Qualifying for Disability Benefits with Spinal Fusion
Spinal fusion is surgery to connect two or more bones in any part of the spine. Connecting the bones prevents movement between them. Preventing movement helps prevent pain. During spinal fusion, a surgeon places bone or a bonelike material in the space between two spinal bones. Metal plates, screws or rods might hold the bones together. The bones then can fuse and heal as one bone. To learn more about how the Social Security Administration (SSA) defines this disability, visit Section 1.00 of the Blue Book.
Does Spinal Fusion Qualify for Disability?
Yes, people with spinal fusions do qualify, but they need to meet the requirements of the SSA’s guidelines for this disability. The Blue Book listings for the spine require that:
- You have a disorder of the spine, such as spinal stenosis, degenerative disc disease, facet arthritis, osteoarthritis, herniated disc, or vertebral fracture, AND
- The disorder causes compromise of a nerve root, cauda equina (the bundle of nerve roots at the lower end of the spinal cord), or the spinal cord itself.
Compromise of a nerve root. To qualify under listing 1.15 for “disorders of the skeletal spine resulting in compromise of a nerve root,” you must demonstrate that you suffer from ALL of the following:
- radiating pain, paresthesia (prickling or “pins and needles” sensation), or muscle fatigue consistent with the compromise of the affected nerve root
- neurological signs during physical examination or testing, specifically (1) muscle weakness; (2) signs of nerve root irritation, tension, or compression; and (3) either sensory changes (such as decreased sensation or sensory nerve deficit on electrodiagnostic testing) or decreased deep tendon reflexes
- imaging results consistent with compromise of a nerve root, AND
- a documented need for an assistive device that requires the use of both hands (walker, bilateral canes or crutches, wheelchair), or a device that requires use of one hand (if you’re unable to use the other hand for work-related activities), or the inability to use both hands for work-related activities.
A vertebral fracture with spinal cord injury would likely meet the above listing because it involves a serious spinal disorder with spinal cord compromise. It’s also likely to be accompanied by symptoms of intense pain, muscle weakness, and even paralysis.
Severe lumbar stenosis. To qualify under listing 1.16 for “lumbar spinal stenosis resulting in compromise of the cauda equina,” you must demonstrate that you suffer from ALL of the following:
- non-radiating pain in one or both legs. or non-radiating sensory loss in one or both legs, or neurogenic claudication (pain or cramping caused by nerve compression)
- neurological signs during physical examination or testing, specifically (1) muscle weakness, and (2) either sensory changes (such as decreased sensation, sensory nerve deficit on electrodiagnostic testing, traumatic ulcers, or bladder or bowel incontinence) or decreased deep tendon reflexes in one or both legs
- imaging results or notes in an operative report consistent with compromise of the cauda equina with lumbar spinal stenosis, AND
- a documented need for an assistive device that requires the use of both hands (walker, bilateral canes or crutches, wheelchair), or a device that requires use of one hand (if you’re unable to use the other hand for work-related activities).
If your spinal fusion didn’t repair your underlying back condition and you experience the symptoms listed above, you may meet a listing. But meeting a listing in this category is very difficult, and only the most serious cases are likely to qualify.
How Do I Apply for Disability Benefits?
To apply for disability benefits, it’s important to understand the disability application process. If you’ve undergone a spinal fusion and believe you may qualify, contact us today for a free disability case evaluation.
