How Hard Is It to Get Disability for Degenerative Disc Disease?

Obtaining disability benefits for degenerative disc disease can be a challenging process. While the pain and limitations caused by degenerative disc disease are undoubtedly real and debilitating, the condition presents unique hurdles when seeking disability approval from insurance companies or government agencies like the Social Security Administration (SSA).

Why Degenerative Disc Disease Claims Are Challenging

A significant difficulty lies in the nature of pain, which is often the primary symptom of degenerative disc disease. Pain is considered a "subjective" symptom, meaning it is felt and reported by the individual but can be difficult for others to independently measure or verify. Insurance providers and disability evaluators require objective medical evidence to substantiate a disability claim, going beyond a claimant's personal reports of pain.

This emphasis on objective evidence means that a diagnosis of degenerative disc disease alone is often insufficient for approval. Claimants must demonstrate that the condition's effects are severe enough to prevent them from performing substantial gainful activity.

The Need for Objective Evidence

To strengthen a disability claim for degenerative disc disease, you must provide comprehensive objective medical evidence. This includes:

• Diagnostic Imaging:
  • MRIs (Magnetic Resonance Imaging): Provide detailed images of soft tissues, including discs, nerves, and spinal cord, showing disc degeneration, herniations, bulges, spinal stenosis, or nerve compression.
  • CT Scans (Computed Tomography): Offer cross-sectional images of bone structures, useful for identifying bone spurs or spinal canal narrowing.
  • X-rays: Can show disc space narrowing or bone changes but are less detailed for soft tissues.
• Neurological Examinations: Documentation from neurologists or orthopedic surgeons detailing muscle weakness, sensory loss, abnormal reflexes, or limited range of motion.
• Nerve Conduction Studies (NCS) and Electromyography (EMG): These tests can objectively measure nerve damage or muscle dysfunction resulting from nerve compression.
• Physical Therapy Records: Documentation of limitations, improvements, or lack thereof during physical therapy, along with assessments of functional capacity.
• Operative Reports: If surgery has been performed, these reports detail the procedures and findings.

Key Elements for a Strong Disability Claim

Successfully navigating the disability application process for degenerative disc disease requires meticulous preparation and thorough documentation.

1. Comprehensive Medical Records

All your medical records, from diagnosis to ongoing treatment, are crucial. This includes:

• Doctor's Notes: Detailed notes from your primary care physician, specialists (orthopedists, neurologists, pain management doctors), and any other treating professionals. These should consistently document your symptoms, functional limitations, treatment history, and prognosis.
• Treatment History: Evidence of consistent medical treatment, including medications, injections, physical therapy, and any surgical interventions. Demonstrating adherence to prescribed treatments is important.
• Medication Lists: A record of all medications prescribed, their dosages, and their effects (both beneficial and side effects).

2. Proof of Functional Limitations

Beyond a diagnosis, you must prove that your degenerative disc disease significantly impairs your ability to perform work-related activities and daily tasks. This includes:

• Inability to Sit, Stand, or Walk for Extended Periods: Many jobs require these basic physical functions.
• Limitations in Lifting, Carrying, Pushing, or Pulling: Document any weight restrictions or difficulty with these movements.
• Difficulty with Bending, Twisting, or Reaching: Common limitations for spinal conditions.
• Problems with Concentration and Persistence: Chronic pain and medication side effects can impact cognitive functions.
• Reduced Range of Motion: Medical assessments showing restricted movement in your spine or limbs.

3. Physician Support and Opinions

Your treating physicians' support is invaluable. Ask your doctors to:

• Provide detailed medical opinions regarding your limitations and prognosis.
• Complete "Residual Functional Capacity" (RFC) forms, which outline what you can still do despite your impairments (e.g., how long you can sit, stand, lift).
• Clearly state why you are unable to perform your past work or any other substantial gainful activity.

4. Consistent Reporting

Maintain consistency in your reports of pain and functional limitations to all medical professionals and during any interviews with disability evaluators. Discrepancies can raise doubts about the severity of your condition.

The Application Process

The disability application process, particularly for Social Security Disability (SSD) benefits, typically involves several stages:

1. Initial Application: Submit your application and supporting medical documentation. This stage often has a high denial rate.
2. Reconsideration: If denied, you can request a reconsideration, where your claim is reviewed by a different examiner.
3. Hearing: If denied again, you can request a hearing before an Administrative Law Judge (ALJ). This stage often offers the best chance of approval, as you can present your case in person, with or without legal representation.
4. Appeals Council/Federal Court: Further appeals are possible if the ALJ denies your claim.

While challenging, securing disability for degenerative disc disease is possible with comprehensive medical evidence, thorough documentation of functional limitations, and consistent effort throughout the application and appeals process.