Many hard-working Americans suffer injuries to their spine and other parts of their skeletal system. Sometimes, these injuries prevent the worker from being able to return to work. The only recourse this injured worker could have is applying for Social Security Disability benefits. We are often asked what is required to qualify for social security disability benefits if a musculoskeletal injury prevents a worker from returning to the work force. This article will focus on what is needed for a musculoskeletal injury to qualify for social security disability benefits.
For all individuals applying for social security disability benefits, the applicant must have a disability. Social Security defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. A medically determinable physical or mental impairment is an impairment that results from anatomical, physiological, or psychological abnormalities, which can be shown by medically acceptable clinical and laboratory diagnostic techniques. The medical evidence must establish a physical or mental impairment consisting of signs, symptoms, and laboratory findings-not only by the individual’s statement of symptoms.
Many things are considered when assessing whether someone qualifies for social security disability because of a musculoskeletal injury. Two such things are loss of function and pain.
Loss of function
Regardless of the cause(s) of a musculoskeletal impairment, functional loss for purposes of social security disability is defined as “the inability to ambulate effectively on a sustained basis for any reason, including pain associated with the underlying musculoskeletal impairment, or the inability to perform fine and gross movements effectively on a sustained basis for any reason, including pain associated with the underlying musculoskeletal impairment.” It is important to establish that the inability to ambulate effectively or the inability to perform fine and gross movements effectively must have lasted, or be expected to last, for at least 12 months.
A simple “difficult to walk distances” is usually not enough. Social Security defines the inability to ambulate effectively as “an extreme limitation of the ability to walk.” which interferes very seriously with the individual’s ability to independently initiate, sustain, or complete activities.
To ambulate effectively, individuals must be capable of sustaining a reasonable walking pace over a sufficient distance to be able to carry out activities of daily living. They must have the ability to travel without companion assistance to and from a place of employment or school. Therefore, examples of ineffective ambulation include, but are not limited to, the inability to walk without the use of a walker, two crutches or two canes, the inability to walk a block at a reasonable pace on rough or uneven surfaces, the inability to use standard public transportation, the inability to carry out routine ambulatory activities, such as shopping and banking, and the inability to climb a few steps at a reasonable pace with the use of a single hand rail. The ability to walk independently about one’s home without the use of assistive devices does not, in and of itself, constitute effective ambulation.
Pain is considered when determining if an applicant may qualify for social security disability benefits because of a musculoskeletal injury. In order for pain or other symptoms to be found to affect an individual’s ability to perform basic work activities, medical signs or laboratory findings must show the existence of a medically determinable impairment(s) that could reasonably be expected to produce the pain or other symptoms. It is important to document the intensity and persistence of such pain or other symptoms carefully in order to determine their impact on the individual’s functioning under these listings.
In order to qualify for social security disability benefits because of musculoskeletal impairments, it is crucial that the injuries are documented by the treating doctors. CT scans and MRIs and myelograms findings can be a beneficial part of the case record. The physical examination must include a detailed description of the rheumatological, orthopedic, neurological, and other findings appropriate to the specific impairment being evaluated. These physical findings must be determined on the basis of objective observation during the examination and not simply a report of the individual’s symptoms.
There is much more that goes into the determination if a person would qualify for social security disability benefit because of a back injury or other musculoskeletal injury. If you or someone you know has worked enough quarters to qualify for social security disability benefits and has a back injury that prevents them from returning to substantial gainful employment, documenting the impairments with a doctor is crucial.
Social security disability benefits are not an entitlement. Rather, hard-working Americans have worked many years to earn these benefits. We have written a book about the battle of obtaining social security disability benefits and invite you to download a free copy.
Personal Injury Attorney Matthew Noyes represents those fighting for social security disability benefits. He is a published author in the field of social security disability and a named partner at the Tampa Bay law firm of Perenich Caulfield Avril Noyes – one of the oldest personal injury law firms in Pinellas County. Call Attorney Matthew Noyes now at 727-796-8282 or complete the form on this page or simply click here to schedule a free case consultation.