Disability Benefits due to Reduced Functional Capacity caused by Back Problems

By Michelle Shvarts
Principal Attorney

If your back impairment or disorder, as mentioned by your doctor/physician in your medical records affects your Reduced Functional Capacity, RFC and Substantial Gainful Activity, SGA, then you might qualify for disability benefits.

Claims due to back pain caused by disc damages or nerve problems are very common to the Social Security Administration, SSA. The SSA realizes that almost 50% of the people between age 40 t0 50 and 70% of people between age 50 to 65 suffer either kind of back problems mostly due to age factor. However, not all back problems are listed under the eligible muskoskeletal problems in the Blue Book of impairments by the SSA. However, it expects most of the people to reach full retirement age to qualify for disability. So, it can get tough qualifying for disability based on not-so-serious back problems.

How to win disability claims for back disorders?

To make sure that you stand a higher chance of winning disability claims for your back pain, you need to show evidence to your disability examiner, DE that your back pain is indeed hindering your ability to move and work properly. The SSA will need to be ensured that your back pain is indeed not moderate and is actually debilitating and severe. Based on your condition, you may have to proved that you are unable to sit or stand for longer amounts of time, or carry out normal bodily movements like bending or scooping without hurting excessively. Also, for all conditions reparable in the back disorders listed by the SSA in the Blue Book, you may also have to prove either that your condition lasted for more than 12 months of consecutive period or that it is expected to last more than a year.

Qualifying for Disability due to Back Pain

If you meet the above conditions, the only criteria you need to fulfill now to avail the disability benefits is that your condition is listed in the SSA’s list of muskoskeletal impairments. It contains the following back problems listed in the document:

  1. Major dysfunction of a joint due to any cause
  2. Reconstructive surgery of a basic weight bearing joint
  3. Disorders of the spine such as nerve root compression, arachnoiditis, osteoporosis etc
  4. Amputation due to any cause
  5. Fracture of the femur, tibia, pelvis, or one or more of the tarsal bones such as herniated disc
  6. Fracture of an upper extremity of the back
  7. Soft tissue injury such as burns, ruptured muscles
  8. Vertebral fracture
  9. Degenerative disc disease

Residual Functional Capacity (RFC) for Back Problems

Your disability examiner, DE with the help of a qualified medical professional will examine your doctor’s reports of your disability due to back pain and see whether it fit the criteria of the SSA. Mostly the doctor’s restrictions listed for back pain disability include prohibition to lifting heavy objects, sitting or standing for too long, keeping bad posture or perform heavy exercise). The DE will give you a rating based on the severity of your condition based on your doctor’s restrictions mentioned in your medical report. These include four levels: sedentary, light work, medium work, heavy work.

You may read more on RFC here.

If your DE assigns you an RFC for light or medium work and have always done heavy work, you could be automatically approved for benefits in some cases (especially if you’re older than 55 years of age). In many cases, however, you will be denied benefits if you have an RFC of medium or light work.

The RFC reports combined with the DE’s ratings varies for each person. However, you might consider the help of a social security attorney to make sure you know how to approach your doctor and DE for full assistance. For instance, if your doctor assigns you heavy restrictions on your back pain, your disability attorney may know the right questions to ask your doctor to assign you a low residual functional capacity.

About the Author
Ms. Shvarts is the managing attorney for Disability Advocates Group. She opened Disability Advocates Group to assist individuals who became disabled and unable to work to obtain the benefits they need and deserve.  Ms. Shvarts and the rest of the team at Disability Advocates Group are dedicated to assisting individuals obtain Social Security Disability Benefits (SSDI) and Supplemental Security Income (SSI) benefits.