Social Security Disability Benefit for Back Pain and Injuries

One of the most difficult applications for a disability case is for back pain due to the fact that it can often be a subjective case. Back pain may be caused by a myriad of spinal conditions like degenerative discs, osteoarthritis, rheumatoid arthritis, arachnoiditis, and spondylitis. The most common problems involving the nerves in the back are spinal stenosis, herniated disc, scoliosis, and nerve root compression.

In other words, the back pain must be the result of some physical abnormality of the spine or the spinal canal. A back pain without a physical impairment is less likely to have the social security and disability benefit. So also the back pains caused by obvious injuries such as a muscle strain or a fracture, which usually have a tendency to heal within a couple of weeks or months would not qualify for the social security disability benefit.

Back pain is usually an agonizing and incapacitating situation, but the social security department does not easily handle out the social security disability benefits to the patients. Unless there is a proper medical documentation with x-rays to support the various spinal and nerve root anomalies, which lasts for at least 1 year, it is often down to the word of the patient and the doctors who have treated the condition against the doctors that have been assigned the case to verify the Social Security Disability. It is often easier when dealing with injuries that result in chronic back pain. It is usually a difficult task to prove or disprove the extent of pain of a person.

Proving Pain for Disability

The department of social security has the job to determine the seriousness of many disability claims and only approves a few of the most severe cases, whereas the others are usually rejected based on the fact that they might be able to work with their back pain. The Department does this by having a look on the objective symptoms to observe whether they match the requirements in the social security impairment list and the set of guidelines. The functional limitation include a decrease in the  range of motion in the form of inability to stoop or bend, trouble walking, or the need to switch positions frequently.

This is where a patient having a long relationship with a family doctor can easily prove the actual pain severity along with its onset. That is because the family physician has continually monitored the deteriorating health of the patient. Various tests to determine the damage in the spine or the spinal canal will assist in proving that the ailment is impairing the level of function and possibly warrants the consideration for social security disability. The patient seeking claim for the social security disability benefit on account of extreme back pain, if  not being able to prove so, by the objective test results, would be advised a psychiatric consultation by the certifying agency. Many applicants are discouraged by the process but it has to be remembered that the Social Security Department protects the interests of all citizens by filtering out the fraudulent applicants from those who genuinely need benefits. Sometimes, the genuine cases do get rejected, but a re-appeal in such case will often result in the desired results.

Prerequisites for getting the disability claim

While evaluating the claim for the disability benefit, the social security agency will look at the objective signs and symptoms of the back problem, the functional limitations of the individual and his credibility.

The patient must be able to prove the  objective signs and symptoms of the back problem as a medically determinable impairment through a myriad of diagnostic imaging techniques like the X-ray, which  demonstrates the fractured vertebrae, a discography or myelogram which highlights the damaged area in the back, a CT scan which can indicate a spinal stenosis, a MRI, which can successfully show the extent of bone degeneration, and a nerve conduction test to establish the muscular weakness in the body.

The functional limitation  include something that the patient  cannot do because of the back problem. The extent of functional limitation and its impact on the ability to work are the two most important aspects of social security benefits claim.  The functional limitation is now used to determine the residual functional capacity, which is the maximum full time regular and sustained work, the patient might possibly do. Patients with more functional limitations have a lesser  residual functional capacity and are more likely to successfully get the social security disability benefit.

Even though the doctors appointed by the Social Security Agency will prepare the residual functional capacity assessment for the claiming patient, it is very important to to have the residual functional capacity assessment form filled up by the treating doctor as well.

Degenerative Disc and Injury Back Pain

Degenerative disc diseases  is a condition involving the shrinking of the vertebral discs, which is the main type of back pain condition where a disability may be considered. Not only is there visual proof of disc damage, through X-rays or an MRI, but also the degree or extent of nerve impingement can be assessed. This is in stark contrast to chronic back pain problems associated with muscle and ligament damage of gradual onset. However, disc degeneration is still difficult to prove when compared to back pain associated with injuries which is of a sudden onset.

One of the factors that the Social Security Disability Department will consider when reviewing a case of Degenerating Discs is the age of the person who is filing for Disability. In other words the department will consider the possible quantum of useful and productive working time of the affected individual, is he/she were not disabled. It is not an easy disability claim to win on especially for the patients who are younger than 40-50 years of age. Also the department of social security ends up granting the disability benefits only to those individuals, whose disease has progressed to severely affected vertebrae, which causes chronic pain, leading to an inability to sit or stand for a prolonged period of time.

Disability or Treatment?

Once the worth of an individual has been determined, the Department of Social Security ponders on the possible cost effective surgical or repair procedures, such as a fusion of damaged discs, or on the possibility of other options, which might return the patient to an active and productive member of the society.

The cost of the therapeutic procedure is weighed against the possible economic damage to the nation by labelling the affected individual as either complete or partially disabled. The decision is more often than not based on strict guidelines that are simply black and white. The patient will often be denied on the first attempt and may need to file an appeal if they believe that the decision was not correct, which consumes more time and tests in order to get back to the appeal process.

 

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