Is Your Back Pain Medically Determinable?

Back Pain, Back InjuryIf you suffer from back pain, you know how frustrating and debilitating it can be.

Some back pain is short-term, resulting from a muscle strain or fracture. Other back pain comes more or less naturally with age and is considered manageable. But some back pain lasts longer and ends up limiting your functionality.

If you have been suffering for several months and are too debilitated to work, it might be time to look into getting Social Security disability benefits, from either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Claims for muscle and bone pain, including lower back pain, are the most common claims the Social Security Administration (SSA) sees, so the administration can be skeptical of these claims.

DisabilitySecrets.Com explains this concept further:

“Social Security receives more disability applications for back problems than for any other physical illness or injury. Disability examiners see back problems and injuries day after day, and they will not grant disability benefits for the moderate or intermittent back pain almost everyone gets after age 40 or 50. To get disability benefits, you must have a medically determinable back impairment such as spinal stenosis, nerve root compression, herniated disc (if it’s chronic and not treatable), or arachnoiditis. And even then, you must meet Social Security’s severity requirements for the particular spinal disorder, which isn’t easy.”

Is your back pain medically determinable?

The SSA looks for objective evidence to prove whether you really have a medical problem. In order to collect this evidence:

  • Establish a relationship with your doctor or “treating physician.” Your physician and you should have some sort of history so that the SSA can trust that your doctor is an expert on your medical condition and a reliable source about your symptoms. The treating physician’s opinion is generally given great weight by the SSA. Don’t bounce around from doctor to doctor.
  • Along with that, get doctor’s notes. You ought to be seeing your doctor regularly and informing him or her of your symptoms and how they affect you. Explain your need for his or her notes for your claim. If you are not seeing a doctor regularly, it is likely the SSA will not be able to determine if your pain is as debilitating as you say. Doctor’s notes should include any diagnosis, comments on a physical examination, etc.  However, doctor’s notes aren’t everything.
  • More importantly, ask your doctor to fill out an RFC form. An RFC is one of the most vital documents in your claim. Though doctor’s notes are helpful, they don’t draw conclusions about your ability to work like an RFC allows your doctor to do. You can find more information about RFCs or download the online form.
  • Don’t rely on alternative “medical” sources for evidence. Even if they work for you, the SSA relies on more mainstream medical evidence, so a chiropractor or naturopath would not necessarily hold sway with a claims judge.
  • Make sure you do recommended objective tests, including MRIs, x-rays, lab work, and physicals. The results of these tests might help your case.
  • Don’t bank on the testimony of non-medical sources. Because the SSA is looking for “functional medical evidence” it isn’t interested in anecdotal tales of your suffering but rather scientific proof of it.

Although there is more to your disability claim than proving it is medically determinable, it is one of the first steps you can focus your efforts on.

Photo courtesy of  J. Heuser JHeuser via Creative Commons