Getting Disability for Spinal Cord Injury or Paralysis

Most severe spinal cord problems seen by Social Security on disability applications are caused by trauma, such as injury from automobile accidents. Other possible causes of spinal cord injury include many kinds of infection, tumors, inflammatory diseases, genetic, and congenital disorders.

Protected by the bony spine, the spinal cord carries the nerve fibers by which the brain interacts with the rest of the body. The top of the spinal cord originates in the lower part of the brain, and then gives off right and left pairs of nerves at regular intervals as it goes downward into the lower back. These peripheral nerves from the spinal cord carry out three major functions:

• carrying motor impulses to muscles to allow movement
• carrying sensory impulses from tissues to the brain, and
• autonomic (unconscious) activity involving many types of tissue.

Social Security is not so much interested in the specific cause of a spinal cord problem as whether it produces the required degree of functional loss as required by Social Security’s disability listing for spinal cord disorders and whether it is likely to last the required minimum time of one year to obtain disability benefits.

Social Security’s Listing for Spinal Disorders

Social Security has a listing of impairments that sets out the criteria for certain conditions to be automatically approved for disability. There is a listing for spinal cord disorders, listing 11.08, that was changed significantly in 2017. Now there are three ways to meet the listing, laid out from more severe to less severe:

• Complete loss of function of any part of the body because of spinal cord injury, such as paralysis of an arm or leg. Paraplegic and quadriplegic individuals should automatically qualify under this part of the listing. However, other kinds of complete functional loss that have nothing to do with muscle paralysis can also qualify. For example, spinal cord disorders can paralyze parts of the gastrointestinal tract, such as the esophagus, stomach, and intestines. Some people with spinal injuries suffer complete loss of bladder function, and that would also automatically qualify for disability benefits.
• Abnormal ability of movement in at least two extremities (either an arm and a leg or two arms or two legs) resulting in extreme difficulty in the ability to balance while standing or walking, to stand up from a seated position, or to use the arms and/or hands. Remember that these problems must be due to a spinal cord disorder, not something else.
• A significant physical spinal cord problem not quite severe enough to be extreme, combined with a serious limitation in any one of the following mental areas:
• the ability to understand, remember, or use information
• social interactions (including the ability to get along with others)
• concentration, persistence, or ability to work quickly (including ability to complete tasks), or
• the ability to take care of oneself (such as self-care activities) or adapt to new changes.

Whatever the type of functional loss or problems caused by a spinal cord disorder, it must be present at least three months for Social Security to assume it will last the required twelve months for an impairment to found disabling. Make sure that any difficulties you have are clearly documented in your medical records, which should also include neurological examination results and any imaging studies (MRI, CT) that you have had done.

Getting Disability for Less Severe Spinal Cord Problems

If your spinal cord problem is not severe enough to satisfy the spinal cord disorders listing above, Social Security will consider the medical limitations you do have in combination with your vocational factors (age, education, work experience) that can affect your ability to do your prior job or any other job that is available. You can still be allowed disability benefits if Social Security cannot show a job you can do within your limitations. The more severe your medical limitations, the more likely you will qualify. Since many claims are allowed on this basis, you should not assume you will be denied benefits if your impairments don’t satisfy the listing.

Don’t assume that your treating doctor knows everything you want Social Security to know, especially problems you have standing, walking, and in use of your hands. If you can’t walk for at least two hours daily, you should be approved for benefits. And lesser limitations can still have a big effect on your disability decision. An inability to stand or walk at least six hours a day will automatically reduce your RFC (residual functional capacity) level to sedentary work. This limitation could easily result in allowance if you are also age 55 or older, unless you are highly educated or you’ve done skilled jobs or sedentary jobs in the past. The vocational analyses that Social Security does can be complex, so don’t assume you know what limitations you have are important; what is important is that your treating doctor agrees with them and includes them in your medical records.

Also, for many who have suffered spinal cord injuries, mental health issues, such as depression or anxiety, can be an issue. Even moderate depression and anxiety can affect one’s ability to begin and complete tasks, get along with others, and deal with stresses of work. If you list mental health issues on your application, Social Security will take them into account when deciding if there are any jobs you can do.