Will Herniated Disc Treatments Make You Well Enough to Return to Work?

Posted on November 29, 2010 by Editorial Board

A herniated disc is one cause of extreme back pain which may be so severe that sufferers are virtually bedridden, or reliant on strong prescription medication to be able to function at all. Many people with this kind of severe pain are simply unable to work due to both their pain and limited mobility.

In any treatment for herniated discs, the main aim is to relieve pain and improve mobility of the patient. In each case, the degree of pain and the symptoms will differ somewhat, partly due to the location of the herniated disc, and also because of the severity of the problem, alongside any other medical issues the person may have.

For a person who can no longer work due to the extent of their pain, one of the main aims of treatment is correcting or alleviating the problem enough that they can return to regular paid work. When it comes to deciding on the correct treatment, it is first vital to get the right diagnosis, rather than simply a doctor’s opinion. Objective evidence in the form of CT scan or MRI scan results are necessary to determine the exact extent of the damage, and these tests can also provide the detailed information needed to decide the best course of treatment.

Many medical professionals won’t consider surgery until other options are exhausted; however, in some cases, early surgery can be the key to a successful recovery. Patients who experience weakening of the arms and legs due to the pinching of a root nerve by a herniated disc often benefit from early surgery to correct the disc herniation, enabling them the opportunity to heal faster and regain full use of their limbs, which is a vital step in returning to work. If surgery isn’t conducted in a reasonable time, there may be resultant nerve loss, which can cause permanent damage, and thus a permanent disability.

In the initial stages after disc herniation, a conservative treatment that reduces pain and discomfort can be utilized, but may require a certain amount of trial and error. These treatments may combine analgesia (pain medicine) alongside physical therapy and/or spinal manipulation. Patients are often also taught good body mechanics, which will help to prevent future disc damage.

In some cases, such treatments will be enough to enable a patient to return to work, especially if they are employed in a fairly sedentary job which places little stress on the spine. Many patients can continue with such treatments over the long term, which will be sufficient to manage the condition. However, patients whose pain is extreme, and for whom such conservative treatments do very little, may require surgery. In these cases, patients simply won’t be able to recover enough to return to work unless surgery is performed, and even then it may not be completely successful.

Surgery for a herniated disc usually involves what is known as a microdiscectomy procedure, where the herniated portion of the disc is removed, taking pressure off the nerve root and thus reducing pressure and relieving pain. Provided the damage to the actual nerve root wasn’t too severe, such surgery may enable the nerve root to heal in time.

Whether or not surgical or conservative treatment for a herniated disc will be sufficient to allow a person to return to work depends heavily on the extent of the problem, and whether or not there was any permanent nerve damage. Herniated discs that are treated quickly, and are followed by good after care and rehabilitation, may heal enough to enable a person to return to paid work.

Posted in Bone & Joint Problems, Your Limitations | 2 Comments

The One Year Durational Requirement

Posted on November 26, 2010 by Editorial Board

The “duration” requirement is one of the fundamental rules of Social Security Disability Law.  The Agency’s regulations state, “Unless your impairment is expected to result in death, it must have lasted or must be expected to last for a continuous period of at least 12 months.”  20 C.F.R. § 404.1509.

Social Security defines “disability” as the inability to maintain substantial gainful employment due to medical conditions.  In other words, you are disabled if you cannot function well enough to keep a full-time job.  Some medical problems keep you from working for only a short period.  Take for example a broken leg, a severe ankle sprain, or even a migraine headache.  Obviously Social Security will not pay disability benefits for short term injuries such as these.  The one-year duration requirement is Social Security’s standard for determining how long a condition must last to qualify for disability compensation.

Social Security uses the duration requirement to deny a large number of disability claims.  For example, the Agency often assumes persons undergoing major back surgery will recover enough to return to work within a year.  Persons undergoing chemotherapy or radiation treatment for cancer are usually denied until their treatment has lasted a full year or more.

Put briefly, Social Security assumes treatments will be more effective than they usually are.  Social Security also tends to assume patients will fully recover after their illness or injury, while in reality most people are never able to do as much as they could before.

Even though it seems simple, the one-year duration requirement is sometimes misunderstood by judges and lawyers.  The most common mistake is thinking the duration requirement means that the claimant needs a year of disability benefits eligibility.   Factors such as income, work, and the filing date of the claim can make a person ineligible for benefits for a certain period of time.  However, these factors are not related to the duration requirement.

For example, Joe Claimant is injured but waits a year before filing an SSI claim.  Joe goes through a surgery and physical therapy and successfully returns to work six months after filing for disability.  Some disability judges think Joe cannot get benefits, but they are wrong.  Joe’s injury lasted 18 months.  He can get six months of benefits for the time between the date he filed his claim and the date he returned to work.

