Disability Benefits for Reduced Capacity Caused by Back Problems

Back problems, injuries, and disorders are some of the most common conditions that qualify disability applicants ("claimants") for Social Security benefits. While claimants with severe stenosis or nerve root compression might be awarded disability under Social Security's Listing of Impairments, most people who get benefits for back problems qualify because their reduced capacity to sit, stand, and walk prevents them from working at any job.

Can You Get Disability for Reduced Capacity Caused by Back Problems?

If your back condition prevents you from working full-time for at least 12 months, the Social Security Administration (SSA) can award you disability benefits. Social Security will determine whether you can still do any jobs despite your reduced capacity for physical activities, such as lifting or bending over, by examining your:

• medical records
• doctors' opinions, and
• functional limitations.

If you can't do any of the jobs you've done in the past, or any other less demanding work, the SSA will find you disabled.

How to Qualify for Disability Based on Reduced Capacity Caused by a Back Injury

A Social Security disability claims examiner—with the help of a medical consultant—will review your medical records for evidence that illustrates how severe your back problems are. The SSA will be on the lookout for the following documentation:

• objective imaging such as X-rays, MRIs, and CT scans that show the extent of your back problem (whether it's mild, moderate, or severe)
• physical examinations showing limitations in your ability to move ("range of motion")
• progress notes containing your doctors' observations and recommendations on how to treat your back problem
• a list of prescribed medications you've tried and any side effects you've had
• admission and discharge notes from any hospitalizations you've had, and
• your doctor's opinion on what activities you should avoid doing.

The claims examiner will review your medical records and your activities of daily living form to determine your residual functional capacity (RFC). Your RFC is a set of restrictions reflecting Social Security's assessment of the most you can do, physically and mentally, in a work environment. The SSA uses your RFC to determine whether you can do your past work or any other jobs in the national economy.

What Is the Process of Getting Disability for Reduced Capacity Due to Back Problems?

A typical RFC for someone with back problems will almost always include limitations on how much weight you can lift and how long you can be on your feet. Social Security refers to these restrictions on basic physical activities as your "exertional level." Your exertional level is defined by the types of jobs you could do within your limitations.

The SSA has five exertional levels that it categorizes as follows:

• Sedentary work means that you can stand and walk no more than two hours out of an eight-hour day, and you can't lift more than 10 pounds occasionally or five pounds frequently.
• Light work means that you can stand and walk up to six hours out of an eight-hour day, but you can't lift more than 20 pounds occasionally or 10 pounds frequently.
• Medium work means that you can stand and walk up to six hours out of an eight-hour day, and you can lift up to 50 pounds occasionally or 25 pounds frequently.
• Heavy work means you can stand and walk enough to do medium work, and you can lift up to 100 pounds occasionally and 50 pounds frequently.
• Very heavy work means you can stand and walk enough to do heavy work, and you can lift more than 100 pounds occasionally and more than 50 pounds frequently.

Most claimants with back problems will get an RFC with an exertional level for medium, light, or sedentary work, depending on how extensive their back condition is. For example, somebody with an X-ray showing mild degeneration in the cervical spine could be restricted to medium work, while somebody with an MRI showing severe lumbar spondylitis might be restricted to sedentary work.

Your RFC will likely also include non-exertional restrictions on activities unrelated to the weight you can lift or how long you can stand. Examples of non-exertional restrictions include:

• Manipulative limitations restrict how often you can use your arms, hands, and fingers to reach, grab, and move objects. Your RFC might contain manipulative limitations if you have cervical spine problems that cause radiculopathy in your upper extremities.
• Postural limitations restrict the amount of bending, stooping, crouching, and crawling you can do. Slipped discs in the thoracic or lumbar spine often result in postural limitations.
• Mental limitations restrict the types of tasks you can perform and whether you can perform them with others. Pain from your lumbar spondylosis or side effects from your medications that have an impact on your mood and concentration can result in mental limitations.

Does Your Reduced Capacity Keep You From Doing Your Past Work?

Social Security will compare your current RFC with the physical and mental demands of the jobs you've had over the past five years. For example, if your past jobs required you to lift and carry more than 75 pounds, but your current RFC limits you to light work, Social Security will find that you can't do your past work.

Being unable to perform your past work can be enough for Social Security to find you disabled under the medical-vocational grid rules, depending on non-medical factors, including:

• your age
• your education, and
• whether you have transferable skills.

If you aren't found disabled according to the grid rules, you'll need to show that no jobs exist that you can do with your reduced abilities.

Can You Do Other, Less Demanding Jobs With Your Reduced Capacity?

Social Security doesn't expect you to do any jobs that are more demanding than your current RFC. For most claimants—particularly if you're under the age of 50—the SSA needs to see that you can't perform even the easiest sit-down jobs. In Social Security lingo, this is called having an RFC for "less than sedentary" work.

