Degenerative disc disease (DDD) is characterized by deterioration of the discs between vertebrae, which causes significant pain and can even lead to loss of mobility. Tears in the outer disc can occur, with scar tissue forming in an attempt to heal the injury. Repetitions in the tears and scarring lead to degeneration over time. DDD can occur in the neck (cervical spine), lumbar (lower back) or thoracic (mid-spine) regions.
DDD is also called spondylosis or degenerative joint disease, and is often just part of the normal aging process as discs wear down and become damaged. When the cushioning effect is gone, pain and inflammation occurs at the site of the degenerated disc.
DDD can become very severe. A person can have so much pain and inflammation that he or she becomes unable to perform any meaningful work. DDD patients have trouble sitting, standing, lifting and bending, making many jobs difficult. When an individual has been unable to perform work or is expected to be unable to perform work for 12 months or more, that person may be eligible for disability.
Disability benefits are a monthly amount of earnings determined by the Social Security Administration (SSA). The SSA maintains a list of qualifying conditions called the Blue Book. Unfortunately, DDD is not listed as a disability. SSA has determined that most back pain associated with DDD is intermittent, so patients who do qualify have to have severe issues like assistance walking with a walker or other aid, or nerve problems caused by the DDD, like numbness and tingling, pain radiating down the legs, muscle weakness, or loss of reflexes.
If a patient can prove that DDD has led to nerve problems or even to other more serious back problems, the SSA does recognize these as a disability claim for degenerative disc disease. Bone spurs that cause spinal nerve root compression are covered, and so are herniated discs. Degenerative joint disease leading to spinal stenosis and arachnoiditis are also covered.
However, there is an alternative way to file a disability claim for degenerative disc disease under SSA’s medical-vocational allowance. If a person can show reduced functional capacity to work, you might be able to qualify.
To go this route, the SSA requires detailed doctor’s notes on functional limitations and restrictions. SSA needs objective medical evidence about the severity of the condition, how long the patient has had it, responses to treatments, and functional limitations. Remember you must have had the disability for at least 12 months, or show compelling evidence that a newer injury is expected to last for 12 months. You will need to produce clinical records like MRI, CT, or x-rays that have been done, blood work, and other records. The SSA will not accept medical evidence from chiropractors—only licensed physicians or specialists like orthopedists, neurologists, and other doctors. Medical evidence from any approved source (including a hospital or clinic) is acceptable.
If you don’t have sufficient evidence of ongoing medical treatment, SSA will require you to see a medical doctor hired by SSA to perform an independent medical exam. These exams are very minimal and definitely not as comprehensive as if you had your own physician’s records. The examiner gathers just enough information to make a decision. This may not be in your best interest because generally they do not approve disability benefits.
SSA will also rate you on your ability to do work (light work, medium work, etc.) For example, if you can only lift 25 pounds, SSA will rate you for light work only.
Age, education level, and past work experience are all factored in, and SSA prefers that you be retrained for another job that is within your ability. People over age 50, since they’re closer to retirement age, are more likely to be approved for disability.