Compression of the nerve roots in the spinal cord results in a great deal of pain, and can also cause sensory loss, tingling, loss of motion, decreased reflexes, and muscle weakness. Patients who suffer from nerve root compression can find it difficult to sit or stand in one position for long, to walk without pain, and to bend over or lift heavy items. Those with severe spinal nerve root compression problems often are unable to work.
Nerve root compression in the spine can be caused osteoarthritis, herniated or slipped discs, degenerative disc disease, or vertebral fractures caused by osteoporosis or trauma to the spine.
Qualifying for Disability Due to Spinal Nerve Root Compression
The Social Security Administration (SSA) recognizes that severe nerve root compression can be debilitating, and as a result, it has created an official impairment listing in the SSA’s “Blue Book” of impairments. If your condition matches the requirements in this listing (which is not easy), you can get Social Security disability benefits.
Under the listing for nerve root compression (listing 1.04A), the SSA specifies the symptoms and severity required for nerve root compression of any kind to qualify as a disability. Basically, evidence of pressure on your spinal nerve root or spinal cord must be accompanied by all of the following:
- limitation of motion in the spine
- loss of sensation or reflexes
- muscle weakness, and
- a positive result on the straight-leg-raising (SLR) test, both in a sitting or supine position, if the lower back is involved.
In addition, your nerve root compression problems must have lasted or be expected to last 12 months or more.
What Underlying Back Conditions Cause Nerve Root Compression?
The SSA notes several examples of back conditions that can involve nerve compression:
- herniated disc (technically known as herniated nucleus pulposis, or HNP)
- osteoarthritis (degenerative arthritis)
- degenerative disc disease
- facet arthritis, and
- vertebral fracture.
There may be other back problems that lead to nerve root compression that the SSA didn’t list; benefits can be awarded for nerve root compression caused by other conditions as well, if the condition meets the requirements above.
Medical Evidence Required to Meet Listing 1.04A
Unlike other spinal disorders, the SSA’s listing for nerve root compression does not technically require objective evidence of the condition, such as x-rays, MRIs, or CT scans. This means that a comprehensive spinal exam by an orthopedic doctor, including testing your reflexes, sensation, muscle strength (recorded over time), and range of motion, along with your subjective reports of pain and your doctor's estimate of your ability to walk, bend, squat and rise, might be able to suffice as evidence of disability -- in theory anyway.
MRIs, X-Rays, CT scans, or myelography reports that show abnormalities of the spine would help a great deal in getting your back problems approved for disability. The SSA will also look at how often you have been to the doctor, and for how long, and what treatments you have tried (for example, pain medications, steroid injections, muscle relaxants, physical therapy, electronic stimulation). The effects, side effects, and efficacy of the treatments should be thoroughly documented by your doctor.
Most Social Security claimants for nerve root compression problems don’t qualify under the above official SSA impairment listing for spinal disorders, because it is quite difficult to meet all of the requirements. If you also have a diagnosis of stenosis or arachnoiditis, you should add these to your claim, as you might be able to qualify for disability benefits under those listings as well.
If the SSA denies your application under the official listing, as the next part of the disability determination process, the SSA is required to consider the effect of your back pain and impairment on your capacity to do daily activities and to function at work. The SSA will then determine whether there is any kind of work you can do. If the SSA determines there are no jobs you can be expected to do, you might be able to qualify for disability benefits under a medical-vocational allowance. For more information, see our article on RFCs for back problems.
Starting a Disability Claim for Spinal Nerve Root Compression
If you don’t know whether you are eligible for Social Security disability insurance (you must have paid enough taxes into Social Security) or Supplemental Security Income (SSI, for low-income filers), you can apply for both. You can call the SSA at 800-772-1213 to set up an appointment to fill out an application for disability for your back problems or you can apply online. When you fill out your application, include both how your back pain affects your life outside of work and how it impairs your ability to work.