Claiming Disability for Back Pain? Why Your Medical Records Are Important

Claiming Disability for Back Pain? Why Your Medical Records Are Important

To be eligible for disability benefits, the claimant must have a “medically determinable� back impairment that can be proved by the medical records.

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The Social Security Administration receives many disability applications for back pain which is a major health concern for many Americans after 40 or 50 years of age. As in any other disability claim, medical records review is an important first step in this case as well. To be eligible for disability benefits, the claimant must have a “medically determinable” back impairment such as spinal stenosis, herniated disc that is chronic and untreatable, arachnoiditis, or nerve root compression. The difficulty in getting a disability claim for back pain granted makes medical record review for attorneys a very important consideration. It is not easy to meet SSA’s severity requirements for the particular spinal disorder, so attorneys need to have all the relevant medical details to determine whether the claim is a feasible one.

What the SSA Considers When evaluating a claim, the SSA will consider 3 important aspects.

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Objective signs and symptoms: These are things that can be proved via MRIs or X-rays, discography, CT scans, EMG (nerve conduction test) and other tests.

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Functional limitations: Whether the back pain is restricting the movement or function of the back – whether it is preventing the claimant from bending over or changing position.

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The credibility of the claimant: The SSA must infer that the claimant’s complaint is genuine. For this they will consider the objective medical evidence available, the statements made by the claimant’s treating physicians, and the statements made by the claimant and other people who know him/her.

The SSA will have to ensure that the claimant has been examined by a medical professional. Therefore copies of medical records and diagnostic testing

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(X-rays, MRIs, CT scans, EMGs and discographies that show physical abnormalities causing the person’s disability.

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A claim may be denied if the back pain is not related to a physical impairment that is known to cause severe back pain.

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A claim may also be denied if the claimant does not obtain appropriate medical attention, or files a claim without the reports or notes from his/her treating physician. The SSA considers medical documentation and the treating physician’s notes as very valuable evidence. Moreover, the claim is all the more strong, if the applicant can produce medical records and physician notes from specialists such as orthopedists, rheumatologists, physiatrists or pain management physicians.

Severe back pain is treated using powerful pain medications including prescription opioids. When making a decision about a claim, the SSA will also consider the applicant’s overall condition including physical and emotional impairments because chronic pain could negatively impact a person’s mental and emotional state also.

SSA reports indicate that approximately 28% of disabled workers are granted benefits on the basis of having a musculoskeletal system or connective tissue impairment. These body systems include all impairments and disorders of the spine. A significant percentage of disability cases involve back pain, and these may be SSDI and SSI cases filed on the basis of spinal stenosis, arthritis of the spine, degenerative disc disease, scoliosis, herniation, and other conditions that may involve an injury or disease process involving the back and causing pain and functional limitations.

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Well-documented Medical Evidence Most Important Medical records review becomes very important in disability determination, and therefore a person filing for disability must have a well-documented medical history of his/her back pain, with details about the cause and treatment of the condition. In most cases, claims are won on the basis of medical records and what they highlight about the claimant’s condition as regards the claimant’s ability or inability to engage in daily activities or work.

A disability claim for back pain can be won by proving that the claimant’s functional limitations do not allow him or her to fulfil the requirements of their past jobs. The SSA may examine all the jobs the claimant performed in the 15 years before he/she became disabled. To be determined incapable of returning to past work, a claimant’s restrictions/limitations must rule out all their past jobs. A disability claim for back pain may be denied if the claimant is found able to do other gainful work.

www.mosmedicalrecordreview.com

(800) 670 2809