How Does Social Security View Disability Claims for Back Pain?

Back pain can be caused by many different spinal conditions, many of which happen normally with age. Chronic conditions causing back pain include scoliosis and degenerative discs (created by wear and tear, or osteoarthritis); inflammatory conditions like rheumatoid arthritis, arachnoiditis, and spondylitis; and problems impacting nerves in the back: spinal stenosis, nerve root compression, herniated discs, and spondylolisthesis (slipped vertebrae).

This article focuses on how Social Security views symptoms of pain and how the consistency between your medical records and your statements about your symptoms and pain (in other words, your credibility) can affect the success of your back disability claim.

Can You Get Disability for Back Pain?

While back pain can be agonizing and frustrating, and sometimes incapacitating (especially lumbar pain), Social Security does not hand out SSDI or SSI disability benefits readily for back pain.

To qualify for disability benefits, first, Social Security requires you to have a "medically determinable" impairment (MDI) that lasts for at least one year. This means that x-rays, MRIs, or at least clinical notes (your doctor's notes after a physical examination) must show that your back pain is caused by some physical abnormality of the spine or spinal canal. If you have back pain without a physical impairment that normally produces pain symptoms like yours, you're unlikely to win disability benefits.

Note that back pain caused by obvious injuries like muscle strains, fractures, or even a herniated disc usually heal within a few weeks or months, so those types of claims often won't qualify for Social Security disability or SSI.

How Social Security Evaluates the Severity of Your Back Pain

Social Security sees many disability claims for back pain, but approves a only few of the most severe cases; Social Security expects most others to be able to work through their back pain. So, Social Security's job is to determine which claims for back pain are the most serious and truly prevent the claimant from being able to do any kind of work. After determining that you have an MDI, the agency assesses the severity of your impairment by looking at:

• your objective symptoms, to see whether they match the requirements in Social Security's impairment listings for certain spinal problems (the listed conditions can be found in our section on spinal disorders), and
• your functional limitations (also called your "residual functional capacity, or RFC") to see what type of work you could do. (For example, Social Security will want to know if you have trouble walking, if your range of motion is limited so that you can't stoop or bend, or if you need to switch positions frequently; see our article on how Social Security assesses a reduced RFC due to back problems.)

Chronic Back Conditions

To learn about the criteria that Social Security requires to meet a listing for a particular back condition, as well as how it assesses a reduced RFC associated with a particular back condition, read our articles on the following types of back problems:

• degenerative discs
• scoliosis
• spinal stenosis
• nerve root compression
• spinal fusion issues
• arachnoiditis
• spondylitis, and
• herniated discs (or spondylolisthesis).

How Social Security Evaluates Your Credibility

Officially, Social Security follows the criteria in the listings and the rules regarding your RFC to determine whether you are disabled. But since your claim may be largely based on your subjective reports of back pain, the claims examiner or judge determining the outcome of your claim is likely to try to assess how believable your symptoms are.

While Social Security no longer formally assesses your credibility as part of a claim, your credibility—whether the claims examiner and/or administrative law judge believes your pain is as bad as you say it is—is still likely to matter in chronic pain cases.

To evaluate your credibility, Social Security will consider some or all of the following factors (in addition to whether your objective test results support your pain complaints):

• how often you have been to the doctor
• what treatments you have tried (for example, medication, therapy, cortisone shots)
• your doctor's opinion of your pain level and limitations
• how the pain affects your activities of daily living
• whether you appear to be exaggerating your level of pain, and
• how much pain is normally reported by others with your physical findings.

If you say you have extreme back pain but your objective test results don't indicate that your pain should be so severe, Social Security might even ask you to see a psychiatrist for a consultative exam.

For more information, see our articles on how Social Security evaluates your credibility and getting disability benefits for chronic pain.

_{Updated April 9, 2021}