Patients who have back conditions often seek treatment from chiropractors rather than physicians (MDs). But applicants who file for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) on the basis of back pain are often denied due to a lack of proper medical documentation to back up their claim for disability. The Social Security Administration (SSA) requires that an applicant has medical documentation from an "acceptable medical source."
Disability claims examiners and judges who work for Social Security will only consider opinions from "acceptable medical sources" when deciding whether a disability applicant has a "medically determinable impairment." Historically, this has meant that the applicant must have a diagnosis from a doctor (M.D.) or osteopath (D.O.) with a medical degree.
Today, Social Security will now also accept medical statements from nurse practitioners and physician assistants (P.A.s). (For cognitive or emotional impairments, the agency will also accept records from licensed psychologists for claims related to intellectual or learning disabilities and from psychiatrists for all other cases involving mental impairments.)
Even though chiropractors are specialists in musculoskeletal issues, they aren't acceptable medical sources. So disability examiners and administrative law judges (ALJs) don't need to consider the opinions of chiropractors when deciding if a disability applicant has a severe "medically determinable" impairment, which is one of the first steps in getting disability benefits.
If you can afford it, see an M.D. or D.O. If you can't afford it, see our article on getting disability without health insurance.
If you're able to submit a diagnosis of a back ailment from a medical doctor to Social Security, then claims examiners and disability judges should take your chiropractor's records into account when looking at the severity of your back pain and how it limits your abilities.
If you have a long treating relationship with your chiropractor, the examiner or judge is required to evaluate your chiropractor's records for information on the severity of your limitations, as long as the records are supported by medical evidence and not inconsistent with other information in your medical records. In addition, examiners and ALJs will review imaging studies ordered by chiropractors, such as x-rays.
But again, claims examiners and judges don't have to rely on a chiropractor's diagnosis and prognosis in determining whether you have a serious medical condition (since chiropractors aren't acceptable medical sources). And examiners and ALJs aren't required to explain how they assessed evidence from a chiropractor and whether they gave it any weight in deciding whether you were disabled.
If you're suffering from a painful back condition that's compromising your ability to perform your job, schedule a visit with a doctor. And it would be wise to schedule and keep regular appointments with the physician. When your doctor has become familiar with your condition, ask them to include in their treatment notes information regarding your functional limitations and actions that you now have difficulty performing as a result of your condition.
Getting a medical doctor's detailed opinion about your diagnosis and prognosis and how your medical condition limits your abilities and activities is the most important thing you can do to win your disability case. Social Security will often give substantial weight to the opinion of your treating doctor—unless it's not supported by objective medical evidence or is inconsistent with other evidence in your file.
If you feel your doctor will support your disability claim, ask them to fill out a residual functional capacity (RFC) form, which is usually in the form of a check-off list of normal daily activities that you can or can't perform, and the degree to which you can engage in them. RFC forms will often ask the doctor to rate your ability to sit, stand, and lift, as well as inquire about your reflexes and range of motion.
Though some doctors are reluctant to take the time to fill out an extensive form, it can help to make a separate appointment to go over the form with your doctor (read more tips about getting your doctor's cooperation for your disability claim).
If you're unable to get a supportive opinion from a medical doctor, read our article on applying for disability without seeing a doctor.
If the only medical records you have in relation to your back pain are from a chiropractor's office, the SSA will likely send you to a "consultative exam" (CE) with a doctor paid for by Social Security. Consultative exams are what most people think of as "Social Security medical exams" and are performed by independent doctors hired by Social Security to provide medical opinions for disability claims.
This type of assessment isn't likely to help your claim, because a doctor who only sees you once for a few minutes isn't going to understand your limitations as well as a health care provider who has seen you over a long period of time. The exams are brief (usually less than 20 minutes) and rarely help someone get approved for disability benefits.
There have been federal court rulings on whether chiropractors can be considered acceptable medical sources. Some federal courts have said that the opinion of a chiropractor who regularly treats a patient should be given the same weight as a medical doctor. Social Security has not changed its rule, however, that says that a chiropractor is not an acceptable medical source, so while you could end up winning your case in federal court after several appeals, it's a much better idea to get an M.D.'s opinion from the get-go.
Whether your chiropractor can put you on disability depends on what type of short-term disability benefits you're applying for--government benefits or insurance company benefits.
Most private and employer-provided short-term disability insurance policies require you to be under the care of a physician before they will approve you for short-term disability benefits. This generally means a medical doctor (M.D.) or an osteopath (D.O.) must certify your claim as the "attending physician." Receiving treatment from a chiropractor (D.C.) and having the chiropractor sign a medical certification stating that you're unable to work isn't enough for most disability insurance companies.
Out of the handful of states that provide short-term disability benefits, about half of them currently allow a chiropractor to sign the medical certificate or certification on the claim form.
For instance, for California short-term disability benefits, the Employment Development Department (EDD) specifically says that a chiropractor (or podiatrist, dentist, optometrist, nurse practitioner, physician assistant, or psychologist) can certify your claim for short-term disability (SDI) in California. And if you apply for CA SDI online, you'll receive a receipt number that you can then give your chiropractor or other health professional so that they can submit their medical certification for your claim.
And for New York short-term disability benefits, a chiropractor, podiatrist, dentist, optometrist, nurse practitioner, or psychologist can fill out the claim form, Form DB-450, as long as they are licensed or certified.
Updated March 29, 2023