Degenerative Disc Disease & Social Security Disability: What Are Your Chances?

by Editorial Board on September 6, 2010 · 0 comments

in Bone & Joint Problems

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One of the problems with degenerative disc disease and other diseases of the spine is that they are often dismissed by Social Security Disability, even though there is a section under the Listing of Impairments in the “blue book” related to disorders of the spine (which includes degenerative disc disease or DDD). According to Social Security, these listed medical conditions are so severe that someone who suffers from one automatically qualifies for Social Security Disability.  But just having degenerative disc disease does not mean you meet the listing and qualify for benefits, you must have the condition at the level described in the listing.

Degenerative disc disease is a common impairment for which people file a Social Security Disability claims. For individuals under the age of 40, it is extremely difficult to qualify for Social Security Disability payments with degenerative disc disease.

Even if an individual’s doctor believes they have an excellent case for receiving Social Security Disability for a degenerative disc condition, especially if they suffer extreme pain and are clearly unable to perform their usual work, the claim will often be rejected because the evidence is not substantial enough to meet the listings level of impairment.

Once a person files a claim for disability, the case is sent to the Disability Determination Services (DDS) where it is assigned to an Examiner who will go through the claimant’s medical records in order to either approve or deny the claim. Even with sound medical records, DDS offices are usually very dismissive of subjective back pain and the effects it can have on a person’s ability to engage in normal work. The problem is that it’s very hard to prove pain, and only the individual experiencing the pain can truly understand how it feels.

In order to be awarded Social Security Disability benefits, it is extremely important that medical records be detailed and complete. A Social Security Examiner will specifically look through medical records to determine whether a physician has diagnosed degenerative disc disease, and whether there is some concrete evidence that the condition exists (this means an X-ray, CAT scan, or MRI scan which shows the spinal damage). If this evidence doesn’t exist, the claim will almost always be denied. For this reason, it is crucial that anyone filing for disability because of a degenerative disc condition ensure that the correct medical imaging tests have been performed to corroborate your doctor’s initial findings. Unfortunately, some physicians will diagnose degenerative disc disease without ordering formal tests (based upon the patient’s symptoms only), and that will typically not be enough medical evidence to support a disability claim.

In addition to formal medical evidence, a Disability Examiner will also look for indications of the claimant’s reduced physical function.  This includes: decreased range of motion, decreased muscular strength, and poor gait.  If the physician has sent the patient to a specialist for a follow-up, or for some form of physical therapy or rehabilitation treatment, it is important that the patient has followed through with all appointments.  Non-compliant patients will not fare well in the Social Security system, since being in treatment is an important factor in obtaining benefits.

Medical records from a specialist, such as an orthopaedic or a neurologist for example, can also help a person’s Social Security Disability claim if these specialists take good notes that can be used to help demonstrate the limitations to disability examiners.  If it is noted that the patient’s condition is not responding effectively to treatment, or that the patient will be unable to ever fully recover, or that they will be unable to work for a period of at least a year, that could all help a disability case.

To have the best chance of qualifying for Social Security Disability for a degenerative disc disease, it is crucial to ensure that the correct medical diagnostic tests have been performed, and that any appropriate specialists have been consulted. An individual who follows through with all appropriate medical treatment will have a much better chance of getting their claim approved than someone who has received a diagnosis from a physician without full testing or complete follow up visits with specialist doctors.

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