Individuals with nerve root compression, sometimes referred to as sciatica pain, generally experience pain, numbness, and/or a tingling sensation in their buttocks and legs, as well as muscle weakness, loss of or decreased reflexes, and sensory loss. The pain associated with nerve root compression can be debilitating, making it difficult to sit or stand for long periods, to walk, or to bend and lift things.
The Social Security Administration recognizes the negative impact nerve root compression can have on an individual’s ability to work, which is why it is considered a disability eligible for social security disability benefits. Yet despite this recognition, it is actually quite difficult to receive SSD benefits for nerve root compression. Although back pain is one of the most common ailments, especially as the workforce ages, many people can continue working with a combination of therapies, pain medication, and workplace modifications, or just straight pushing through the pain.
Another factor that makes approval for spinal conditions difficult is that pain is often subjective – one person’s level 8 on the pain scale is another person’s level 3 – making it somewhat of an unreliable indicator (from the SSA’s perspective, anyway) of an applicant’s ability to work. Getting approved for social security disability benefits for nerve root compression will, therefore, depend largely on the completeness of your medical records and whether specific medical tests support your claims that the condition interferes with your ability to work.
What causes nerve root compression?
Nerve root compression occurs when the spinal nerve roots are irritated or compressed. It is often attributed to physical trauma or a degenerative disorder, but can also be a natural effect of aging. It is commonly associated with other spinal conditions, several of which are specifically included in the Blue Book, a list of more than 100 conditions the SSA considers disabling and eligible for SSD benefits. These include:
- Herniated lumbar disc;
- Spinal stenosis;
- Spinal arachnoiditis;
- Facet arthritis, or;
- Vertebral fractures.
Nerve root compression may also be caused by other spinal or degenerative disorders. You can still qualify for benefits for these other conditions, provided you meet the SSA’s disability criteria.
Qualifying for SSD benefits with nerve root compression
The first step to qualifying for social security benefits is to prove that your condition has lasted, or is expected to last, 12 months or longer. You must then be able to prove that the condition impacts your ability to perform substantial gainful activity; for 2020, this is defined as the ability to earn more than $1,260 per month.
Nerve root compression is often diagnosed with an X-Ray or MRI, and must be accompanied by the following:
- Limitations in spinal motion;
- Muscle weakness;
- Sensory or reflex loss, and;
- A positive straight-leg raising test while sitting or lying down, if the nerve compression involves the lower back.
Together, your medical records and application must show that the nerve compression has caused functional losses in either your ability to effectively ambulate (walk) or perform fine and gross motor tasks for a sustained period. An inability to walk generally means you cannot walk at a reasonable pace without the use of a hand-held aide, such as a cane or arm crutches, or other assistance. The ability to perform these tasks around your home is not, however, considered proof that you can walk effectively. Being able to walk from the bedroom to the kitchen unassisted is much different than being able to walk outside on uneven surfaces or at the office.
An inability to perform fine and gross motor tasks means the extreme loss of function in both arms. This would negatively impact your ability to reach, push, pull, or grab. For example, loss of fine motor ability could make you unable to sort papers or place files in a drawer that sits at or above waist level.
A comprehensive exam by an orthopedic physician that specializes in spinal conditions can provide evidence that you meet these criteria. In addition to ordering diagnostic tests to confirm the compression, the physician will need to test your reflexes, muscle sensation, muscle strength, and the range of motion in your spine.
Importance of accurate medical records
Diagnostic and other tests can easily confirm whether your nerve roots are compressed or other indicators such as your range of motion, reflexes, and muscle strength. Categorizing your pain level and how the other indicators interfere with your ability to walk, bend and lift, and perform other work-related tasks, however, is not as easy.
Because of this, it is extremely important that you visit your physician regularly for treatment, and that you describe your level of pain and how the condition affects your ability to perform everyday activities at each visit. This not only creates a record of how the nerve root compression is affecting you and your ability to work but can show a continued pattern that the condition is, if not getting worse, then not improving.
When describing limitations to your doctor, be as specific as possible and try to relate your ability to perform certain functions to work-related tasks.
For example, assume you can walk across the room, but it takes you longer than it did pre-diagnosis. Saying, “I can walk across a room” might be technically accurate. However, it gives a false impression that you can walk without difficulty and would have no problem delivering documents to your supervisor down the hall or walking to the photocopy machine. A better response would be, “It takes me 5 minutes to walk from my desk to the copy machine, and I must use either a cane or the wall to support me.”
Being specific with your descriptions and making sure to discuss your limitations and pain levels with your doctor at every visit creates a record of how the conditions is affecting you and your ability to work. It also helps to show a continued pattern that the condition is, if not getting worse, then not improving. This type of specificity can mean the difference between your SSD application being approved.