For those who suffer a herniated disc disability, seeking Social Security benefits may be the next logical step.
A herniated disc, often called a “slipped disc,” is a common condition in men between the ages of 30 and 50 years old—although it can happen at any age, and not just to men.
This condition occurs when the area between spinal vertebrae, called a disc, splits and some of the soft material inside slips out. Often this condition affects the lower back. It can cause pain, nerve irritation, numbness, and weakness, or it may cause no pain whatsoever.
Symptoms usually resolve within weeks. However, sometimes a herniated disc condition can persist or worsen and become disabling.
Treatments can include taking medications and injections to lessen symptoms, therapy, or, in extreme cases, surgery.
If your herniated disc condition has become disabling, you may be wondering if it can qualify you for Social Security benefits.
The short answer is: Yes, it can.
However, as with any disability, you must meet certain criteria to be considered eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
If you’re exploring whether you qualify for SSI or SSDI benefits, consulting an attorney can have a decisive impact on the outcome of your case.
Here is what you need to know about your herniated disc disability and qualifying for Social Security benefits.
Qualifying for Social Security
The Social Security Administration (SSA) determines disability based on whether the severity of your condition prevents you from engaging in “Substantial Gainful Activity (SGA).” Typically, your condition must either meet a strict disability listing or be determined to prevent you from doing a past relevant job or other jobs in the U.S. economy.
In most cases, you cannot be gainfully employed above the SGA monthly income level or you will be disqualified.
For SSDI, you must acquire a certain amount of work credits, or “quarters” (up to four per year), to qualify for this earned benefit.
According to the SSA, “Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.”
For SSI, you must meet a certain income level to qualify. SSI is a means-based program for those who make little to no income. You must not make more than a certain amount of income to qualify. This is not connected to the credits you earn for SSDI.
In all cases, you must provide evidence to prove your disability, including medical records, test results, and written doctors’ opinions.
Qualifying for Social Security with a Herniated Disc Disability
In order for a herniated disc condition to qualify for Social Security disability listing, according to the SSA’s definition, it must meet the following criteria:
- compromise of a nerve root (including the cauda equina) or the spinal cord. With:
o Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine)
o Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours
o Lumbar spinal stenosis resulting in pseudoclaudication (pain in the lower extremities when standing for a long time), established by findings on appropriate medically acceptable imaging, manifested by chronic pain and weakness, and resulting in difficulty walking
However, it can be difficult to qualify for a specific disability listing. The SSA will examine your Residual Functional Capacity (RFC), or ability to perform past work following your injury or deterioration of your condition—as well as your ability to perform other types of work in the U.S. economy, as determined by an adjudicator.
Consulting a Disability Attorney and Next Steps
Claimants can consult an attorney at any step during the process of applying for benefits. However, it can be beneficial to contact a qualified attorney early so they can help guide you through your case from start to finish.
Although back injuries and disabilities are common, they can be difficult to prove with the SSA. A majority of those who seek benefits are initially denied and must appeal their claim.
Appeals can go through multiple stages, including:
- Reconsideration by the SSA
- Hearing with an Administrative Law Judge (ALJ)
- Consideration by the Appeals Council
- Hearing in federal court
Each of these stages is time consuming and can be complicated. An attorney can help you prepare, as well as advocate on your behalf during hearings.
Attorneys can keep you abreast of the status of your claim and how to navigate the initial stages of the process.
After an initial claim is denied, navigating the appeals process becomes increasingly complex. Disability attorneys will know how best to guide you through this process.
Local attorneys will be familiar with administrative law judges and other court personnel. They will have insights into expectations and preferences during the process, and they can advocate on behalf of their clients to seek the best possible outcome.
When you retain the services of a Social Security disability attorney, the fee is typically limited to 25 percent of the past-due benefits you are awarded, up to a maximum of $6,000. Note that, in these instances, the attorney will be paid only out of your past-due benefits, or “back pay.” If no back benefits are awarded, the attorney will not receive a fee.
If your SSDI/SSI or Workers’ Compensation claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck & Gordon can help. We’ve been helping people in Georgia just like you for over 40 years. Sign up for a free case evaluation here, or call us (404) 795-7449.