Herniated disc, or herniated nucleus pulposis (HNP), is a fairly common reason that people apply for Social Security disability benefits. A herniated disc occurs when the inner part of an intervertebral disc pushes through a weakened part of the disc. Specifically, a tear in the outer ring of the disc allows the central portion (the "nucleus pulposis") to bulge out, which can place pressure on nearby nerves. Herniated disc usually affects people in their thirties and forties and is often caused by wear and tear from years of doing heavy or improper lifting, bending or twisting, or extended periods of sitting. Herniated disc is also known as a slipped disc, prolapsed disc, ruptured disc, or bulging disc.
People with a herniated disc or discs can experience acute (temporary) or chronic (long-term) pain, which can be caused by either the disc tear, inflammation, or by nerve root compression caused by the protruding disc impacting on nearby nerves. Herniated discs can lead to continuous pain the lower back, buttocks, or thighs, or even the knees or feet. If the herniated disc is in the lumbar region and the sciatic nerve is irritated, it can cause sciatica as well. In severe cases, herniated disc can cause numbness and tingling, muscle weakness, and loss of reflexes, as well as radiculitis, the inflammation of a spinal nerve root, which causes pain along the spinal nerve paths. In the most severe cases, where the herniated disc impinges on the spinal cord or cauda equine (a thick braid of spinal nerve roots at the base of the spine), a herniated disc can cause permanent nerve damage and loss of bladder and bowel control and sexual function.
The Social Security Administration (SSA) gets many applications for disability based on herniated discs, and does not approve many of them. To qualify for disability because of a herniated disc, you must either match the SSA's definition of a severe spinal disorder or you must be able to convince the SSA that there are no jobs you can do. Specifically:
In addition, to get Social Security disability benefits, your disability must have lasted or be expected to last at least twelve months. If the SSA is not convinced your herniated disc impairment will last twelve months, you won't be approved for benefits.
The pain from herniated discs can be temporarily debilitating, but many people with herniated discs often recover after a few months with conservative treatment, such as pain medications, dietary modifications, and physical therapy. Others opt for surgery, including spinal fusion, laminectomy, or discectomy. But the SSA usually considers a three- to four-month period sufficient for recovery from surgery for herniated discs (usually laminectomy, discectomy, or spinal fusion), so even with surgery, the SSA is not likely to expect impairment from herniated discs to last long enough to qualify for benefits.
The first way to get disability benefits is if your condition matches the requirements in listing 1.04, Disorders of the spine, but this is quite difficult. To match the listing, the SSA requires that your herniated disc includes one of the following three conditions at a certain level of severity, and the severity requirements aren't easy to meet:
Assuming you don't have arachnoiditis or stenosis, you would have to show that your herniated disc is causing such serious nerve root compression that your sensation or reflexes have decreased, your spinal motion is limited, you've lost muscle strength, and that you have a positive result on the straight-leg-raising test (SLR). Many patients suffering from a herniated disc, however, don't have neurological changes that cause loss of reflexes or muscle strength, so they won't qualify under this listing. If you do have these symptoms, you are a likely candidate for surgery to decompress the root, which would eliminate the nerve root compression needed to qualify under this listing.
Assuming you can't qualify under the above impairment listing, you might be able to qualify because your herniated disc has reduced your functional capacity. The SSA will evaluate your doctor's notes on your functional limitations and restrictions, as well as your reports of pain, to determine if your back problems rise to the level of a disability that prevents you from working. The SSA will give you a rating of the type of work it thinks you can do (sedentary work, light work, medium work, or heavy work) based on your doctors' restrictions. This is called your residual functional capacity (RFC). If the SSA determines there are no jobs you can be expected to do with your RFC, there's a chance you could qualify for disability benefits under a medical-vocational allowance.
The most common doctors' restrictions for herniated disc are no lifting heavy objects and limited bending over. If you are limited to lifting 25 pounds or less, you'll receive a light RFC. If you are limited to lifting 50 pounds or less occasionally, you'll receive a medium RFC. If you've had surgery for herniated disc, you're likely to have restrictions of occasional bending and lifting no more than 50 pounds occasionally and 25 pounds frequently -- a medium RFC.
Your chances of getting disability through a medical-vocational allowance are low unless you are over 50. For instance, if the SSA says you can do medium work, you won't be considered disabled unless you're older than 55, have less than a 6th grade education, and have limited skills—in most other cases, if you can do medium work, the SSA will presume that you can learn a new job. If you have a light RFC, you might be considered disabled if you are over 50, have less than a 6th grade education, and have limited skills. For more information on medical-vocational allowances, see our article on getting disability through an RFC for back problems.
To apply for disability for a herniated disc, you need to undergo a comprehensive spinal exam by an orthopedic doctor, including testing your reflexes, sensation, and muscle strength (recorded over time). Your medical records should include your doctor's estimate of your ability to bend and lift objects. An MRI or myelography report showing a herniated disc would be helpful to your case, but an MRI (or other imaging test) showing a protruding disc is not in itself enough to prove a disability, because many people have protruding discs with no symptoms, as is the case when the protruding disc doesn't impinge on any nearby nerves. The results of a straight-leg-raising test (SLR), both from a sitting and lying down position, should be included.
The SSA will also look at how often you have been to the doctor, and for how long, and what treatments you have tried (for example, pain medications, epidural steroid injections, physical therapy, and surgery). The effects, side effects, and efficacy of all treatments should be thoroughly documented by your doctor.
Call the SSA at 800-772-1213 to set up an appointment to fill out an application for SSDI and/or SSI disability benefits for your herniated disc. When you fill out your application, be sure to include details on how your herniated disc and the resulting pain affects your life outside of work and how it impairs your ability to work.