Social Security Disability and SSI for Back Pain Caused by Nerve Root Compression

Sciatica is the most common symptom of compression of a nerve root of the lower spine, but nerve root compression can happen anywhere in the back or neck. Also called nerve root impingement, nerve root compression occurs when something like a bone spur, herniated disc, tumor, or vertebral fracture pushes on the main nerves of the spine.

Sciatic pain happens when a nerve root of the lumbar (lower) spine is compromised, and pain radiates down the sciatic nerve, which runs down both legs. This is called "lumbar radiculopathy."

When individuals have a compromised nerve root of the upper spine, often accompanied by facet arthritis, they may have pain in the neck, or pain in an arm and difficulty using their hand on that side, called "cervical radiculopathy."

Severe forms of radiculopathy can cause significant pain and limitations to your functional capacity, such as not being able to stand or sit for long periods. If you reach the point where you can't work, you can apply for disability benefits from the Social Security Administration. The fastest way to get disability benefits for back problems is to meet the requirements of Social Security's disability listing for disorders of the spine.

Social Security's Disability Listing Based on Nerve Root Compression

First, know that this is not an easy disability listing to "meet," and most claimants with neck or back pain and/or sciatica won't meet the listing. Not only do you have to have x-ray or MRI evidence of nerve root impingement, but you also have to have muscle weakness or atrophy and an inability to walk without help ("severe problems with ambulation") or to use your hands for fine and gross motor movements.

When you read the complex requirements below, keep in mind that only 10% of claimants who are approved for back or musculoskeletal issues are approved through the listings (more on this below).

To qualify as disabled under this listing, you must have all of the following:

• radiating pain, tingling, or muscle fatigue consistent with nerve root compression
• a diagnostic test or clinical exam showing a radiating pattern of all of the following:
• muscle weakness
• signs of nerve root irritation, tension, or compression, and
• sensory issues like decreased sensation, sensory nerve deficit on electrodiagnostic testing, or decreased deep tendon reflexes.
• an X-ray, MRI, or other imaging showing compromise of a nerve root, and
• a resulting physical limitation, with medical documentation, that makes one of the following true:
• you need a walker, bilateral canes or crutches, or a wheelchair or scooter that requires both hands
• you can't use one hand due to nerve root compression, and you need the other to operate a one-handed wheelchair, cane, crutch, or other device, or
• you can't use either hand to do work due to nerve root compression.

In addition, if the lower spine is where the nerve root is impinged, your medical records should show that you have a positive straight-leg raising test (lying down and sitting).

The above required symptoms and tests must be present simultaneously, or within a "close proximity of time." Social Security generally defines a close proximity as being within four months of each other. So if you had an MRI showing nerve root compromise last year and the other three symptoms or tests last month, Social Security might not count the MRI (unless, in a doctor's opinion, the MRI findings could be reasonably expected to have been present when the disability began).

Note that Social Security has lengthened this window of time to 12 months during the COVID pandemic and for six months after it ends.

Medical-Vocational Allowance for Nerve Root Compression

If there isn't enough evidence in your medical record to meet the above listing for nerve root compression—for example, because your treating doctor hasn't noted whether you have muscle weakness or a loss of deep tendon reflexes, or you're able to walk without an assistive device —you may still be able to win disability benefits through a "medical-vocational allowance." Social Security will assess your residual functional capacity, or RFC—what you can do in spite of the limitations caused by your back or neck condition—when making this type of medical determination.

If your back or neck pain causes significant limitations to your functional capacity, such as not being able to bend or stoop, not being able to stand or sit for long periods, or not being able to walk without crutches or a wheelchair, make sure these limitations are in your medical records. If these limitations make it impossible for you to perform any of your past relevant work or any other type of substantial work activity, you could win your disability through a medical-vocational approval. For more information on RFCs, see our article on reduced functional capacity due to back problems.

Medical Evidence Needed for Disability Based on Nerve Root Compression

You shouldn't apply for disability benefits until you have the following types of evidence:

• clinical notes from a doctor's examination of your spine and mobility
• the results of an x-ray or MRI
• a written history of any treatments you've tried and what the results were
• a statement from your doctor about your restrictions and limitations, and
• a record of any hospital or ER visits.

In addition, you can help you strengthen your claim by getting the following:

• a statement from a former employer about how your condition limited you
• any performance evaluations reflecting your physical problems
• a record of sick days from your last job, and
• a statement from a family member about how your condition makes it difficult for you to do daily activities.

How to Apply for Disability Based on Nerve Root Compression

If you're applying for Social Security disability insurance (SSDI), you can file your entire claim online on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim. Most individuals filing for SSI only can't file the whole application online, but they can get started on Social Security's website. For more information on applying for either SSDI or SSI, see our article on applying for Social Security disability benefits.

If you'd like help with your application, think about working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time.

_{Updated November 5, 2021}