Can You Get Disability for Spinal Stenosis? Get Social Security Disability Accommodations From the SSA

Degenerative spinal changes affect up to 95% of the population by age 50. ​​In many cases, those deteriorations don’t even register as problematic save for a few age-related aches and pains. But for some, it precipitates back issues like spinal stenosis—a narrowing around the spinal cord—that can become debilitating. However, can you get disability for spinal stenosis?

The short answer is yes, the Social Security Administration will consider spinal stenosis a disability if the repercussions are severe. However, to qualify for benefits, an individual will have to prove their condition via a strict set of SSA tests. Keep reading to learn the criteria for a spinal stenosis disability accommodation, and the steps you must take for approval.

Getting Social Security Disability for Spinal Stenosis: Key Takeaways

• Qualification. Spinal stenosis qualifies for disability benefits under the SSA’s Blue Book listing 1.16.
• Symptoms. Key criteria to prove the condition include pain, numbness, muscle weakness, nerve deficit, and physical limitation.
• Documentation. Medical records and tests are a requirement for proof of disability from spinal stenosis.
• Benefits. Qualified applicants may receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits depending on their work history and income.
• Application. There is a detailed application process for anyone with spinal stenosis that applicants must stringently follow.
• Representation. Having a lawyer will increase your chances of a positive outcome and claim approval.

What is Spinal Stenosis? Symptoms and Side Effects

Spinal stenosis is the narrowing of space throughout the spinal canal, which is the tunnel running through the spine’s vertebrae. Less space in the canal can cause irritation, compression, or pinching in the spinal cord or nerves housed within. This can turn into back pain or nerve issues, like sciatica.

The progression of spinal stenosis is usually gradual, meaning some people don’t know they have it until severe symptoms surface. Frequently, spinal stenosis is a secondary condition that develops because of another back condition, such as arthritis or disc herniations.

Types of Spinal Stenosis

The symptoms of spinal stenosis range from none at all to incapacitating. When they do show up, they tend to get worse over time and depend on the part of the spine.

The condition most commonly affects the lower back and neck:

• Lumbar spinal stenosis. The lumbar vertebrae are L1 to L5 and are the largest in the spine. Spinal stenosis in the lower back tends to cause cramping or tingling in the buttocks, legs, and feet. Pain usually worsens when standing for a long time, walking, or walking downhill. Leaning forward, sitting, or walking uphill may feel better and ease discomfort.
• Cervical spinal stenosis. The cervical spine consists of seven vertebrae in the neck—C1 to C7. Spinal stenosis in the neck usually shows up as nerve issues below the point of nerve compression. Symptoms include neck pain, balance problems, and numbness, tingling, clumsiness, or weakness in the arm, hand, leg, or foot. A decrease in function in the hands is another possible manifestation.

Disability Criteria From the SSA

Since the symptoms of spinal stenosis can vary widely, the SSA had to compose very specific criteria for diagnostic confirmation. Spinal stenosis is in the SSA’s Blue Book 1.16, as “Lumbar spinal stenosis resulting in compromise of the cauda equina.” This listing is under the “Musculoskeletal Disorders” section.

To qualify for SSDI or SSI for spinal stenosis, an applicant must demonstrate they suffer from ALL of the following:

• Non-radiating pain or loss of feeling in one or both legs, or neurogenic claudication (tingling, cramping, and aching from nerve compression).
• Neurological signs present during a physical examination or testing. Specifically, the SSA will wish to see evidence of muscle weakness, sensory changes, or decreased deep tendon reflexes.
• Imaging or an operative report showing lumbar spinal stenosis in the cauda equina (nerve roots at the spinal cord’s bottom).
• Documentation showing physical impairment that requires the use of assistive devices requiring one or both hands. In other words, the condition necessitates the use of a walker, wheelchair, crutches, cane, and similar.

Because an applicant must meet all the above requirements, it’s imperative to have a doctor who understands disability claims. A disability lawyer can also help you find the right medical caregiver and ensure you have the appropriate documentation.

Does the SSA Consider Spinal Stenosis a Disability?

Yes, the SSA considers spinal stenosis a disability with its own section in the SSA’s “Listing of Impairments.” It falls in the Musculoskeletal Disorders category under the section on “Disorders of the Spine.”

To qualify for disability benefits, however, individuals must demonstrate that their spinal stenosis symptoms significantly hinder their ability to function. And that includes being able to participate in substantial gainful activity (SGA)—or, in other words, work.

Additionally, the Americans with Disability Act (ADA)—which prohibits discrimination against anyone with disabilities – considers spinal stenosis a serious impairment. However, this holds true only if the stenosis substantially limits an individual’s functional ability.

SSA Disability Requirements for Spine Disorders

The SSA will evaluate all skeletal spine disorders per the criteria set in the Blue Book.

To qualify for disability, spinal stenosis must also prevent the applicant from being able to work for a year or more.

If you don’t meet the “Blue Book” requirements, there’s still hope. You might be able to qualify through the Medical-Vocational contingency. This allows an applicant disability consideration based on their symptoms, age, educational experience, past work record, and any transferable skills. Anyone older than 55 with few transferable work skills and less education has better approval chances.

For this option, Social Security will still review all imaging tests and doctor’s records. However, they’ll also be looking closely at an individual’s functional limitations. The purpose of that is to decide if the spinal stenosis is bad enough to prevent someone from working.

To qualify through this option, the applicant’s doctor must complete a Residual Functioning Capacity (RFC) evaluation and form. RFC is an assessment of how a medical condition may cause physical and mental limitations in a person’s work setting.

