Social Security’s Definition of Disability

The SSA has a strict definition of disability, and to qualify for SSD benefits, you must prove that:

• You cannot engage in substantial gainful activity (SGA) because of your back injury. SGA refers to working and earning above a certain monthly income level. If you are working and earning more than the SGA threshold, you will not be considered disabled, regardless of your condition.
• Your condition is severe enough to significantly limit your ability to do basic work activities for at least 12 months or is expected to result in death.
• Your back injury prevents you from performing any type of work, including both your previous job and other types of work that your skills, education, and age may allow you to do.

Types of Back Injuries That Can Qualify for Social Security Disability

Back injuries can range from muscle strains to more severe conditions like spinal cord injuries or degenerative disc disease. The SSA evaluates these injuries under the Listing of Impairments, which outlines conditions that are considered severe enough to qualify for benefits. While back injuries themselves may not always appear on the list, certain spinal conditions are recognized by the SSA.

Some conditions related to back injuries that may qualify include:

• Herniated Discs: A herniated or slipped disc can cause severe pain, numbness, and mobility issues. If the injury leads to significant impairment and prevents you from working, you may qualify for SSD benefits.
• Spinal Stenosis: This is the narrowing of the spaces within your spine, which can put pressure on your nerves, causing pain, weakness, or difficulty walking.
• Degenerative Disc Disease: This condition involves the breakdown of the discs between vertebrae, causing pain, limited mobility, and other symptoms that can interfere with work.
• Spondylolisthesis: This is when a vertebra in your spine slips out of place, which can lead to nerve compression and pain.
• Spinal Fractures: Severe spinal fractures from trauma (such as a car accident) may qualify for SSDI if they significantly impact your ability to function.
• Osteoarthritis or Other Joint Conditions: In some cases, osteoarthritis or similar conditions affecting the spine may qualify if they result in significant pain or limited range of motion.

How Does the SSA Evaluate a Back Injury for Disability?

When the SSA reviews your disability claim, they will assess the severity of your back injury using a five-step evaluation process:

• Step 1: Substantial Gainful Activity (SGA) – The SSA will first determine if you are working and earning above the SGA threshold. If you are, your claim may be denied right away.
• Step 2: Severity of Your Condition – The SSA will determine if your back injury is severe enough to limit your ability to perform basic work tasks. If it doesn’t significantly limit your activities, your claim may be denied.
• Step 3: Meet a Listing – The SSA has a Listing of Impairments for spinal disorders and musculoskeletal issues. If your back injury meets the criteria for a listed impairment (such as severe spinal stenosis or herniated disc), you may be approved for SSD benefits without the need for further evaluation.
• Step 4: Past Work – The SSA will evaluate whether you can still do your previous work. If you are unable to perform your past work due to your back injury, the SSA will move on to the next step.
• Step 5: Other Work – If you can’t perform your previous work, the SSA will evaluate whether you can perform other types of work that your skills, age, education, and work experience would allow. If you are unable to do any other work, you may qualify for SSD benefits.

The Importance of Medical Evidence

One of the most important factors in securing Social Security Disability for a back injury is providing solid medical evidence. The SSA will require detailed medical records to evaluate the severity of your condition and how it impacts your ability to work.

• Doctor’s Records: You will need to provide documentation from your treating physicians, including medical history, diagnoses, test results (such as MRI or X-ray reports), and treatment plans.
• Physical Limitations: If possible, you should also include documentation about the physical limitations your injury causes, such as the inability to lift, bend, or sit for extended periods.
• Work Restrictions: A letter from your doctor detailing your work restrictions, such as limitations on physical activity (lifting, walking, standing), will be crucial for your case.
• Functional Capacity Evaluations: Sometimes, a Functional Capacity Evaluation (FCE) may be required to show how much your back injury impairs your ability to perform physical tasks. An FCE can provide detailed information about your limitations.

The Appeal Process for Denied Claims

It’s important to note that back injuries are a common reason for Social Security Disability claims to be denied initially. If your claim is denied, you have the right to appeal the decision.

• Request for Reconsideration: This is the first step in the appeals process. You can provide additional medical evidence and ask for the SSA to review your claim again.
• Hearing Before an Administrative Law Judge (ALJ): If reconsideration is denied, you can request a hearing before an ALJ. At the hearing, you’ll have the opportunity to present your case, call medical experts, and provide additional evidence.
• Further Appeals: If the ALJ denies your claim, you can appeal to the Appeals Council and, in some cases, take the case to federal court.