Can I Qualify for Social Security Disability for Neck Pain?

If you suffer from severe neck pain, you may be eligible for Social Security Disability benefits. There are several causes for debilitating neck pain. The Social Security Administration (SSA) oversees the Social Security Disability Insurance (SSDI) program, which is for people who have worked enough to earn sufficient credits and who have paid in enough in taxes to Social Security.

If you are determined eligible for benefits, you may have dependents who are also eligible for benefits as well. Benefits are paid monthly and are to help with medical costs and living expenses since you will have no regular employment income because of your inability to work. Disability benefits are only available to those who are completely disabled and who will be unable to work for at least a year.

Neck pain can be the result of many different medical issues. It can be caused by worn joints, muscle strain, nerve compression, degenerative disc disease, pinched nerves, herniated discs, arthritis, whiplash, fractured vertebrae, meningitis, and some kinds of cancer. The symptoms you experience may vary greatly and include shooting pain, difficulty swallowing, headache, numbness, dizziness, shooting pain in the face, severe shoulder pain, arm tingling and numbness, and sharp shooting pains.

In order to qualify for SSDI for your neck pain and problems, you must meet the requirements of a disability listing in the SSA’s medical guide, which is called the Blue Book. The listings in the Blue Book prove that you don’t have the capacity to return to work because of restrictions set by your doctor or because of the severity of your conditions. Providing sufficient documentation is the key.

The Cost of Treating Neck Pain

Any medical condition can be expensive to treat and neck pain is no exception. Medscape reports that about 9% of all medical costs are related to treating spine problems, which totals about $86 billion per year. The individual’s cost is dependent upon the condition and its severity. For the individual with health insurance, there are co-pays, deductibles, and coinsurance for doctor visits, prescriptions, therapy, and procedures including surgery in some cases.

On average, an individual with chronic severe neck pain can be expected to spend about $3,500 per year on treatment and therapy. There are some instances where the cost may be more, of course. You may qualify for Medicaid if your financial situation meets your state guidelines.

Medical Qualifications and the SSA Evaluation

While there is not a specific listing in the Blue Book for neck pain, the listing that is for disorders of the spine does address many causes of neck problems and neck pain. If you think you qualify because your severe neck pain and problems meet the requirements of this listing because of cervical spine listing, the SSA may not even have to consider how your activities are limited by your neck pain and problems. You may automatically be approved for Social Security disability benefits.

To meet the requirements of the listing, you have to show that the nerve root or spinal cord are impacted and you have either spinal nerve root compression pain, muscle weakness that results in loss of reflexes or feeling in those muscles, and limited spine movement. Another option is that you suffer from a painful disorder caused by spine inflammation that makes you have to change your position more than once every two hours.

You have to provide adequate medical evidence to show that you do indeed meet the requirements of this particular listing. Your documentation must include evidence of an in-depth examination of your spine, documentation of your neck’s range of motion, lab findings and medical imaging that shows your specific impairment.

Because the pain as you describe it cannot be easily measured or confirmed, you need to be able to provide medical evidence that shows there is a possible or a definitive source of the pain. You need to provide your history of treatments received to address the problem, how long you received these treatments, and how your body responded to those treatments.

While your neck pain could be caused by a variety of things, there may be other listings that could be helpful in your path to disability approval. Your neck pain could fall under:

  • Section 1.02 – Joint Dysfunction

  • Section 14.09 – Rheumatoid Arthritis

To qualify under one of those listings, you must meet the criteria that are set forth for that particular condition. Other conditions that can cause neck pain may also qualify, including:

  • Degenerative Disc Disease

  • Inflammatory Disorders

  • Whiplash

  • Pinched Nerves

  • Herniated Discs

  • Infections

Qualifying for Disability with a Residual Functioning Capacity and a Medical-Vocational Allowance

If you don’t meet the criteria set forth under one of the Blue Book listings, you may still be eligible to receive Social Security disability benefits if you are unable to return to work. Disability Determination Services will assess the severity of your condition and your restrictions using a residual functioning capacity (RFC) form and how your work activities are limited. Your physician can also fill out one of these forms to detail your restrictions, conditions, symptoms, and treatment.

The RFC should indicate how your ability to use your neck and arms have been limited by your condition. As an example, a decreased feeling of sensitivity in your arms may prevent you from grasping, holding, and lifting. Severe pain in your neck and face may impact your ability to concentrate. Your severe pain may require you to adjust your position more frequently than every two hours, and you may not be able to walk significant distances or for long periods of time.

When using the medical-vocational allowance, several other things are also considered in addition to your conditions and symptoms. Your age, work experience, education level, training, transferable skills, and your ability to do lighter duty work will also be given consideration. The disability process is complicated and detailed you may face up to denials which you will have to appeal. The final step would be a hearing before an administrative law judge for a ruling on your case.

Generally, if you are over 50 and are unable to work you may be more likely to be approved for benefits. For example, if you're 55, work in the construction industry, and your neck pain makes you unable to pick up objects that are more that 10 pounds, you may be more likely to be approved for benefits than someone who is 30 and works at a sedentary office job.

Applying Specific Medical Tests to Your Disability Case

Your severe neck pain has required you to undergo extensive testing. You should be able to provide these test results as evidence to support your disability claim. You should include any lab results, x-rays, MRI scans, CAT scans, physical therapy records, doctor’s notes, and details about medical examinations of the spine and neck conducted by your medical providers.

If Disability Determination Services needs additional information about your condition, they may order a medical evaluation at the expense of the SSA with the physician they choose. This is not for medical treatment, but strictly for informational purposes to assist with the decision making process. On occasion, a mental evaluation is also ordered to see if your ability to remember, concentrate and function have been impacted.

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