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Obtaining Benefits for Back Injuries

April 13, 2016 Blog

Back injuries can be caused by trauma or occur due to your aging.  Either way, your back injury could be so debilitating that you are unable to work.  Back injuries are one of the most common type of claims for Social Security Disability Insurance (SSDI) benefits, but Tampa back injury lawyers often see these claims denied.

Why Is It Difficult To Qualify For Disability For Back Injuries?

Many people suffer from back pain ranging from moderate to severe.  Only severe and chronic back pain may qualify for disability.  However, since back injury claims are largely based on the severity of your pain, and pain is subjective (based on your personal experience), it is difficult to prove using scientific measurements.  Even if objective medical evidence indicates you have a back problem, your pain and limitations may be more severe than the evidence suggests.  Thus, for the Social Security Administration’s (SSA) Disability Determination Service (DDS) claims examiner and/or medical consultant to grant your disability claim, he or she must believe whether you are not exaggerating.

Types of Back Injuries

Back injuries resulting in chronic back pain could be caused by:

  • Degenerative disc disease
  • Deterioration like osteoarthritis or osteoporosis;
  • Inflammatory conditions such as rheumatoid arthritis, arachnoiditis, and spondylitis
  • Postural problems resulting from improper lifting, bad posture, scoliosis, extended periods of sitting, years of wear and tear from heavy lifting and bending
  • Problems involving the spinal nerves such as spinal stenosis, nerve root compression, herniated discs, scoliosis or spondylolisthesis

 How Do I Medically Qualify for SSDI Benefits for Back Injuries?

To qualify for SSDI benefits, you must have a “medically-determinable” impairment that lasts for at least one year.  Thus, a doctor must have diagnosed your condition and your condition cannot be cured within less than a year.  If your condition meets these basic requirements, then the claims examiner will look to the severity of your condition and how debilitating it is.

He or she will first look to see if your condition is listed under the List of Impairments or if your condition may be equal to the criteria of a similar condition found in the List of Impairments.  For example, if you have been diagnosed with herniated nucleus polyposis (ruptured disc), arachnoiditis, spinal stenosis, degenerative disc disease, facet arthritis, osteoarthritis or vertebral fracture, your condition may fall under the listing of “disorder of the spine.”  The DDS claims examiner will then evaluate your claim by reviewing your:

  • Objective signs and symptoms – what can be proven scientifically to show you have a back abnormality, such as:
  • X-ray demonstrating fractured vertebra
  • MRI demonstrating herniated discs or bone degeneration
  • CT scan showing you have spinal stenosis
  • EMG (nerve conduction test) establishing the presence of muscle weakness in your body
  • Discography or myelogram highlighting the damaged area in your back
  • Functional limitations – what you cannot do because of your back injury. The claims examiner may review your physical examination reports that show limitations of your back rotation, bending, lifting; the need to frequently change positions; how long you can sit or stand; how long and far you can walk without taking a break; how far you can reach; etc.  Functional limitations are used to determine your residual functional capacity (RFC), which is the most you can do on a regular and sustainable basis (full-time).   Your limitations must be documented in your medical records.
  • Your credibility – how honest and truthful you are. Tampa back injury lawyers often see claims denied if the applicant exaggerated or lied.  The claims examiner will assess your credibility by comparing a variety of factors such as:
  • Objective medical evidence
  • Statements by your treating physicians regarding your prognosis
  • Statements made by you or other people who know you (e.g. employers, friends, family, doctors) describing how your symptoms impact your ability to work, attempts you made to work, any treatments you underwent and how well you did or did not respond to them.
  • Your activities of daily life (ADLs)
  • Your pain and symptoms location, how long they last, their intensity, and how often they occur
  • Factors that cause or exacerbate your pain or symptom
  • Medications you take to control or relieve your pain and symptoms, their dosage, how well they work, and any side effects
  • Anything else you do to control or relieve your pain and symptoms, such as acupuncture, physical therapy, massages, etc.
  • How often you visit your physician for your back pain

 It is crucial that your statements are consistent throughout your record and to the SSA.  The efforts you take to alleviate your symptoms are also an important factor because it shows your long-term effort to finding a successful treatment.  The less effort you make suggests you are exaggerating your pain, and that you can live with the pain and still function.

Obtaining Help with Your Claim

To increase your chances of success for you back injury claim or appeal of a denial of your disability claim due to back injury, seek our Tampa back injury lawyers will, among other steps:

  • Evaluate your claim
  • Prepare the required forms for your application
  • Review your medical records for thoroughness and consistency
  • Obtain your doctor’s narrative detailing your medical history, treatment, test results, findings, diagnosis, prognosis, recommended treatment, and functional limitations.
  • Obtain statements from co-workers, employers, friends, and family regarding your symptoms caused by your condition and how they affect your daily and work life
  • Recommend how you could increase your chances of success, such as keeping a diary detailing your symptoms, intensity, how long they last, how they affect what you are doing, what may have caused it, your good and bad days, etc.

For assistance, call (813) 264-5363 or toll free at 877-SSI-ATTY.