WHAT IS SPINAL STENOSIS?
Spinal stenosis is a condition that causes an abnormal narrowing of the spinal canal and compression of the spinal cord and nerves. Spinal stenosis is most often the result of degenerative arthritis or a result of the aging process, but sometimes a bulging or ruptured disc may be the cause. Spinal stenosis usually occurs in the neck or lower bank.
The most common types of spinal stenosis are lumbar stenosis and cervical stenosis. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.
Symptoms, if they occur, include pain, numbness, tingling, muscle weakness, loss of motor control, loss of balance, and impaired bladder or bowel control. Treatment options for spinal stenosis can be surgical or non-surgical.
CAN I GET SOCIAL SECURITY DISABILITY FOR SPINAL STENOSIS?
Spinal Stenosis pain and associated symptoms can impact your ability to work. Social Security Disability benefits may be available to you.
If you are not engaging in gainful activity due to Spinal Stenosis, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)
Generally, to establish Spinal Stenosis as a medically determinable severe impairment, you must show:
- Objective medical imaging such as MRIs or CT Scans establishing spinal stenosis;
- Consistent complaints of pain or other symptoms for a period of time and which is not controlled through conservative treatment modalities
At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For Lumbar Spinal Stenosis, SSA will determine if your condition meets Listing 1.04C – Disorders of the Spine – Lumbar Spinal Stenosis.
- 1.04C can be met if your condition
- Causes lumbar spinal stenosis resulting in pseudoclaudiction established by findings on appropriate medically acceptable imaging,
- Is manifested by chronic nonradicular pain and weakness,
- Results in inability to ambulate effectively, which is defined as
- The inability to walk without the use of a walker, two crutches or two canes,
- The inability to walk a block at a reasonable pace on rough or uneven surfaces,
- The inability to use standard public transportation,
- The inability to carry out routine ambulatory activities, such as shopping and banking, and
- The inability to climb a few steps at a reasonable pace with the use of a single handrail.
The key to meeting the listing is to have the appropriate objective medical testing including MRIs or CT Scans which show lumbar spinal stenosis. In most cases, in my experience, the medical listing will not be met, but having a good knowledge of what you have to prove can help you discuss your case with your doctor.
If your condition and/or related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your stenosis and pain), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.
TIPS FOR SSDI APPLICATION FOR SPINAL STENOSIS
- Make sure an imaging report (MRI, CT, X-ray) diagnosing Spinal Stenosis is in your medical records. It is important that you “know your medical records.”
- Make sure your medical records document ALL of your symptoms and limitations including, but not limited to, numbness, tingling, muscle weakness, loss of motor control, loss of balance, and impaired bladder or bowel control. Your medical records should not just document your pain. Let your doctor how often you feel the symptoms, how severe each symptom is, and how long each episode lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms.
- See a specialist. Treatment of spinal stenosis by an orthopedist or neurologist or a chronic pain specialist will carry more weight than the same diagnosis from a family physician or internist professional.
- Comply with your doctor’s orders and try various modes of conservative or less invasive treatment, if recommended.
- See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic pain and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions. Pain is often accompanied by or is the cause of mental health conditions. Treatment of the depression can help with the pain.
- See your doctor regularly and keep your appointments.
- If you can, provide evidence of a long work history.
- Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity.
- Include information from nonmedical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time. These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
- Keep a journal. Make regular notes about your impairment, level of function, and treatments.
- If you need assistance with your claim, contact an attorney who is knowledgeable in obtaining Social Security Disability benefits for spinal stenosis.