Social Security Disability: A Look at The Listings: Orthopedic and Spinal Conditions

One issue Social Security must determine is whether you meet an impairment listing.  There is an appendix to the rules that lists several impairments, and is organized in twelve chapters, with certain impairments listed together.  There is a chapter for orthopedic issues, another for neurological problems, and others, including mental impairments.  You do not have to prove that you meet a listing to obtain benefits, but it does make things easier.

In our experience, probably one of the most common conditions claimed by our Social Security clients are orthopedic issues, which includes arthritis of the major joints, inflammatory disease (lupus, fibromyalgia) and spinal disease(low back disc bulges, herniations, or nerve root compression).The impairment listings for orthopedic and muscle disorders rely heavily on pain reports. Although pain is not something that can be measured, it is the pattern of pain that Social Security wants to know about. For example, if you have a spinal nerve root compression, then your pain may radiate in a way that confirms there is pressure on a particular nerve root leaving your spinal column.

Another common aspect to the orthopedic listings is a finding that you are not able to “effectively ambulate.” This simply means that you have a hard time getting around. However, when you look at the definition, it uses terms like “extreme” and tells us that your condition must “very seriously” interfere with your ability to initiate, sustain, or complete activities. When dealing with the legs, the listing the finds ineffective ambulation as needing a cane or other assistive device is proof that you cannot effectively ambulate. However, this does not mean you must need some kind of assistive device in order to show that you are not able to “effectively ambulate.”

Orthopedic and muscular disabilities are not limited to the spine. Sometimes, a person may have arthritis or some other inflammatory disease that affects their ability to use their hands. In this case, Social Security will look to see whether not the Claimant is unable to perform fine and gross movements effectively. This essentially means that the disease process, whether it is arthritis or some other inflammatory process, interferes “very seriously” with your ability to initiate, sustain, or complete activities involving the use of your hands. Social Security looks at functions like reaching, pushing, pulling, grasping and fingering, and how it affects your ability to do everyday activities.

As with all disability claims, the loss of function, whether it is loss of use of the hands and arms, or the legs, must have lasted, or be expected to last, for at least 12 months.

Social Security handles pain in a special way, as we explained above. This is because there is no objective way to measure pain. In the orthopedic listings, Social Security acknowledges that pain or other symptoms may be an important factor that contributes to your disability. However, there must be some objective evidence, like an x-ray or laboratory finding that could be “reasonably expected” to produce the pain or other symptoms that you report. Unfortunately, an x-ray may show moderate to mild findings, but can validly result in significant pain. There are other cases where an x-ray or MRI may show significant degenerative disc disease or a disc bulge, but do not produce a lot of symptoms. Each case must be evaluated on its own merit.

The introduction to these listings also discusses what is needed in an examination. Many doctors will not perform a comprehensive orthopedic examination for their patients at every visit. However, it is always helpful if the doctor describes how you walk, how far you can move the affected body part, whether it be your back, your hip, or your neck, whether there is a loss of motor control, muscle atrophy, or loss of strength. These are all “objective” findings that can explain and support your reports of limited function.

We work with doctors and physicians of all kinds to document limited function in the Social Security Disability claim. If you have questions about how to pursue your claim, contact us at 503-325-8600. We can answer your questions, and let you know what you need to do to prove your case.