Back pain is a debilitating condition that can impact your ability to work and earn a living. The Social Security system is there to support people who are unable to work because of a disability. However, obtaining disability payments requires meeting SSDI eligibility requirements. Unless back pain is a symptom of a long-term health condition or injury, it can be difficult to receive disability payments for the condition. Jon Sipes, Attorney at Law, helps West Texas clients suffering from chronic back pain that prevents them from working to get the disability benefits they deserve. Jon Sipes understands the difference disability payments can make to his clients and fights to make sure they get the disability awards they are entitled to under the law.

What Are Social Security Benefits?

There are two types of Social Security benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI and SSI benefits are generally available to individuals who suffer from a long-term injury or medical condition that prevents them from working. 

Which program you are eligible for depends on the number of years you have worked and paid Social Security taxes. You must have worked and paid Social Security taxes for at least 10 years to qualify for SSDI. 

If you have never worked or have worked for less than 10 years, you are not eligible for SSDI. Instead, you may be eligible for SSI, a need-based program available to the elderly and those who are blind or have another disability.

Payments under SSDI are based on actual taxes paid while SSI payments are based on different factors but generally based on an allowed amount set by Congress. Therefore, monthly SSDI payments are generally higher than SSI payments. Additionally, individuals approved for SSI are eligible for Medicaid immediately, while those who are approved for SSDI must wait 2 years to qualify for Medicare. 

What Is a Disability?

To qualify for either SSDI or SSI benefits, you must have a severe, long-term medical condition that is expected to last at least 1 year or result in death. The medical condition must also keep you from being able to perform any substantial gainful activity (SGA). 

In 2020, SGA is defined as performing work that results in earning an income of more than $1,260 per month. The monthly income threshold may change based on inflation and economic conditions, but it is set for at least a year at a time.

Many different conditions can result in a disability that prevents you from working, including physical injuries, chronic medical conditions, or mental illness. The Social Security Administration maintains a guide it uses to assist in determining whether an injury or condition qualifies as a disability for benefits purposes. 

Is Chronic Back Pain a Disability?

The Social Security Administration does not consider back pain by itself a disability. Instead, back pain is considered a symptom of other long-term medical conditions that may be classified as a disability. This means back pain must align with symptoms of known medical disorders that impact the back and spine.

How Does the Social Security Administration Evaluate Disability Claims Based on Back Pain?

To evaluate whether chronic back pain is a symptom of a disability, the Social Security Administration compares your symptoms to those of medically recognized medical disorders, such as degenerative or worn spinal discs; inflammatory conditions such as rheumatoid arthritis, arachnoiditis, and spondylitis; and nerve damage in the back resulting from conditions like spinal stenosis, nerve root compression, herniated discs, scoliosis, or spondylolisthesis.

In reviewing a claim for disability benefits, the Social Security Administration will consider:

  1. Your objective symptoms, comparing them to the symptoms of recognized spinal disorders;
  2. Limitations in your range of motion, such as the inability to bend, kneel, stand, or switch positions and how your range of motion limits your ability to work; and
  3. Your credibility, since most evidence supporting back pain comes in the form of your statements regarding the pain you experience. 

How do I Prove I have Chronic Back Pain?

The easiest and most reliable way to prove you have debilitating back pain that will impact your ability to work for more than 1 year is through medical evidence such as X-rays or MRI scans. When reviewing X-rays or MRI scans, the Social Security Administration looks for evidence of a physical abnormality of the spine that is the source of the pain. Your doctor’s notes, suggesting a physical connection between your spine and your pain may also be helpful. Without showing a physical connection between the spine and the pain, the Social Security Administration is less likely to award disability benefits for reported back pain.  

How do I Prepare to File a Social Security Benefits Claim?

If you have chronic back pain, the best thing you can do to improve your odds of receiving Social Security disability benefits is to be diagnosed with a physical condition that causes the pain. Apart from obtaining a diagnosis, make sure you take the following steps now to strengthen your case.

Keep Detailed Medical Records

Proving a disability ultimately comes down to the information in your medical records. You should keep copies of all your medical appointments, diagnoses, any treatments, and any improvements or setbacks to substantiate your claims for back pain. In addition, keeping your own diary of medical appointments, including the type of physician seen (general practitioner or specialist) and your takeaways from each appointment can also be helpful.

Keep Detailed Records of Work History

A disability is a condition that prevents you from working, so it is important to document how your back pain impacts your ability to work. If you are currently employed or were employed in the past but had to stop working because of your back pain, it is essential that you keep records of your job position, the requirements of the job, and how your physical condition limited your ability to perform the job. 

Continue Going to Your Doctor

Eligibility for Social Security benefits requires that the disability be current and continue for at least 1 year. Therefore, you should continue going to your doctor and keeping all other medically related appointments, such as physical therapy. Continue going even if your treatment is not helping as it is essential to establish that your condition is ongoing.

Consult with a Social Security Disability Attorney

Back pain can severely limit your quality of life and ability to work. However, because back pain is subjective and hard to prove, the Social Security Administration is skeptical of awarding disability for back pain alone. Jon Sipes, Attorney at Law, understands eligibility factors the Social Security Administration considers when evaluating back pain and can help you build your strongest case for disability benefits. If you are in South Texas, contact Attorney Sipes to discuss your condition today.