Getting Disability Benefits for Spinal Cord Injury or Paralysis

Your spinal cord is the core of your central nervous system, connecting your brain to the rest of your body. When your spinal cord is damaged, your body can have difficulty with basic movement, or can even stop being able to move entirely (paralysis).

Most severe spinal cord problems are the result of trauma like injuries from automobile accidents, but infections, tumors, inflammatory diseases, and congenital disorders can also result in damage to the spine. The Social Security Administration (SSA) can award you disability benefits if symptoms or paralysis from your spinal cord injury prevent you from working full-time.

What Causes Spinal Cord Injuries?

Protected by bones in your spine called vertebrae, the spinal cord contains nerve tissue that lets electrical impulses travel from your brain up and down your back. The nerves branch off from your spinal cord into your arms and legs (called peripheral nerves), sending messages that let you move around and feel sensations. When a spinal cord injury (SCI) causes damage to the nerves, these messages can get scrambled or lost entirely.

SCIs are described by referring to the location of the vertebra surrounding the damaged nerve. For example, a C-5 spinal cord injury means that the damaged nerve is found at the 5th vertebra of the cervical spine (your neck).

Does Spinal Cord Damage Mean You'll Have Paralysis?

Injuries higher on the spinal cord are more likely to affect all limbs and cause paralysis in most of the body (people with these conditions are called tetraplegic or quadriplegic), while injuries lower on the spinal cord might cause paralysis from the waist down (paraplegic).

Not all SCIs result in paralysis, however. Depending on whether your SCI is complete or incomplete, you could find it more difficult—but not impossible—to move your arms or legs. You might experience numbness, tingling, or loss of sensation in your affected limbs.

How Can I Get Disability Benefits for a Spinal Cord Injury?

Social Security recognizes that spinal cord damage can significantly reduce your mobility, interfering with your daily activities and ability to work full-time. If you're unable to work at any job for at least twelve months, you could qualify for Social Security disability benefits.

You can be found disabled due to your SCI in one of two ways:

• meet or equal a listed impairment ("medically disabled"), or
• be unable to perform any type of job ("vocationally disabled").

List of Spinal Disabilities Social Security Considers Automatically Disabling

The SSA maintains a list of illnesses, injuries, and disorders that the agency considers especially severe. If your medical record contains specific documentation that Social Security has already determined to be enough to prove that you're disabled, you'll be awarded benefits without having to show that you can't do any job. Qualifying for benefits this way is called "meeting or equaling a listed impairment."

Spinal cord injuries are one of the SSA's listed impairments. Under Listing 11.08, in order to qualify for disability automatically, you need to show:

• complete loss of function of any part of the body due to a spinal cord injury, such as paralysis of a limb or organ
• extreme—but not total—loss of function in two of your extremities to the point that you can't stand up, walk, or handle objects without help, or
• difficulty standing up, walking, and holding objects by yourself while also struggling with mental functions like remembering instructions and concentrating on tasks.

You'll have to show that the above functional restrictions have been present for at least three months after your SCI diagnosis in order to meet or equal Listing 11.08. Make sure that your doctors know about any difficulties you're having with focus or movement, and that your medical records include neurological exams and imaging studies.

If your medical records don't contain the evidence required to meet Listing 11.08, you could still qualify for automatic disability under a related listing for disorders of the spine resulting in the compromise of a nerve root (Listing 1.15). Nerve roots are "compromised" when a physical object (such as a vertebra) is pressing on the nerve, making it harder to send messages to other parts of the body.

To meet or equal the requirements of Listing 1.15, you need to show:

• symptoms of pain, tingling, or muscle fatigue in the part of the body affected by the nerve
• tests or examinations (such as a nerve conduction study) showing weakness, irritation, or decreased reflexes,
• objective imaging (MRI, X-ray, CT scan) showing the nerve compromise, and
• evidence that you can't use both of your hands independently (for example, you need to use your hands to operate an assistive device like a walker).

Getting Disability Based on Reduced Functional Capacity

Few disability applicants ("claimants") have the medical evidence required to meet or equal a listing. Most claimants are awarded benefits because they show that no jobs exist that they can perform with their current residual functional capacity (RFC).

Your RFC is a set of limitations that reflect the most you're able to do, physically and mentally, in a work environment. For claimants with moderate spinal cord injuries, a typical RFC will include restrictions on the following:

• how long you can sit, stand, and walk for
• how much weight you can lift and carry
• whether you should avoid bending, kneeling, crouching, or crawling
• whether you can reach above, in front, or underneath to pick things up
• how frequently you can use your hands to move objects, and
• whether you can perform complex or simple tasks.

The SSA will first use your RFC to decide whether you can do any of the jobs you've performed in the past. If you can't do your past work, the agency will then decide whether you can do any other jobs despite your limitations. If no jobs exist that you can perform with your RFC, the SSA will find that you're disabled and you'll receive benefits.

The more limiting your restrictions are, the more likely no jobs will exist that you'll be able to do. Social Security is required to consider every illness, condition, or impairment you have when deciding your RFC. For example, moderate depression and anxiety can affect your ability to complete tasks, get along with others, and deal with normal work stresses. If your record shows evidence of mental limitations, Social Security will take them into account when deciding if you can work.

How to Apply for Disability for SCI

The SSA provides several easy ways to file for disability benefits:

• If you're applying for Social Security Disability Insurance (SSDI), you can file your entire claim online at Social Security's website. Filing online has many benefits, such as giving you a dated receipt of your application and allowing you to start and finish the application at your own pace.
• If you're applying for Supplemental Security Income, you can start your application online, but the agency will contact you to finish your application in person at your local Social Security field office.
• If you're applying for SSDI, SSI, or both, you can apply over the phone at 800-722-1213 between 8 a.m. and 7 p.m. Monday through Friday. (If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.)
• You can always apply in person at your local Social Security field office. (Please note that this option can involve lengthy waiting.)

Consider contacting an experienced disability advocate to help you file your disability application. An attorney or representative can help you gather medical evidence, communicate with the Social Security Administration on your behalf, and represent you at a disability hearing.

_{Updated November 15, 2022}