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I Need to Apply for Social Security Disability benefits given my back problems. What Concerns Should I Have Going Forward?

First and foremost, when attempting to apply for Social Security disability in ME, MA or NH, for issues involving one’s back, it is important that you are seeking (and that you have sought in the past), appropriate treatment that shows an aggressive effort to recover from these problems. The Social Security Administration (SSA) is looking to see (as should you) that everything is being done that can be done to get better and return to some manner of employment.

It’s important that the nature of your back problems has been diagnosed. We many times encounter individuals who have been suffering for many years from back problems, but have not sought out an answer as to why, and what can then be done to fix the problem. Without an answer as to what is going wrong in the form a firm diagnosis, it becomes difficult to show SSA what the severe medical impairment they are suffering from (which is required under step 3 of the sequential evaluation process). Likewise, without such a diagnosis, it becomes difficult for a treatment provider to provide an appropriate course of treatment.

One of the worst mistakes an individual with longstanding back problems can make is choosing to continue treatment with a chiropractor. SSA provides a list of what they consider to be acceptable medical sources who are deemed qualified to provide evidence in establishing what an individual’s diagnosed medical impairments happen to be.  Chiropractors are not considered acceptable medical sources: in addition to not being licensed physicians, they remain incapable of ordering medications, providing injection therapy, or undertaking surgical options. For claims filed on or after March 27, 2017, the new Social Security regulations provide that acceptable medical sources that might treat back problems would include not only licensed physicians, whether medical or osteopathic physicians, but also certain APRNs along with Physician Assistants (PAs).

SSA will also look to see that you are exhausting available diagnostic imaging for purposes of obtaining a definitive diagnosis as to what is causing your symptoms. In addition to x-rays, it might be appropriate to proceed with a CAT scan, an MRI or even an EMG study to help with this process.

Likewise, SSA will look to see that available treatment options are being exhausted as well, whether it be through medication management, injection therapy, physical therapy and potentially surgery (although the SSA regulations take into account the fact that there may be side effects to medications and risks associated with invasive procedures such as injection therapy and surgery that may cause one to avoid certain treatment options). Other treatment options may even include that of a TENS unit for pain and a spinal cord stimulator (SCS).

We always recommend that for any condition that one believes is severe that you remain in treatment with a specialist, not simply with one’s primary care physician. Typically, this might require evaluation with a neurologist or a neurosurgeon, or referral to pain management providers that might include a physiatrist, injection specialists or medication management specialists.

Ultimately, in evaluating a claim for a back condition, SSA will first look to see whether one’s back condition meets the Medical Listings of Impairments guidelines for back conditions, which are set forth under Listing 1.04 Disorders of the Spine. However, in order to meet such a listing, there are very specific findings that must take place, in association with compromise of a nerve root that many times will simply not be evident. Most claims involving one’s back will ultimately require a showing under Social Security’s regulations that one remains incapable of performing any of their past relevant work (that is, to say, any work they’ve performed in the 15 years prior to becoming disabled) or any work for which they are reasonably suited, taking into account any limitations imposed by their severe medical impairments along with their age, education and experience. It is important to understand as well that for those are who 50 years of age and older and a past history of physical work that they can no longer perform as a result of their ongoing back problems, SSA will apply the Medical Vocational Guidelines, otherwise known as the Grid rules in determining their ability to return to other forms of gainful employment.

For answers as to how the Social Security Administration might evaluate your individual circumstances, including your history of back pain, treatment and how it’s impacted your ability to function in a work setting, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622.