Spinal injuries or disorders may cause a great deal of pain or limit a person’s movement. There are many causes of spinal conditions, including infections, injuries, degenerative bone changes, spondylitis, scoliosis, and tumors. Some of these disorders can be disabling in nature. Spinal injuries or disorders are relatively common. In fact, spinal conditions and back pain are one of the leading causes of disability.
When a back condition forces someone to miss work, it is necessary to carefully document how the back condition is disabling. First of all, objective testing is required to make a correct diagnosis and reveal the severity of the condition. Objective testing may include x-rays, MRIs, and CT scans, among other tests. One overlooked form of objective evidence is a list of signs observed by the treating physicians. Observable signs may include an abnormal gait when ambulating, pain with movement, and noted areas of the spine which are tender or painful on palpation. Range of motion testing is another type of evidence that is helpful to demonstrate disability. A range of motion test shows the degree to which a person can move each of their joints.
After objective evidence has been used to make a diagnosis, all treatment options must be considered. In most cases, conservative treatment is attempted prior to surgical intervention. Conservative treatment usually means rest, heat or ice therapy, physical therapy or home exercises, pain medications (NSAIDS and/or steroids), injections (nerve blocks and steroids), and non-traditional treatment such as massages, chiropractic adjustments, and acupuncture. If a spinal condition remains severe after conservative treatment and surgery is a possibility, a referral may be made to an orthopedic surgeon or neurosurgeon. Available surgical procedures include laminectomy, discectomy, or a spinal fusion. If surgery is not an option for the patient, then they may be referred to a specialist in pain management.
While some patients are fortunate enough to have a surgery that returns them to their pre-disability condition, some are not as fortunate. If surgical intervention was not successful, then it is likely that the patient will be referred to a specialist in pain management. A pain management specialist will attempt all of the non-surgical treatments that are available to determine which treatment most alleviates pain. Even if physical therapy and surgical interventions are no longer possible, a pain management specialist can help patients control their pain as much as possible and provide referrals if necessary.
Short Term and Long Term Disability Insurance Claims
There are some things to remember when a spinal disorder causes a worker to file a disability insurance claim. First, seeking and maintaining treatment is essential to provide proof of disability to the insurance company. A treating physician will order objective testing, which will be carefully reviewed by the disability insurer. However, the treating physician will also likely be required to provide regular updates to the insurance company about the patient’s ongoing treatment and ability to function. Therefore, it is necessary for the physician to properly document the patient’s condition during office visits and procedures. It may also be important for the doctor to document the patient’s abilities to perform activities of daily living, who helps the patient with activities of daily living, and whether the patient requires ambulatory aids such as a cane or wheelchair. Without thorough medical records to describe the patient’s disability, the insurance company may deny or terminate disability benefits. If your short term or long term disability insurance claim has been denied, please contact the O’Ryan Law Firm immediately for a free consultation.
Social Security Disability Benefits
Similar to long term disability insurance claims, it is essential for treating physicians to thoroughly document the patient’s disability for the purpose of a Social Security disability claim. Another consideration for Social Security disability claims is whether or not a patient meets Listing 1.04 for “Disorders of the Spine.” This listing encompasses the following conditions, among others: herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord.
The Social Security Administration requires that the following be proven to meet Listing 1.04:
A. 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);
OR B. 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;
or C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.
More information is listed under 1.00 of the SSA’s website to describe how the SSA defines certain terms under the listing for spine disorders. Please contact O’Ryan Law Firm immediately if your Social Security disability claim has been denied. We can investigate your Social Security disability claim and provide a free consultation.