“Do I have to have back surgery to get disability?”

Lumbar (low back) problems are a common reason for social security disability insurance benefits.   Social security disability applicants are often in the process of considering various medical procedures that have been recommended by doctors.  For example, the back surgeon wants to do a lumbar fusion or the pain management doctor wants to implant a spinal stimulator.  Sometimes disability claimants can feel a little like the strawman in the Wizard of Oz when the Wicked-Witch-of-the-West jabbed the flaming broom his way saying “How about a little fire scarecrow?”.

I am often asked about the implications that a decision to have or forego medical surgery or procedures will have on the pending social security disability claim.  There unfortunately is no easy answer.  Here, however, are a few guidelines:

  1. The social security disability assessment system looks at the ability to work inspite of medical efforts to return functioning to normal.  So the failure to secure medical treatment, the failure to take prescribed medications, and ignoring medical advise is not helpful to a social security disability case.
  2. Claimants are NOT required to undergo risky surgeries to be approved for social security disability benefits.  This is particularly true for claimants who have already had several surgeries that have not been successful.
  3. My experience is that claimants usually refuse surgeries such as spinal fusions out of fear:  they know someone who has not been successful, or have an unreasonable fear of dying in what are fairly routine procedures.  These are “fear-based” reasons to not have surgery, and will not help your disability claim.
  4. If you decide against a surgery that is offered, have (i) a well thought-out reason, and (ii) chart an alternative path to better functioning with your doctor(s).


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