benefits. While the pack pain DDD causes can make life miserable and make it very difficult to continue working, it's not easy to get disability benefits for the condition, especially for individuals younger than fifty (and particularly for individuals under the age of forty).
Social Security knows that many people suffer from degenerative disc disease, a natural part of aging in which the vertebral discs shrink. For some people, the pain is intermittent and they are able to go on working, for the most part.
As a former disability examiner, I can state that in many cases, Social Security expects an individual who has performed work of a certain exertional level to go back to that same job (after a period of time off after a back injury), or to a job where the physical exertional requirements are similar. This usually means that an individual who performed medium-level work in the past is expected to return to such work. (Medium exertion is defined as the ability to lift 50 lbs occasionally and 25 lbs frequently.) Obviously, in many cases, this is unfair and not at all realistic. Anyone who has ever experienced severe and continuous back pain (myself included) knows how debilitating it can be. And anyone who has ever picked up a 50-pound weight knows how heavy that weight is.
This is one of the fundamental problems regarding disabling impairments that involve pain: only the person experiencing the pain can actually know how bad it is and the degree to which it affects them. For this reason, and because disability examiners give little consideration to complaints of pain, medical records are very important in cases involving back conditions. Social Security ends up granting disability benefits only for those whose disc disease has progressed to having severely impacted vertebrae that can be seen on medical imaging—and that cause chronic pain and the inability to sit or stand for periods of time without assistance. That's why medical records are so important in these cases.
When a disability examiner opens a newly assigned disability application and sees either degenerative disc disease, back pain, lumbar problems, degenerative joint disease, or the acronym DJD (which stands for degenerative joint disease), the examiner begins to look for the following evidence (once they have in hand, of course, the records they've requested from a claimant's doctor):
Preferably, a disability examiner wants to see clinical evidence of:
If your DDD has advanced enough to cause one of these conditions, visit the above links to learn about the criteria needed to meet Social Security's listing for that condition.
If you don't have one of the listed conditions above, Social Security will look at your functional limitations (such as having trouble walking, an inability to stoop or bend, or an inability to lift more than 30 pounds). Social Security will create a residual functional capacity, or "RFC," form for you that lists the restrictions that your doctors have included in their notes.) For more information on this process, see our article on how Social Security assesses RFCs for back problems).
Whether you meet one of the above listings above or will need to rely on your RFC, your disability examiner will want to see that your back problem severely affects your ability to function, such as by limiting:
Interpretations of imaging studies (where a doctor reads an x-ray film and gives an opinion as to its meaning) are extremely important, since x-rays, CAT scans, and MRIs are the only purely objective evidence that will come into play in a disability case involving back problems. While a physician can easily diagnose degenerative disc disease based on a patient's symptoms, without the imaging studies, there is no way to prove the extent to which the condition exists. For this reason, disability claimants should always follow through on appointments for x-rays and the like.
Additionally, disability examiners look for certain other indications in the treating physician's notes regarding decreased range of motion, poor gait, positive straight leg raises, and reduced muscular strength. For strength, doctors use a five-point scale; for example, 5/5 right leg strength indicates full right leg strength, while 1/5 indicates severely diminished right leg strength.
Just as it is crucial in a disc disease claim to have the necessary imaging studies performed, it is also crucial to be followed closely by a physician, particularly an orthopedist. Getting regular medical treatment from a medical doctor (M.D.) or osteopath (D.O.) can help ensure that you have sufficient medical records to substantiate your disability claim for a degenerative back condition. Diagnosis and treatment by a chiropractor will not be accepted as evidence of degenerative disc disease by the SSA.
To rise above the many disability claims for degenerative disc disease, you'll need a great deal of medical evidence to corroborate your allegations. For more on how to properly support your claim, read our article on tips to winning a disability claim for degenerative disc disease.
If you're applying for Social Security disability insurance (SSDI), you can file your whole claim online on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim. Most individuals filing for SSI only cannot file the entire application online, but they can get started on Social Security's website. For more information, see our article on applying for Social Security disability benefits.
Written by: Tim Moore, former Social Security disability claims examiner