Can You Get Disability for Spinal Stenosis?
You Have a Strong Disability Claim for Spinal Stenosis if the Condition Causes Severe Pain in Your Back and Legs and Affects Your Ability to Walk or Stand
Spinal stenosis is a commonly diagnosed spine disorder affecting hundreds of thousands of Americans each year. It is a leading cause of functional disability impacting a person’s ability to walk and stand and the most common reason that older patients undergo spinal surgery.
The pain, numbness, and other symptoms of spinal stenosis often cause chronic pain and diminish a person’s capabilities. In addition, this pain may lead to other disabling mental conditions such as depression or anxiety. If you have spinal stenosis that makes it challenging to continue working and earn a living, you might be eligible for financial and medical assistance.
The Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). And you may be entitled to disability benefits for spinal stenosis under one or both of these programs.
This article aims to explain how to qualify for disability for spinal stenosis. Our firm’s hope is that you use this information to receive up to $3,345 per month in disability payments.
Contact us now for a free consultation. We have obtained workers comp settlements and Social Security disability benefits for many clients with spinal stenosis. And we want to help you.
What is Spinal Stenosis?
Bone provides the frame for your body, including the spine.
And your spine has several bony hollow openings (foramina).
The spinal nerve roots leave the spine through these openings and travel to other areas of your body. These nerves help control your motor, sensory, and autonomic functions.
The term stenosis refers to the narrowing of an opening.
Spinal stenosis, therefore, is the narrowing of the vertebral canal holding the spinal cord and cauda equina or of the openings between vertebrae (the intervertebral foramen).
This narrowing decreases the available space for your spinal cord and spinal nerves. And if the narrowing is severe enough, the spinal stenosis may pressure the spinal cord or irritate the nerve roots, resulting in back pain, sciatica, numbness, tingling, and muscle weakness.
What are the Types of Spinal Stenosis?
The medical profession classifies the types of spinal stenosis based on where the narrowing occurs. And it is possible to have more than one type of stenosis at the same time.
Cervical spinal stenosis and lumbar spinal stenosis are the most common types of stenosis. However, you may also develop thoracic spinal stenosis (narrowing in the part of the spine in your mid-back). But in my experience handling workers comp and car accident claims, thoracic stenosis is less common than stenosis of the cervical and lumbar spine.
Cervical Spinal Stenosis
Cervical spinal stenosis is the narrowing of your neck’s spinal canal or nerve root passages.
Though cervical stenosis is not as common as lumbar stenosis, it can be just as dangerous (if not more so). Indeed, cervical stenosis may lead to myelopathy, causing permanent nerve damage, paralysis, and even death if left untreated.
Lumbar Spinal Stenosis
You suffer from lumbar spinal stenosis if there is narrowing in the part of the spine in your lower back.
Lumbar spinal stenosis is the most common type of stenosis, impacting about 75 percent of persons diagnosed with the condition. And lumbar spine stenosis frequently affects the S1 nerve root, which travels down your back, through the buttocks, and down the back of your leg. This condition is called sciatica.
What Causes Spinal Stenosis?
Many factors may cause or contribute to the development of spinal stenoses, such as:
- Acute Trauma (Injury): A work-related back injury, car accident, or slip and fall may displace the spine or result in vertebral burst fractures that produce bone fragments that damage the spinal canal, causing swelling that pressures the spinal cord or its nerves.
- Aging: As we age, bone spurs (osteophytes) may form on the vertebrae or spinal canal, ligaments may ossify (thicken and stiffen), facet joints may break down, and other conditions called osteoarthritis or degenerative disc disease (DDD) may occur. In turn, these medical conditions may cause stenosis.
- Congenital Defects (present from birth): You may be born with a small spinal canal or have a structural deformity that narrows the spinal canal.
- Cysts: Synovial cysts may form and compress the spinal nerves.
