“Can I Get Disability for Spinal Stenosis?”
This is the simple answer: yes, you can receive social security disability benefits based upon the diagnosed condition of spinal stenosis. But the mere fact that a doctor has diagnosed you with spinal stenosis is not enough to win social security disability approval. Whether you win social security disability benefits depends on the specifics of your case, including:
- How severe is your spinal stenosis?
- How severe are your symptoms?
- What kind of work might you be capable of based on your age, education, and work background?
This article examines the specifics of spinal stenosis and how it is assessed in a disability case by the social security administration.
What is Spinal Stenosis?
Spinal stenosis is a medical condition characterized by the narrowing of the spinal canal, which houses and protects the spinal cord and nerves. This narrowing can lead to compression and pressure on the spinal cord and nerves, resulting in a variety of symptoms and impairments.
The spinal canal is a hollow space that runs through the vertebrae, the bones that make up the spinal column. It houses the spinal cord, which is a bundle of nerves responsible for transmitting signals between the brain and the rest of the body. The spinal cord extends from the base of the brain down to the lower back.
When the spinal canal narrows, it can impinge on the spinal cord itself or the nerves that branch out from the spinal cord. This compression can cause pain, numbness, tingling, and weakness in the areas supplied by those affected nerves. The symptoms can vary depending on the location of the stenosis along the spine.
There are two main types of spinal stenosis:
Lumbar Spinal Stenosis
This type of stenosis occurs in the lower back and is the most common form. It typically affects the nerve roots of the lower back and legs. Symptoms may include lower back pain, radiating pain down the buttocks and legs (sciatica), weakness in the legs, and difficulty walking or standing for extended periods.
Typical symptoms of lumbar spinal stenosis:
- Pain, weakness, spasms, and/or numbness in the legs (one or both) with standing or walking that eases is only aleviated with sitting, lying down or bending forward;
- Tingling, numbness, weakness, stinging or odd sensations in the legs and/or feet;
- Back pain;
- Burning, tingling, or stinging pain moving into the buttocks/hip and radiating into the legs and feet;
- Numbness, tingling, cramping, or weakness in the legs;
- Diminished or lost sensation in the feet.
- A weakness in a foot that causes the foot to slap down when walking (“foot drop”)
Cervical Spinal Stenosis
- This type of stenosis occurs in the neck region of the spine. It can affect the nerve roots that supply the arms, causing symptoms such as neck pain, radiating pain down the arms, numbness or tingling in the hands and fingers, and weakness in the arms and hands. In severe cases, cervical spinal stenosis can also lead to problems with coordination and balance.
- In cervical spinal stenosis, the most common symptoms include:
- Weakness in hands, arms, feet or legs;
- Neck pain;
- Difficulty with walking or balance;
- Numbness or tingling in arms, hands, feet or legs
- Spinal stenosis is often a result of degenerative changes in the spine that occur with age. These changes can include the thickening of ligaments, the formation of bone spurs, and the breakdown of the intervertebral discs. Other causes of spinal stenosis include congenital abnormalities, spinal injuries, tumors, and inflammatory conditions like arthritis.
- Diagnosis of spinal stenosis typically involves a comprehensive evaluation of medical history, physical examination, and diagnostic imaging tests such as X-rays, CT scans, or MRI scans. Treatment options can vary depending on the severity of the condition and the impact on an individual’s quality of life. Non-surgical approaches may include pain management techniques, physical therapy, and lifestyle modifications. In more severe cases or when conservative treatments fail to provide relief, surgical intervention may be necessary to decompress the affected spinal structures.
What causes Spinal Stenosis?
- Achondroplasia is a type of dwarfism that interferes with bone formation in the spine as well as other parts of the body.
- Ankylosing spondylitis is a type of arthritis that causes chronic inflammation in the spine. It can lead to the growth of bone spurs.
Congenital spinal stenosis
- Congenital spinal stenosis occurs when you’re born with a spinal canal that’s naturally narrow.
Ossification of the posterior longitudinal ligament (OPLL)
- In this condition, calcium deposits form on the ligament that runs through the spinal canal.
- In osteoarthritis, the cartilage that cushions your joints breaks down. The condition can affect the cartilage between vertebrae and may also cause bone spurs to grow in the spine.
Paget’s disease of the bone
- Paget’s disease of the bone is a chronic condition that causes bones to get weaker and grow larger than usual.
- Rheumatoid arthritis involves chronic inflammation, which can cause bone damage and the development of bone spurs.
- Scoliosis is an abnormal curving of the spine. It may result from certain genetic conditions, neurological abnormalities, or unknown causes.
Slipped (herniated) discs and bone fractures may cause vertebrae or bone fragments to put pressure on the spinal nerves.
