Herniated Disk or Disks and Social Security Claims for Disability Benefits.

Many people seeking Social Security Disability and Supplemental Security Income benefits are suffering from a herniated disk or several herniated disks.  The presence of a herniated disk or other back and neck conditions , if severe enough,  can automatically qualify a person  for Social Security Disability or Supplemental Security Income benefits.

The key to whether a herniated disk will qualify a person for benefits is more than just the presence of a herniated disk.  The disk must be disabling.  At least two studies examining the necks (cervical spine) of volunteers with no neck complaints found focal disc protrusions in 50% of participants.  see : Robert E Windsor (2006). “Frequency of asymptomatic cervical disc protrusions”. Cervical Disc Injuries.. eMedicine. http://www.emedicine.com/sports/byname/Cervical-Disc-Injuries.htm. Retrieved 2008-02-27. ^ Ernst CW, Stadnik TW, Peeters E, Breucq C, Osteaux MJ (Sep 2005). “Prevalence of annular tears and disc herniations on MR images of the cervical spine in symptom free volunteers”. Eur J Radiol 55 (3): 409–14. doi:10.1016/j.ejrad.2004.11.003. PMID 16129249

Obviously, a herniated disk that causes no noticeable symptoms is not a disability that would entitle a person to social security benefits.

If the claimant has a herniated nucleus pulposus or any other condition of the spine such as spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, or vertebral fracture, the claimant must also show compromise (compression) of the nerve exiting the spine, or the condition must compromise the spinal cord itself (see MRI above), with evidence of neuro-anatomic distribution of pain, limitation of range of motion of the spine,  motor loss with atrophy or muscle weakness accompanied with sensory or reflex loss.  If the lower back is involved, the claimant must also show pain and discomfort on straight leg raising tests, both sitting and laying down.  If the claimant satisfies these conditions he has a listed condition and automatically qualifies for benefits.

Neuro-anatomic distribution of pain means that the complaints of pain are generated by the nerve(s) which has been compromised or compressed by the herniated disk or other spinal condition.  Each nerve exits the spine (see photo at right) and courses through the body to provide nerve signals to the specific area of the body,  much like the wires that leave the circuit breaker box in your house.  Different wires serve different rooms.  Certain nerves exiting the cervical spine provide feeling and muscle commands to specific areas of the shoulder, arm, hand and fingers.  The complaints of pain must come from the area of the body served by the compressed nerve.

Limitation of range of motion is self explanatory.  When a normal person leans their head back as if looking to the sky they can flex their head back 60 degrees.  A claimant who cannot flex his neck at all has significant limitation to their “flexion” range of motion in the cervical spine. see: Guides to the Evaluation of Permanent Impairment , Third Edition, American Medical Association, P. 81.

Motor loss with atrophy addresses the ability of the nerve serving a muscle group to send commands to the muscle to exert force.   If a person has muscle atrophy to a specific muscle group it usually means the muscle is shrinking because it is not being used and many times it is caused by nerve damage.  Where the nerve is compromised,  the claimant will have much less ability to exert force when the doctor conducts his physical exam which is muscle weakness.  The muscle weakness should be accompanied with sensory (lack of feeling) or reflex loss  (the nerve doesn’t react properly when struck by the rubber hammer, etc)

If the condition involves the lumbar spine, the claimant must also show pain and discomfort on straight leg raising tests while  sitting and laying down on the exam table.  Normally,  the doctor will have the patient sit on the table hanging their legs over the side of the exam table at a 90 degree position.  The claimant is then asked to straighten the affected leg(s)  to 180 degrees, or parallel to the ground.  Pain and discomfort should be shown.

Social Security claimants should  know that even if the herniated disk or back condition is not as severe as outlined above, they may still qualify for benefits if other medical conditions and factors such as age, education, physical and psychiatric restrictions and lack of transferable skills from their old job combine with the back problems to prevent them from working.

In many cases the claimant is wrongfully denied Social Security Disability and Supplemental Security Income benefits because the decision maker in the case doesn’t understand the records or doesn’t even have the records.  A dedicated Social Security Disability claimant attorney or lawyer can help the claimant work their way through the maze of rules to get their benefits.

Contact our office today if you have a back injury or any other injury that prevents you from working.  The compensation you deserve…. it’s what we work for.