Filing for Disability for Spinal Stenosis

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Spinal stenosis is a narrowing of the spinal canal in the cervical and lumbar regions of the spine, which can lead to compression of the spinal cord and nerves. In turn, this can lead to loss of deep tendon reflexes (DTR), muscle weakness in the legs, and numbness and pain in the back, buttocks, and legs. Spinal stenosis often occurs as the result of another back problem, such as degenerative disc disease, nerve root compression from osteoarthritis, herniated discs, or scoliosis. Spinal stenosis can be caused by natural aging (the vertebral discs become drier and smaller as fluid dries up) or by a spinal injury causing nerve compression.

Many patients who suffer from stenosis are unable to work because of pain in their back and legs and their inability to walk effectively or stand for prolonged periods of time. Fortunately, lumbar spinal stenosis is one of the few back conditions recognized by the Social Security Administration (SSA) as an official impairment listing, meaning that those with documented cases of severe lumbar spinal stenosis are automatically granted disability benefits – if you can meet the SSA’s tough requirements.

Qualifying for Social Security Disability for Stenosis

To qualify for disability because of spinal stenosis, you must meet several requirements:

  • The stenosis must be in your lumbar region.
  • You must have a positive imaging test (MRI, myelography, and/or CT scan) showing evidence of lumbar spinal stenosis.
  • You must have pseudoclaudication (pain in your lower back, buttocks, and thighs, with weakness in your lower extremities).
  • You must experience chronic nonradicular (not radiating from a nerve) pain.
  • You must not be able to walk effectively (that is, you require a walker or two crutches to get around, or you need help getting to work or using public transportation).

The last requirement rules out all those who are living with great pain but who are able to walk and get places without assistance.

Medical Evidence Required

The SSA will request your medical records from your treating doctor. Your records should include an imaging test confirming a diagnosis of stenosis and a detailed physical exam, including testing your reflexes, sensation, muscle strength, muscle atrophy, and range of motion, as well as your ability to walk, bend, squat and rise.

Your records should also include the various treatments you have tried, such as pain medication, physical therapy, or steroid injections, as well as the side effects of the pain medication. You should ask your doctor to record how your pain, medication side effects, and other symptoms limit your ability to work, and what functional restrictions your doctor has placed on you (for example, no standing or walking for longer than two hours at a time).

If you have been diagnosed with spinal stenosis, but you don’t fulfill the three requirements above (say you are in great pain much of the time but have not resorted to the use of a walker), you may still be able to qualify for disability benefits under what’s called a medical-vocational allowance, particularly if you are 55 years or older (most people who suffer from lumbar stenosis are at least 50 years old). For more information on medical-vocational allowances, see our article on disability RFCs for back problems.

Starting a Disability Claim for Stenosis

Call the SSA at 800-772-1213 to set up an appointment to fill out an application for disability benefits (SSDI and SSI). When you fill out your application, include both how your back pain and impairments to your back and/or legs affects your ability to work and how it affects your life outside of work. Include all back problems related to the stenosis, such as osteoarthritis or disc problems, as these can also help you qualify for disability. In addition, if you have both spinal stenosis and a mental impairment such as depression (as many people with back problems do), be sure to include symptoms and documentation of the mental impairment as well.

If your stenosis fulfills the SSA’s three requirements above, you have a good chance of getting disability benefits on your first try, and it might not make sense to pay a lawyer for help. If, on the other hand, your case is borderline, or if you are denied benefits the first time around, consider contacting a disability lawyer for help. (The attorney’s fee should come out of your award of back pay from your disability benefits; if you don’t win, the lawyer shouldn’t get paid.) When you interview a disability attorney, ask if he or she has experience with spinal cases, and in particular lumbar spinal stenosis.

This article is provided for informational purposes only. If you need legal advice or representation,
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LA-NOLO4:DRU.1.6.3.20141021.28794