- These tissue growths may develop in the spinal canal, trigger inflammation, and cause changes in the surrounding bone.
Meeting the Requirements for Social Security Disability Benefits for Spinal Stenosis
To qualify for Social Security Disability benefits, an individual must meet specific criteria set by the Social Security Administration (SSA). These criteria include:
1. Severity of the condition: The SSA requires medical evidence showing that your spinal stenosis is severe enough to significantly limit your ability to perform basic work-related activities.
2. Duration of the condition: Your medical records should demonstrate that your spinal stenosis has lasted or is expected to last for at least 12 months, rendering you unable to work during this period.
Winning Spinal Stenosis Disability via the “Blue Book”: Meeting the Listing
There is widespread misunderstanding about the so-called “Listings” and the “Blue Book” for all medical conditions, including spinal stenosis. (The Blue Book criteria and the “Listings” are one and the same.)
The Listings/Blue Book for spinal stenosis listed in section 1.04 of the Blue Book, Disorders of the Spine provides for automatic approval only for the most severe cases of spinal stenosis. Under the listing you must prove that the spinal stenosis has impinged or inflamed a nerve in the spinal cord. This spinal code nerve compression must be documented by medical evidence, typcially in the form of an MRI or CT scan.
Also under the spinal stenosis listing you must have medical evidence that the spinal stenosis causes pseudoclaudication. This medical term refers to the following:
“Pain, tingling, tiredness, weakness, numbness or heaviness in the legs, hips, glutes and lower back.”
Perhaps the most restrictive requirement for meeting the listing for spinal stenosis that the pseudoclaudication must “seriously interferes with the ability to walk”.
Evidence Needed Related to Your Lumbar Stenosis Diagnosis
The first type of medical evidence that the Blue Book directly requests is a complete medical history of your Lumbar Spinal Stenosis.
As there is no specific test for lumbar stenosis, medical records from your physician are of vital importance. They should include your presenting symptoms, the history and progression of your disease, as well as the results of a full physical examination. Be certain that your doctor addresses the following in his notes:
Any pain that you experience in your legs that is caused by compression of your nerve roots, referred to as pseudo claudication. Typically, this pain is made worse by standing or walking and is often relieved by sitting or lying down.
Any difficulty that you have with mobility due to pain, numbness or weakness
Any required use of an assistive device, such as a walker, cane, or wheelchair
Any assistance that you require navigating stairs or getting in and out of a car due to pain, numbness or weakness
Your physician should perform and document the results of a straight leg raise test, both sitting and lying down.
If you have required surgery as a result of your lumbar spinal stenosis, your operative note and/or a pathology report should be included in your records.
Imaging results such as x-rays, MRIs or CT scans are of vital importance to provide related to your case
Medical Evidence and Diagnostic Tests
When filing a disability claim for spinal stenosis, it is crucial to provide substantial medical evidence to support your case. This evidence may include:
1. Medical records: Gather all relevant medical records, including doctor’s reports, diagnostic test results, and treatment history. These documents will help demonstrate the severity and duration of your condition.
2. Imaging tests: Diagnostic tests such as X-rays, CT scans, or MRIs can provide visual evidence of spinal stenosis and the resulting compression on spinal nerves or the spinal cord. These images can substantiate your disability claim.
3. Nerve conduction studies: Nerve conduction studies assess the functioning of the nerve roots affected by spinal stenosis. These tests can reveal nerve damage or impairment, further strengthening your claim.
Residual Functional Capacity (RFC) and Ability to Work
The SSA evaluates an individual’s residual functional capacity (RFC) to determine their ability to perform work-related activities. RFC takes into account your physical and mental limitations caused by spinal stenosis. Factors considered include:
1. Ability to stand and walk: Spinal stenosis can cause difficulty in walking or standing for prolonged periods. If your medical records indicate that you have significant limitations in these areas, it can support your claim for disability benefits.
2. Physical limitations: Muscle weakness, limited range of motion, and chronic pain associated with spinal stenosis can affect your ability to perform various physical tasks required in a work environment. Make sure to provide detailed medical evidence describing these limitations.
3. Medical treatments: If you have undergone extensive medical treatments, such as physical therapy, injections, or surgeries, but your condition still prevents you from working, this information can strengthen your disability claim.
An Experienced Disability Attorney is Important
Navigating the process of applying for Social Security Disability benefits can be complex and overwhelming. Consulting with a disability attorney who specializes in disability claims can be beneficial. A qualified attorney can help you understand the requirements, gather necessary medical evidence, and guide you through the application process. They can also represent you in case of a denial or appeal, increasing your chances of a successful outcome.