The SSA will look at an applicant through the lens of their RFC and how that would impact work ability. If the SSA determines that the symptoms preclude an individual from being able to work, then they’ll award disability benefits.

Which Spinal Stenosis Symptoms Might Limit Your Ability to Work?

Spinal stenosis may present in a variety of ways, but some manifestations will make it harder to work than others. An inability to continue working because of spinal stenosis may be provable for individuals with the following symptoms:

• Difficulty standing or walking for long periods of time
• Challenges with balance and coordination
• Weakness in the feet or legs
• Decrease of function in the hands
• Clumsiness of the arms and legs
• Significant chronic pain

Obviously, anyone in a career that requires standing or walking will suffer trying to work with severe spinal stenosis. Those requiring the use of assistive devices like canes, crutches, and wheelchairs will also face serious limitations.

Other Medical Conditions & Comorbidities That May Help You Get Disability for Spinal Stenosis

Proving you deserve disability because of spinal stenosis isn’t an easy proposition. As such, keep in mind that it’s typically easier to qualify if you have more than one debilitating diagnosis.

If you have concurrent conditions that are common with spinal stenosis, you’ll want to include them in your application too. Some of the related conditions that might strengthen your stenosis claim include:

• Osteoarthritis
• Bone spurs on the spine
• Bulging or herniated discs
• Scoliosis or other skeletal deformities
• Thickened ligaments
• Spinal fractures and injuries
• Tumors or cysts on the spine

It’s a good idea to talk to your lawyer about what other types of qualifying medical conditions you might have. Remember the burden of proof is on the applicant. So, it’s smart to include all the possible elements compounding your disability in your application.

Medical Evidence You’ll Need for Your Spinal Stenosis Disability Claim

Remember that anyone applying for disability benefits because of their spinal stenosis will have to definitively demonstrate their condition. The SSA will require that there’s documentation showing an applicant satisfies all four “tests” in their Blue Book listing. And they will evaluate how that affects the applicant’s ability to work. Here are the minimum requirements for a successful claim.

Medical Records

The SSA will want to see detailed records from any medical providers who have diagnosed, assessed, and treated you. You’ll need to obtain copies of these records. Remind your doctor it will help if they also document how spinal stenosis affects your daily functional abilities.

Medical Evidence

Specific tests will be necessary as proof, including imaging like an MRI or X-ray to show evidence of spinal stenosis. Additionally, there will need to be a physical exam that tests reflexes, sensation, movement impairment, and loss of muscle strength. The SSA will also want to know what medications/treatments you’ve tried—including cortisone injections, physical therapy, or pain meds.

Evidence that Work Triggers Your Symptoms

Documentation that links your symptoms to work activities is imperative. That’s because the crux of needing disability is that the applicant is unable to work. Proof that work triggers your stenosis symptoms might include statements from your employer or physical or occupational therapist. You’ll want to make sure any corroborations detail how work conditions exacerbate your spinal stenosis symptoms. Showing a direct connection between your work and worsening symptoms makes your claim more viable.

Proof of Other Conditions

As mentioned above, if you have comorbid conditions—such as herniated discs, osteoarthritis, or bone spurs—include evidence of these. Comprehensive documentation of all relevant medical conditions demonstrates the full scope of your impairments.

How to Apply for Spinal Stenosis Disability Benefits

If you think you meet the SSA requirements for spinal stenosis, then you should apply for disability benefits. However, it’s important to know that there are different types of benefits available.

First of all, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits aren’t for short-term or partial disabilities.

Non-medical eligibility requirements also include not being able to participate in substantial gainful activity (SGA) for 12 months. Applicants must not be working consistently if they hope to receive disability for spinal stenosis.

Also, anyone applying for SSDI will have to show a previous work history. Typically, that means working at least five out of the last 10 years and paying into the SSA system.

SSI applications don’t have the work history requirement but necessitate demonstrations of very low income.

Before applying for any disability program, spend time gathering all your documents to prove your case. The more organized you are, the better your chance of success. A disability lawyer can also help you put together all the requisite materials.

Submitting an Application for SSDI or SSI With Spinal Stenosis

To apply for SSDI, you can start the application online through the Social Security Administration’s portal.

Or call ​​1-800-772-1213, Monday-Friday 8 a.m. – 7 p.m.

Tell the agent you want to set up an appointment to apply for benefits. They’ll schedule it and determine whether it’ll be on the phone or in person.

How Hard Is It to Get Disability for Spinal Stenosis?

The chance of getting disability benefits for spinal stenosis depends on the severity of the symptoms. Since the SSA requires that applicants meet ALL the criteria for the condition, qualifying can be tough. Applicants must provide extensive medical documentation proving their condition significantly impairs their ability to work. Anyone capable of walking without assistance will also find it more of a challenge to win a spinal stenosis claim.

However, on a positive note, back pain, arthritis, and recovering from surgery make up about 30% of all approved claims. One reason for this is that these disabilities frequently stem from working too much.

Work With a Disability Lawyer to Improve Your Odds of Approval

Even if your spinal stenosis seemingly meets all the SSA requirements, rejection of your initial application isn’t uncommon. An estimated 80% of applicants face rejection from the SSA for benefits on their first try. Acquiring disability benefits is a complicated process with lots of additional elements like financial qualifications and work history requirements.

However, working with a disability lawyer can improve the likelihood of success. Not only can they help you navigate the abundant required paperwork and tests. But, having a lawyer file your claim makes you three times more likely to get benefits.

The bottom line is that there are many steps to getting a disability application through the system successfully. And during that process, it’s smart to get someone in your corner who has your back.