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Back pain can cause limitations in your daily life that can range from being a nuisance to completely debilitating. In most of the cases we see, back pain is caused by degenerative disc disease in the lumbar or cervical spine. Arthritis in the lumbar and cervical spine can result in nerve root impingement. When the nerve root in compressed, it can cause pain that radiates down the arms, in the case of cervical degenerative disc disease, or pain that shoots down the legs, in the case of lumbar degenerative disc disease. Pain that shoots down the legs due to compression of the nerve root in the lumbar spine is called sciatica or lumbar radiculopathy. Pain that shoot down the arms due to compression of the nerve root in the cervical spine is usually referred to as cervical radiculopathy. These conditions can also result from lumbar or cervical stenosis, which is a narrowing of the spinal canal.
If you are experiencing back pain, you need to seek every kind of treatment you can possibly obtain and get all the diagnostic imaging and testing available to you. In most cases, x-ray imaging and a handful of visits to your primary care physician are not going to be enough. In a back pain case, we typically see certain progression in treatment and the judges are also looking for this typical pattern. First, a person goes to see their primary care physician who attempts to treat the problem with a course of conservative treatment that usually includes muscle relaxers, pain medication, physical therapy and sometimes injections over the course of several months to years depending on the severity level of the problem. Although an MRI of your back is not technically required, you need an MRI to win in most cases. It is also very helpful if you can get a nerve conduction study on your arms or legs. An EMG/NCS can show if you have cervical or lumbar radiculopathy.
Conservative treatment works for most people. If it works for you, then your back problems are probably not bad enough to contribute much to your disability claim. If conservative treatment does not work for you, your primary care physician usually refers you to an orthopedic surgeon who can provide an opinion as to whether or not surgery might help you. If you opt to have surgery and it helps, then you might still have a shot at what we call a closed in period of benefits, which means that your disability started on one date and ended on another. However, you must have been disabled for a year or more in order to be considered disabled. Too often we talk to people whose symptoms did not improve following surgery. Be sure to keep going back to the doctor to complain of your continued symptoms. Under the regulations, you are not required to have back surgery if that option is available to you but you do not want to pursue it because of the risks involved. This is particularly true if your doctor has told you that surgery would probably not improve your symptoms appreciably because your degenerative disc disease is so extensive. However, as a practical matter, turning down any form of treatment that might help you would probably affect your credibility with the judge. From the judge’s perspective, if you are not pursuing every option you have, then you must not hurt that much. That is why you also need to complete your full course of physical therapy even if you don’t think it is helping.
For people under 50, we would need to be able to prove that your back problems would prevent you from being able to do sedentary work on an 8 hour a day, 40 hour a week basis. Only in severe cases of back pain would that be the case. For instance, if an orthopedic surgeon who treats you and your other doctors are willing to state that your back pain would be so severe that would need to change positions between sitting and standing/walking more frequently than once every 30 minutes and you would need rest away from the work station for significantly more time than is usually allowed, then you could be considered disabled.
However, if you are over 50 the rules make is easier for you to be considered disabled on the basis of your back pain. If your doctors are willing to state that you would be limited to no more than sedentary work, then you could be considered disabled depending on your work background. Sedentary work is defined as being able to stand or walk in combination no more than 2 hours total out of an 8 hour work day and lift no more than 10 lbs. occasionally and nothing more than light things such as papers or files frequently.
If you are over 55 then all we need to show is that you are limited to no more than light work depending on your work background. Light work is defined as being able to stand or walk no more than 6 hours total out of an 8 hour work day and lift no more than 10 lbs frequently and no more than 20 lbs. occasionally. Therefore, your back problem does not need to be quite as bad for you to still have a shot at being considered disabled if you are over 55.