Claimants with severe back problems have a lot of ways to show that they can't perform sedentary work. Usually, this involves combining exertional and non-exertional limitations to rule out all jobs. Common examples of limitations that eliminate sedentary jobs include:

• being unable to stand or walk for longer than two hours total in a workday
• needing to elevate your legs, recline, or lie down to reduce pain in your lumbar spine
• having difficulty raising your arms above your head or reaching in front of you
• needing to frequently alternate between sitting and standing
• being restricted in using your hands or fingers to move small objects
• missing too many days of work or taking too many breaks, and
• having reduced productivity due to poor concentration and focus.

Why Social Security Might Deny Your Disability Claim Based on a Spinal Condition

Social Security is more likely to deny your initial claim for disability than to approve it. Statistically, the SSA initially denies about 65% of all disability applications. And the approval rate is even lower for back problems.

There are many reasons Social Security might deny your disability claim even if your back problems are so severe that you really can't work.

What If Social Security Mistakenly Thinks You Can Still Do Your Prior Job?

Sometimes, the claims examiner doesn't fully understand the physical and/or mental capacity needed to do your past work. For instance, let's say you used to work as a forklift operator, but you can't do that job anymore because arthritis in your lumbar spine and bulging disc keeps you from lifting 20 pounds regularly. A claims examiner who mistakenly believes that a forklift driver doesn't have to lift 20 pounds regularly would think you could still do that job.

In such a case, you'd have to appeal the denial and convince a Social Security judge that a forklift driver job requires more lifting than your back can handle.

What If Social Security Thinks You Can Do More Than You Can, Despite Your Back Condition?

Sometimes, Social Security gets the wrong impression about what you still can and can't do. For instance, your doctor might have said you can only do light work, but the SSA could give you an RFC for medium work.

If your degenerative disc disease means you really can't do medium work—for instance, if you can't lift more than 10 pounds regularly—you'll need to prove that your RFC should be for light work.

What If Social Security Thinks There's Other Work You Could Do?

It's possible Social Security agrees you can't do your old job because of chronic back pain, but thinks your job skills could be used in other work that doesn't require the same physical or mental exertion. For instance, if you were a forklift driver, the SSA might believe your experience operating a machine would transfer to some other kind of work—even if you're an older worker.

This matters because the grid rules say that a 55-year-old restricted to light work should be considered disabled. But if Social Security believes you have transferable job skills, and that you could use them at a job within your RFC, the grid rules don't apply.

What to Do If You're Disability Claim for a Bad Back Is Denied

Most successful disability claims for back problems are won on appeal. So, an initial denial doesn't mean you can't get disability benefits. But you'll need to approach the appeals process strategically.

Find Out Why Social Security Denied Your Disability Claim

First, find out precisely why Social Security denied your back impairment claim so you can decide what arguments you can use. Your denial notice should include a "technical rationale" (which includes an explanation of your RFC and why you were denied). If it doesn't, you should request your file from Social Security so that you can review it.

Request an Appeal Hearing

Let's assume the explanation in your denial letter or file states that you have an RFC for light work but that you can do your old job. You'll need to request an appeal and prove that you can't, in fact, do your old job.

At your appeal hearing, the administrative law judge (ALJ) will ask you what was required of you at your old job and how your back impairment limits you from doing it. The ALJ must compare each requirement of your past job with the limitations in your RFC. If there's a limitation in your RFC that conflicts with even one of the demands of your job, the ALJ should find that you can't do the work.

Challenge the Vocational Expert's Opinion

Your judge will likely request that a vocational expert (VE) attend your hearing to testify whether the limitations from your back condition prevent you from doing your old job. If the expert thinks you can do your past work despite your impairment, and the ALJ agrees, your claim will be denied.

For example, if your RFC is for light work, for the vocational expert to say you can do your past work, the job must have required only light work, meaning regularly lifting only 10 pounds or less. But if your past job required more exertion than that—say lifting 20 pounds regularly—you can challenge the VE's opinion.

The VE can get it wrong by using an inaccurate job title or description to decide your past work was light work when that wasn't the case. To challenge the VE, you'll need to politely inform the ALJ that you were required to lift 20 pounds (or whatever the higher exertion was) and offer proof. Learn more about correcting the details of your past work.

Legal Representation Can Help You Get Disability Benefits

Because Social Security sees so many applications for disability benefits based on reduced capacity from back problems, standing out among other claimants can be challenging. Consider hiring an experienced disability attorney to help you with your claim. A lawyer will be able to do the following:

• know what medical evidence Social Security wants to see for your particular back condition
• help obtain a favorable medical source statement from your doctor, and
• represent you at a disability hearing.

Your disability attorney will also know to ask you for essential details about your past work at the hearing, such as:

• how many pounds you had to lift frequently
• whether you had to stoop or bend, and
• whether you were able to rest when necessary.

Your attorney can make sure the VE and ALJ understand your job as you did it, as opposed to how a similar job title might be listed in the Dictionary of Occupational Titles (DOT). For instance, let's say your RFC is for light work, and your past job required you to lift 20-30 pounds frequently. Your lawyer can ensure those facts come out at your hearing. And once the ALJ and VE know what your job actually required, they'll likely agree that you can no longer do your past work.

Learn more about proving you can't do your past work at your hearing.