Degenerative disc disease (DDD) happens when the discs of the spine wear out over time. Spinal discs are like cushions that are supposed to act as shock absorbers, but they can dry out or become damaged. While the neck or back pain that DDD causes can make life miserable and can 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).
Disc degeneration in the lower back or neck can be caused by:
Not everyone has symptoms from degenerating discs, but common symptoms include:
When the intervertebral discs become dried out or damaged, the vertebrae can rub against each other, causing bone spurs (bony growths) and muscle weakness. Overtime, disc degeneration can lead to:
DDD is one of the most common impairments for which people apply for disability benefits, and Social Security doesn't approve many claims.
Social Security knows that many people suffer from degenerative disc disease and considers mild cases to be a natural part of aging. For some people, the pain is intermittent and they are able to go on working.
Most Social Security claims examiners expect people go back to their same or similar jobs after a period of time off after a back injury. This usually means that an individual who did medium-level work in the past (the ability to lift 50 pounds occasionally and 25 pounds frequently) is expected to return to such work. Obviously, in many cases, this isn't realistic. Anyone who has ever experienced severe and continuous back pain knows how debilitating it can be.
One big problem regarding back pain is that only the person experiencing the pain can actually know how bad it is and the degree to which it affects them. Claims examiners will give little consideration to complaints of severe pain unless your medical records include objective evidence that backs up your level of pain. That's why x-rays and MRIs are very important in cases involving back conditions.
Social Security will generally only grant disability benefits for those with medical imaging (x-rays, MRIs, or CT scans) that show the DDD has severely impacted the vertebrae or spine. During the disability determination process, a doctor who works for Social Security has to agree that the imaging explains why the applicant has severe, chronic pain and is unable 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 an application and sees degenerative disc disease, back pain, lumbar problems, or degenerative joint disease, the examiner looks for evidence that the applicant has a severe impairment. So the examiner will look for the following in the medical records:
Next, the disability examiner will look to see if there's enough evidence in your medical records to meet one of Social Security's spinal disorder listings:
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. Functional limitations are limitations on what you can do, such as having trouble walking, an inability to stoop or bend, or an inability to lift more than 25 pounds. Social Security will create a residual functional capacity, or "RFC," form for you that will include any limitations and restrictions your doctors have included in their treatment notes.
Disability examiners will also look for indications 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 left leg strength" indicates severely diminished left leg strength.
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:
(For more information on this process, see our article on how Social Security assesses RFCs for back problems.)
To have the best chance of getting approved for disability, try to submit a few of the following types of evidence to your claims examiner:
To rise above the many disability claims for degenerative disc disease that Social Security sees, the more evidence you have to corroborate your back pain, the better. This is why it's crucial to be followed closely by a physician.
Well, while it's true that doctors determine what goes into medical files, it's also true that patients can exercise a small degree of influence over that process. Here are some tips that may help tips the scales in your favor.
Get regular medical treatment. The importance of this cannot be overemphasized. Disability examiners and administrative law judges (ALJs) who work for Social Security find it difficult to approve cases in which the newest medical records are more than two months old. (This is true even in situations with good long-term medical records. Try to go to a doctor at least once every two months.
Getting medical treatment from a medical doctor (M.D.) or osteopath (D.O.) can help ensure that you have strong medical records to support your disability claim for a degenerative back condition. Social Security can't accept a diagnosis from a chiropractor or physical therapist. If you can get a referral to an orthopedist, that's even better.
Try to be seen by the same physician on an ongoing basis. By doing this, you can develop a relationship with a doctor who, in turn, may be more attentive and responsive to your condition.
The simple truth is, most doctors see an incredible number of patients and tend to be more responsive to the ones they are more familiar with. By seeing one physician more frequently, as opposed to several physicians infrequently, you may end up with better records, as well as a more sympathetic doctor. And when the time comes to ask your doctor for a statement supporting your disability case, your doctor may be more willing to take the time to write one up.
Make your doctors aware of your physical limitations when you visit them. If, for example, you have trouble bending, stooping, or crouching, let the doctor know. Doctors seldom check a patient's ability to stoop, bend, or crouch during an examination, and yet bending, stooping, and crouching are the three primary nonexertional limitations that disability examiners look for when they evaluate the RFC of applicants with degenerative disc disease. If you are completely unable to stoop, for example, you have a good chance of getting benefits, since most jobs require a least some stooping.
For this reason, disability examiners will often call applicants and ask them questions such as:
Since your regular physician may not test you for these limitations when you have a doctor's appointment, it's a good idea to mention them to your doctors in the hopes that they will record them in their treatment notes.
Keep your family and friends up to date on your physical limitations. Disability examiners often call applicants to ask questions about their daily activities, but they also routinely contact the relatives and friends of applicants. Examiners refer to these calls as ADL calls ("activities of daily living" calls).
Technically, examiners are supposed to make ADL calls for the purpose of gathering "supporting" information on claims, but they usually use them to gather evidence to deny cases. Examiners can ask tricky questions to try to get applicants to give responses that aren't helpful to their case. For this reason, disability examiners aren't allowed to make ADL calls to applicants who are represented by legal representatives. (Social Security must contact their representatives instead.)
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.
If you'd like help with your application, think about contacting with a legal representative or disability firm that specializes in SSDI. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Click for a free case evaluation with a legal professional to determine if your back problems qualify you for benefits.
If you receive a denial letter and feel your case is strong enough to win an appeal—maybe your back has gotten worse or you have a new MRI—consider contacting a disability lawyer for help appealing your claim. Applicants who go to an appeal hearing represented by a lawyer have a better approval rate than applicants who represent themselves.
Updated October 28, 2021