Disability Benefits for Spinal Fusion or Back Surgery

Back surgeries and spinal fusions can be needed for many different reasons. Back surgery can relieve the compression of spinal nerves caused by arthritis, scoliosis, degenerative disk disease, or herniated disks. It can also stabilize the spine for those with conditions that cause spine instability, such as lumbar spondylolisthesis (vertebral slippage), fractured vertebrae, or tumors.

Types of Back Surgery That Can Cause Disability

The most common type of surgery is spinal fusion, where two or more of the vertebrae in your spine are connected to become one solid piece, but other types of surgeries can also help chronic back pain and instability:

• diskectomy, or microdiscectomy, which is the removal of part or all of a herniated disk
• laminectomy, which is the removal of part of the bone that lies over the spinal canal
• vertebroplasty, which is the injection of bone cement into compressed vertebrae, and
• artificial disks, which is the placement of artificial disks in between two vertebrae. Placement of such disks is done as an alternative to spinal fusions.

How Back Surgery or Spinal Fusion Can Lead to Impairments

Some back surgeries fail to improve back pain or mobility; they are often referred to as "failed back surgeries." This term doesn't necessarily mean that a patient's condition deteriorated after surgery; it can simply mean that the surgery wasn't successful. But some patients do experience adverse effects following back surgery, including the following complications:

• infection at the opening from the surgery or in the vertebrae bone itself
• instability in the spine when vertebrae are not fused together
• degeneration (wearing down) of the vertebrae above and below the fused vertebrae
• arachnoiditis, or inflammation of a membrane that surrounds the nerves of the spinal cord
• scar tissue that builds near a spinal nerve root (epidural fibrosis), or
• damage to the spinal nerve, which can lead to limited range of motion in the spine, permanent loss of sensation, weakness and pain in the legs, and problems with the bowel and/or bladder.

Disability Benefits Following Back Surgery or Spinal Fusion

In order to receive Social Security disability benefits, you must have evidence of certain conditions in your back that match one of Social Security's disability listings for back disorders (called "meeting a listing") or you must convince your claims examiner that your back problems limit your functioning so much that there are no jobs you can do (called getting a medical-vocational allowance).

Meeting a Disability Listing for Spinal Surgery or Fusion

There is no specific disability listing for back surgery or spinal fusion, but if the surgery didn't correct your impairments, you might meet the requirements of a listing based on the impairments that led you to need back surgery or spinal fusion. Or, where surgery causes nerve compression or arachnoiditis, you might qualify for benefits under the listings for those conditions. The two main listings related to the spine are:

• listing 1.15, compression of a spinal nerve root, and
• listing 1.16, narrowing of the spinal canal in the lumbar area.

Social Security used to have a listing for arachnoiditis, but the agency deleted the listing in April 2021. Arachnoiditis is now evaluated under listing 11.08, the neurological listing for spinal cord disorders. Visit the above links for information on getting disability for those disorders.

Social Security also has a listing for the surgical fusion of weight-bearing joints (listing 1.17), but that listing applies only to hips, knees, ankles, and feet. While the spine isn't included in this listing, limitations on walking that can occur from surgeries involving the weight-bearing joints are similar to those that occur from back surgeries. You can actually qualify for benefits by "equaling" a listing if your condition is considered medically equivalent to that in a listing. If you had a spinal fusion and have problems walking, you could equal listing 1.17 if your difficulties are just as severe and will last as long as 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. For more information, see our articles on getting disability after hip replacement surgery or knee replacement surgery.

Medical Evidence Required to Meet a Listing

The medical evidence that is required to get disability benefits for back surgery includes detailed clinical notes from a physical examination of the spine, descriptions of any problems with walking, 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). You'll need some kind of medical imaging such as an x-ray, an MRI, or a CT scan.

Duration of Your Symptoms and Medical Records

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.

Showing Your Functioning Is Too Limited for Any Jobs

Many patients who apply for disability benefits following back surgery will not meet or equal a listing, but can 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 first look at your ability to do physically challenging work, such as walking, lifting, or carrying, called exertional limitations. Then the examiner will assess whether you have other abilities that may be required to do work, such as stooping, crouching, speaking, concentrating, or remembering instructions, 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 you have damage to a spinal nerve, you might have limited range of motion in the spine. If 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 probably not enough for you to qualify for disability benefits on your own.

Nonexertional limitations. If you also have non-exertional limitations, such as an inability to reach for files or an inability to concentrate enough to finish a task or remember instructions, you may be more likely to be approved for benefits.

Less than sedentary work. If you can't do medium or heavy work, you'll likely have to be able to sit down for an extended period of time to work. Individuals who have had back surgery may have difficulty sitting in one position without discomfort or problems concentrating if they have residual pain in their back or legs. Additionally, bowel and bladder issues from spinal nerve issues may also increase their need to use the bathroom, which could further interrupt their ability to complete tasks. (Social Security calls not being able to work a desk job being able to do "less than sedentary work.")

If your exertional and non-exertional limitations combined make it impossible for you to do heavy or medium work requiring lifting as well as light or sedentary work requiring sitting and concentrating, 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, which can prevent you from getting benefits, as long as that job exists in the economy. 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.

How to Apply for Disability Benefits

If you are going to apply for Social Security disability insurance (SSDI), you can file your entire claim online on Social Security's website. (For SSDI, you must have enough work credits to qualify.) If you're not comfortable filling out forms online, you can call Social Security at 800-772-1213 to get your claim started.

If you don't have enough work credits and you have low income, you can apply for SSI (Supplemental Security Income). Most individuals filing for SSI cannot file the whole application online, but they can get started on Social Security's website. For more information, see our article on how to apply for Social Security disability benefits.

_{Updated October 15, 2022}