Social Security Disability (SSD) considers degenerative disc disease, or DDD, to be a disabling condition eligible for benefits. Though it is included under section 1.04 of the Social Security Administration’s (SSA’s) list of disabling conditions as a spinal disorder, it is not actually a disease.
Degenerative disc disease is a condition in which a damaged disc causes pain, numbness or tingling in arms and legs, or muscle weakness. The pain can vary depending on the patient’s position (i.e., sitting versus standing versus lying down); activity type and level (i.e., some patients feel relief walking versus being sedentary); intensity and severity; may be intermittent or persistent, and; can affect different areas of the body, depending on the location of the damaged disc.
Almost everybody experiences some type of back pain in their life, and most exhibit at least some level of wear and tear on their spinal discs as they age. But many people who suffer back pain associated with a spinal disorder are able to continue working, either with or without workplace accommodations, and with or without medical intervention.
Understanding the reasons behind degenerative disc diseases is crucial. Typically, they stem from injury, age, or certain activities. Objective tests like MRIs or sometimes X-rays illustrate this condition best. Social Security also considers EMG and CV tests to determine nerve involvement and severity.
Equally important is the content of medical records. Notably, when a doctor asks about your condition and you respond with specifics like, “I can only lift two pounds now,” or “I can use my hand for only five minutes,” it significantly strengthens your case.
Social Security sometimes misinterprets pain scales. Consistently expressing high pain levels might lead them to believe you can perform any job. However, repeatedly stating limitations in sitting, standing, or lifting over weeks or months of treatment anchors your credibility.
In addition to pain, they scrutinize records for muscle weakness, limited range of motion, sensory alterations, reflex issues, and the need for assistive devices like walkers or canes. Bowel and bladder incontinence signify higher severity levels.
Based on my experience, Social Security judges prioritize these factors when evaluating degenerative disc diseases. Obtaining a medical statement from a specialist that aligns with your medical records can significantly support your case. To learn how to ensure your disability claim stands strong, watch this short video.
So when filing for SSD due to degenerative disc disease, a simple claim of back pain is an insufficient basis for granting an award, particularly because one’s level of pain is personal and cannot readily be quantified by the claims examiner. So in cases of degenerative disc disease, appropriate medical documentation of the injury is vital to improving the chances that your SSD application will be approved.
To satisfy the SSA’s criteria for degenerative disc disease, the damaged disc must compromise a nerve root or the spinal cord. It must also be accompanied by other signs and symptoms, such as limitation in spinal movement, motor loss, or an inability to ambulate effectively.
Diagnosis and evaluation of degenerative disc disease should be supported by “appropriate” medical imaging. “Appropriate” means any technique that is proper to support diagnosis of the impairment; in other words, the one most physicians who specialize in spinal disorders would use to make the diagnosis. Forms of appropriate documentation include (but are not limited to):
- Detailed description of the joints affected, including range of motion and muscle condition;
- Defects in circulation;
- CAT scans, or;
Case notes are also vital in documenting DDD (or any type of spinal disorder whose chief complaint is pain), and they must be as objective as possible. Whenever possible, complaints should be verified by alternative testing. For example, if the complaint is of muscle weakness, a medically acceptable test for determining relative strength of a muscle should be conducted.
Whenever possible, tests documenting the physical complaints should be conducted over regular intervals, to show that the pain or associated symptom is not an isolated event that has since resolved. The documentation should show that the pain and its effects are continuous.
It is also important that you routinely see your doctor for treatment and examination of DDD. Being followed by a doctor (ideally the same doctor, to avoid the notion that you are doctor shopping) lends credence to your claim that the pain adversely impacts your life and your ability to work – you don’t want a disability examiner to determine failure to see a doctor on a regular basis for the pain means it isn’t severe enough to interfere with your ability to work.
Are you applying for SSD benefits or have you been denied SSD benefits? Consider the Law Office of The Good Law Group for your representation. Call #(847) 577-4476 or fill out this form online for a free case evaluation.