How to Get Disability Benefits for Spinal Arachnoiditis

If your arachnoiditis affects your ability to stand, walk, or sit for two hours without changing your position, you may be able to get disability benefits.

By , Attorney · UC Law San Francisco
Updated by Diana Chaikin, Attorney (Seattle University School of Law)

Spinal arachnoiditis (sometimes abbreviated as ARC) is a painful condition caused by the inflammation of the arachnoid, a membrane that surrounds and protects the nerves of the spinal cord. The membrane can become inflamed for several reasons, including:

Most cases of arachnoiditis occur in the lumbar spine, causing persistent pain in the lower back and legs. Additional symptoms include numbness and tingling in the hands or feet, loss of bladder or bowel control, sexual dysfunction, and difficulty sitting for more than a short time.

Because arachnoiditis isn't curable, patients often have to manage their symptoms with exercise and medication. Many people with the disorder still have limitations despite treatment. If you're unable to work due to spinal arachnoiditis, you may qualify for disability benefits from the Social Security Administration (SSA).

Qualifying for Social Security Disability for Arachnoiditis

The SSA administers two types of benefit programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program has certain financial eligibility requirements—SSDI is based on your work history, while SSI is available for low-income households.

As long as you're legally eligible to receive at least one of these benefits, the agency can find you disabled in one of two ways:

  • you meet or equal the criteria of a listed impairment ("medically disabled"), or
  • you can't do any full-time job on a regular basis ("vocationally disabled").

The SSA evaluates these steps in sequential order, so if you're not found medically disabled, you can still be found vocationally disabled. Either way, you'll first need to show Social Security that you have a severe impairment that keeps you from engaging in substantial gainful activity for at least 12 months.

Getting Disability for Arachnoiditis by Meeting or Equaling a Listing

Social Security's "Blue Book" of listed impairments describes conditions that the agency considers automatically disabling, provided that your medical records contain evidence of specific test results and functional limitations. Qualifying for disability this way is referred to as "meeting" (or "equaling") a listing.

Spinal arachnoiditis previously had its own separate listing in Social Security's Blue Book, but the agency removed that listing in April 2021. Since then, the agency has evaluated arachnoiditis under listing 11.08 for spinal cord disorders. You can meet listing 11.08 in one of the three ways described below.

Complete loss of function. Social Security will find you disabled if you can't move, feel sensations with, or otherwise use your affected body part for at least three months after your symptoms began. The agency may delay a decision on your claim to see if your symptoms improve after three months, but if you have evidence showing that the loss of function is permanent, the SSA can approve your claim within three months. (In cases of total spinal cord transection resulting in paralysis below the injury, the claim will be approved immediately.)

Disorganization of motor function in two extremities. If your spinal arachnoiditis interferes with your ability to move at least two extremities—resulting in an inability to independently walk, stand, get up from a seated position, or use your arms or hands—Social Security will find you disabled. The affected extremities can be your lower limbs (legs and feet), upper limbs (arms, fingers, wrists, hands, and shoulders), or a combination of both.

Limitations in physical and mental functioning. If you can function independently but only with significant difficulty (in Social Security lingo, you have "marked limitations"), the SSA will find you disabled under listing 11.08. You'll need to show that your arachnoiditis causes marked limitations in both your physical functioning and at least one of the following mental areas:

  • understanding, remembering, or using information
  • interacting socially and getting along with others
  • concentrating long enough to complete tasks, or
  • taking care of yourself or adapting to changes in your routine.

All of the above listing criteria do require you to provide evidence that your limitations last for at least three months after the onset of symptoms. So, for instance, if you were diagnosed with arachnoiditis following spinal surgery but two months after the operation you have only mild limitations in physical or mental functioning, you won't meet the listing. However, you can still get disability if you can show that you're unable to do any job.

