Of all the medical conditions that form the basis for claims for social Security Disability Insurance benefits (SSDI), back pain is the most common. Unhappily, claims for benefits based on back pain are among the most frequently denied claims. If approached properly, a claim for back pain can have just as high a probability of approval as a claim based on any other type of illness or injury.
Proving the existence of a back injury
The Social Security Administration classifies most types of back pain as “musculoskeletal disorders.” The SSA uses this term to separate disorders of the bony structures of the spine (vertebra, transvers processes, ligament and disks that comprise the spine) from the neurological spine, which includes most soft tissue injuries.
Other disorders, including arthritis, spinal curvature, and peripheral arterial disease, are also treated separately from disorders involving the bony structures of the spine. As with other disorders, the claimant must provide written medical evidence of the existence of the disability. This evidence is usually a letter from the healthcare provider together with pertinent medical records.
The injury or illness must be permanent. According to SSA regulations, the injury must be diagnosed as either permanent or likely to lead to death within 12 months. This aspect of the claim is usually the subject of an opinion of the relevant healthcare provider.
No one can receive SSDI benefits unless they can prove that they are unable to engage in “substantial gainful activity” because of their disability. Substantial gainful activity is defined as earning at least $1,350 per year. Generally, proof of low earnings alone is insufficient to prove disability. The claimant must also prove that they are in fact unable to work.
Solid legal support
The assistance of an attorney who is familiar with the SSDI claims and appeal processes can provide a significant advantage in the claims process. A knowledgeable SSDI lawyer can assist in assembling the medical and vocational evidence necessary to support the claim.