Posted in Basics of SSD, Date Issues, Filing Initial Application, Legal Concepts in SSD, Severe Impairments (Step 2), Why People Are Denied | Comments Off on The One Year Durational Requirement

Sustainability as an Alternate Theory

Posted on November 24, 2010 by Editorial Board

Many disabled individuals are able to do some amount of work.  You might qualify for Social Security disability benefits even if you are able to do a part time job.  Social Security looks at whether you can do a full time job to decide if you qualify for disability benefits.  They also look at whether you can sustain the job over time.

Social Security reviews the evidence in your case to determine your physical and mental functioning.  They estimate your ability to stand, walk, and sit throughout the work day.  They also estimate how much you can lift and carry, and how well you can use your arms and hands.  Your ability to concentrate, follow directions, and interact with other people is also considered.  Basically, Social Security estimates how all of your medical conditions affect you.  Social Security calls this your “RFC” (Residual Functional Capacity).  Social Security then decides whether you can still work despite the limitations of your RFC.

When Social Security decides your RFC they often fail to consider whether you could sustain that level of effort over weeks or months.  For example, if you have a knee or ankle condition you might work a full day but then miss work the next day because the joint swells and becomes painful.  Other medical conditions allow you to work until you have a “flare up”, such as gout, fibromyalgia, depression, and bipolar disorder.  Missing too much work can be just as disabling as not being able to work at all.

Why might Social Security fail to consider your ability to sustain work?  If Social Security sent you to a physical or mental exam they look very closely at that exam in deciding your case.  However, the exams are done in less than a day.  They don’t show how you would hold up under the strain of full time work day after day.

Also, Social Security usually doesn’t have evidence showing how your condition affects you over time.  You can’t get a physical and mental exam done every day.  To fix this problem, tell your doctor if you had a flare up since your last visit.  Describe the flare up and how long it lasted.

At your disability hearing make sure to explain what your health is like on your good days and your bad days.  Remember, if you have some good days when you can be active that doesn’t mean you aren’t disabled.  If you are honest about what you can do on a good day the disability judge should believe you when you tell the judge what you can’t do on the bad days.

Posted in Legal Concepts in SSD, Past Relevant Work (Step 4), Vocational or Work Issues, Winning Disability Benefits | Comments Off on Sustainability as an Alternate Theory

Depression Treatment Essential When Filing for Disability Benefits

Posted on November 23, 2010 by Editorial Board

Every year millions of Americans are affected by depression. This debilitating mental illness can have a devastating effect. Some people lose their jobs, their families and even their lives.

Applying for Disability Benefits Due to Depression

For some people depression is a manageable illness. With counseling, and in some cases medication, they are able to stay on top of their condition and live relatively normal lives. For others a normal life may be impossible. Many people with depression find themselves severely limited in their ability to function, with some unable to even get out of bed in the morning.

You may be eligible to receive both Social Security Disability and or SSI benefits if you are deemed to be suffering from depression at a severe enough level to keep you from working full time. Social Security will need to evaluate the severity of your depression and whether it prevents you from functioning in your normal life. They will analyze your medical records that relate to your depression. This could include notes from doctors, counselors, psychologists or psychiatrists, any stays in the hospital, or any other related treatment.

If Social Security is not able to make a decision based on your medical records, they will send you to a doctor that they pay for to get a mental status examination (MSE). This often occurs because the records that doctors and other health professionals keepusually  don’t contain a full psychological evaluation.  The MSE will include questions about how you feel about your own mental health, memory tests, judgment and concentration testing.

 

Staying in Treatment While Applying for Disability

To win benefits, a record of ongoing treatment lasting a substantial amount of time is very helpful. This shows that the applicant has battled the illness in treatment, that they have been unsuccessful in decreasing symptoms, and also that the illness shows little sign of improving in the future.

Doctors’ visits, sessions with psychologists and psychiatrists, hospital stays as an inpatient are all  part of being in treatment. Most claims for benefits which are based on a mental health disorder will end up at a Social Security hearing before an Administrative Law Judge (ALJ).  The ALJ has the authority to weigh the evidence from many sources, and decide whose opinion on your condition is controlling.  If you are claiming disability benefits for a mental illness such as depression, staying in treatment with a psychiatrist or psychologist and being compliant with taking your medication, is integral to your success.

Posted in Mental Conditions, Treatment & Compliance | Comments Off on Depression Treatment Essential When Filing for Disability Benefits