Saturday, May 02, 2009



Filing For Disability On the Basis of Back Pain

Back pain is the fifth most common reason for doctor visits in the United States and it has been suggested that nine out of ten Americans will suffer from some type of back pain at some point in their lives. Studies further indicate that five out of ten working Americans suffer from back pain each year. With statistics like this it is not at all surprising that many individuals file for Social Security disability on the basis of some type of back condition that produces a significant amount of pain.

As a former Social Security disability examiner, I found that the Social Security disability process was not very favorable to disability claimants at the initial disability claim and reconsideration appeal level. It was also my experience that Social Security did not give much credence to the pain caused by an individual’s back condition or the side effects caused by pain medication and muscle relaxers.

However, individuals who suffer from back pain also have another problem when filing for disability. Many individuals do not have sufficient medical treatment records documenting their back condition. Sometimes this is simply because doctors inform patients with back problems that there is no treatment for their back condition (or additional treatment beyond what they are currently receiving that might be helpful); as a consequence, many do not seek out any other treatment.

These individuals often seek relief from chiropractors. But Social Security does not give the same weight to chiropractic treatment notes that they give to other treatment sources such as orthopedists or family physicians (another way of putting this is to say that the records obtained from a chiropractor are not looked at whatsoever). In fact, disability examiners can only use the objective testing or laboratory results contained within the medical notes of chiropractic sources for their medical disability determinations.

A lack of current medical treatment information often leads to consultative examinations being scheduled for claimants whose cases are pending at the initial claim and reconsideration levels (though, sometimes, consults are also ordered by judges at the hearing level). Social security medical exams are actually performed by physicians who do not work for Social Security but who have contracted to provide such services.

Consultative examinations are usually not that favorable for a claimant, and very very few claimants win disability benefits on the basis of a consultative examination. Why? Mainly because they are one-time medical examinations (paid for by Social Security) that are quick and often not very thorough. Even in cases where Social Security requests a spinal x-ray, it is unlikely for a claimant to be approved on the basis of back pain (Spinal x-rays do not show the detail of MRIs or CT scans and often do not show the source of an individual’s back pain).

Some practical advice for any individual who is filing for disability on the basis of back pain is to attempt to have medical treatment notes that document your back pain and the treatment you have received. Better yet, of course, are treatment notes that either indicate what your functional limitations are, or allow some judgement regarding your functional limitations to be extrapolated. It goes without saying that claimants who have no medical treatment notes generally have much weaker disability cases.



Return to the Social Security Disability SSI Benefits Blog




Other Posts

Social Security Disability and Medical Evidence
Social Security Disability Requirements
How long does it take to get a decision on a Social Security Disability or SSI case?
Social Security Disability SSI - Reapplying is NOT the same thing as appealing
How to get Approved for Disability Benefits
How to Qualify for Disability - social security disability or SSI

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5 Comments:

Blogger Frank Scimeca said...

I have a question. I just started to receive benefits for disability. I actually filed on Sept 20, 2008 and was reviewed and received my first check on March 3, 2009. Pretty quick.
Here is my question, during this time I was receiving short term disability from my past employer, which is still continuing through June of 2009.
How will the SSA know that this is short term disability and will it effect my future benefits?
My only assumption is that when I file my taxes it will give me an opportunity to put that info in the system so it is coded properly. Since Short term dis. is a taxable item it is reported as wages even though I did not work. Please advise and feel free to email me at franksflying1@yahoo.com
I appreciate your work!

9:21 AM  
Blogger Sheryl said...

It's appalling to me that pain itself is so disregarded in the disability process. While I understand intellectually the basis for this position -- pain can be faked, not to put too fine a point on it -- it's entirely wrongheaded, for the simple reason that pain does strike, often chronically, while leaving no clear sign of its origin or cause.

Basically, the system believes us all to be malingerers and liars who want to get out of work. I'm sure such people exist, and I've no doubt many of them attempt to game the system to get out of working, but I'm not one of them and I don't know any of my fellow chronic pain sufferers who wouldn't give just about anything to be able to work full-time in our chosen professions. We want to be productive. Disability isn't a prize to be won -- it's a last-gasp measure to simply exist.

If more consideration were given to this simple fact, I believe the chronically afflicted would be then able to focus their energies on healing and recovery. As it is, such a shift would require a major philosophical change in approach, so I don't hold out much hope.

2:11 PM  
Blogger Disability Blogger said...

Thanks for the comments. We, and by this I mean the medical community and society in general, tend to brush aside considerations of pain and their limiting effects in this country. We take the same approach to how we consider mental illness also. So, its not surprising that this gets reflected in decisional outcomes with social security disability and SSI cases. How to fix it? Possibly mandating a more intensive course of training for disability examiners might help. That and bringing all state disability agencies under direct federal control.

5:42 AM  
Blogger Disability Blogger said...

Hi Frank, I'll post today and address your question.

5:48 AM  
Blogger Disability Blogger said...

Frank:

Social Security Disability and Short Term Disability Benefits

6:35 AM  

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