Getting Disability for Arachnoiditis If You Don't Meet the Spinal Cord Disorder Listing

If you've been diagnosed with arachnoiditis but don't meet the criteria of listing 11.08, you might qualify for benefits if the limitations in your residual functional capacity (RFC) rule out all jobs. Your RFC is a set of restrictions that describes what you can and can't do in a work environment. A typical RFC for somebody with spinal arachnoiditis will include limitations on how much weight you can lift and carry as well as how long you can sit, stand, and walk for.

Social Security will review your work history to see if you can still perform all the duties of your past jobs despite the limitations in your RFC. If not, the agency needs to determine whether you could switch to a less physically or mentally demanding job.

For example, if your doctor says you can't walk for six hours a day or lift 20 pounds, your RFC will restrict you to sedentary (sit-down) jobs. And if your past work was as a cashier—a job that is usually classified as light work—Social Security will find that you can't work as a cashier anymore.

Depending on your age, education, and skill set, being unable to do your past jobs may be enough for you to qualify for disability under the medical-vocational grid rules.

But applicants under the age of 50 generally also need to show that they can't do even the easiest sit-down jobs before they can get benefits. Needing to elevate your legs to relieve lower back pain or requiring extra time to complete tasks are examples of restrictions in your RFC that can eliminate all full-time work.

Medical Evidence Required to Get Disability for Arachnoiditis

Your medical records are the foundation of your disability claim. Without them, Social Security can't determine whether you meet a listing or if you can do any work, so you'll want to make sure that the agency has all the details it needs—including your health care providers' names, addresses, contact information, and dates of service (for doctors' visits)—to make a decision on your application.

Once you let Social Security know where you've received treatment, the agency will request your medical records from that provider. The SSA wants to see objective evidence that you have arachnoiditis, not simply a diagnosis made based on your subjective pain symptoms. The following records are considered objective evidence:

  • operative notes (what a surgeon writes about what they saw during surgery)
  • pathology reports of a biopsy (tissue sample), or
  • imaging tests (MRIs, X-rays, and CT scans).

Your evidence should demonstrate nerve root thickening and swelling, causing your doctor to diagnose spinal arachnoiditis. If you have a type of arachnoiditis called "adhesive arachnoiditis," the evidence should show clumping of nerve roots.

Your medical records should also include a detailed physical exam documenting the following:

  • any abnormal test results of sensation or reflexes
  • your range of motion (ability to fully move your limbs)
  • the amount of weight you can lift, and
  • how well you can walk, bend, sit, squat, and rise.

Social Security is also interested in the various treatments you've tried in order to reduce your symptoms, such as medication, physical therapy, or spinal cord stimulation. Any limitations you have due to side effects of medication should be included in your RFC, so don't forget to mention them in your activities of daily living questionnaire.

Consider asking your regular doctor to submit a written statement discussing how your pain, medication side effects, and other symptoms limit your ability to work. If your doctor agrees to write a letter, ask them to include specific functional restrictions (such as not lifting anything heavier than ten pounds or no sitting for longer than 30 minutes at a time).

Starting a Disability Claim for Arachnoiditis

You can start your application easily online, over the phone at 800-772-1213 between 8 a.m. and 7 p.m., Monday through Friday, or in person at your local field office.

When you're filling out your application, discuss how your back pain affects your life outside of work, as well as how it impairs your ability to work. If you have a mental health disorder in addition to arachnoiditis, be sure to discuss your mental symptoms as well. Social Security has to consider the combined effects of all your impairments when deciding whether you're disabled.

You can ask a disability lawyer for help with your initial application or, if you've already been denied benefits, your attorney can help with your appeal. Disability lawyers work on contingency, meaning they won't get paid unless you win your case. Attorney's fees for winning claims come out of any past-due benefits you'll receive.

Most disability lawyers have handled claims based on spinal disorders, but you might find a potential representative who has experience with arachnoiditis cases in particular. If you need guidance on selecting an attorney who is a right fit for you, check out our articles on hiring a disability lawyer.

Updated January 31, 2024

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