- Herniated Discs/Bulging Discs: Soft cushions (discs) sit between the vertebrae that form your spinal cord. Trauma, overuse, or age may cause some of the material in these discs to escape and press on the spinal cord or nerve roots.
- Spondylolisthesis: In this condition, a vertebra slips forward onto the bone (vertebrae) below it.
- Tumors: Irregular tissue growth may occur within the spinal canal, causing compression and inflammation.
What are Common Spinal Stenosis Symptoms?
Some people with spinal stenosis do not have symptoms for a long. In this situation, the stenosis is considered asymptomatic.
But the chances are good that you have developed symptoms (often due to specific trauma) if you found this article.
Often, the first complaint of stenosis is generalized back pain.
This pain then progresses into extremity numbness, weakness, tingling, and pain – with cervical stenosis affecting the arms and lumbar stenosis impacting the legs.
Other signs and symptoms of stenosis include:
- Balance problems
- Cauda equina syndrome (severe spinal stenosis is a primary cause of this condition)
- Cramping (particularly in the legs)
- Decreased range of motion with spinal extension or flexion
- Discomfort when standing
- Loss of bladder or bowel control
- Loss of function of the hands
- Low back pain
- Neck pain
- Neurogenic claudication (increased leg pain when walking for prolonged periods or specific distances)
- Paralysis (it is uncommon for stenosis to cause permanent paralysis)
- Paresthesia
- Radiating pain
- Relief when sitting down
Who is at the Greatest Risk of Developing Spinal Stenosis?
Anyone can develop spinal stenosis. But some people have a higher risk of suffering from the condition.
Statistically, stenosis affects men more than women. And persons over the age of 50 have an increased risk of developing disabling stenosis.
How is Spinal Stenosis Diagnosed?
Your medical providers have several tools to diagnose stenosis.
Physical Exam to Diagnose Spinal Stenosis
The doctor will often suspect stenosis based on your history (patient’s history) and the physical examination.
Your physician will assess the following during your clinical exam:
- Balance. Are you able to keep your balance when your eyes are closed and your feet together (the modified Romberg test)?
- Extremity Strength (legs and arms)
- Gait. Do you walk normally or with a limp?
- Postural maneuvers. Do you have difficulty standing, bending, crouching, crawling, kneeling, stooping, or reaching?
- Range of motion. Do you have pain with spinal flexion or extension?
- Reflexes
- Sensation. Are you sensitive to touch? Is your skin abnormally hot or cold (a sign of complex regional pain syndrome (CRPS))?
Diagnostic Imaging to Identify and Confirm Spinal Stenosis
Depending on the physical exam and how you respond to treatment, your healthcare provider may refer you for diagnostic imaging studies.
Imaging studies to rule out or diagnose stenosis include:
- Bone Scan
- CT Scan (including CT Myelogram): A computed tomography (CT) scan creates images of the spinal cord and nerves. And at least one study has found that CT has an 89 percent accuracy in detecting spinal stenosis, with the accuracy rate increasing to 93 percent when myelography is added.
- Electromyography: This test can help differentiate between spinal stenosis and peripheral neuropathy.
- Magnetic Resonance Imaging (MRI): MRI creates images of the nerves, discs, and spinal cord.
- Nerve Root Blocks
- Plain Film X-Rays: X-rays can show injuries or bone structure changes that narrow the spine’s space. Typically an x-ray is only helpful if you have obvious, severe stenosis. Otherwise, a CT scan or MRI is needed.
Will Spinal Stenosis Heal on Its Own?
No, in most cases.
Your body cannot cure spinal stenosis on its own.
Treatment, however, can heal the underlying condition and help you manage your symptoms.
What are the Treatment Options for Spinal Stenosis?
Available treatment options for spinal stenosis depend on how severe the condition is, the problem’s location (central spinal stenosis versus intervertebral stenosis), and how it impacts you.
Generally, mild spinal stenosis will improve with conservative treatment. However, twenty to forty percent of patients with mild to moderate spinal stenosis will require surgery.
Potential medical treatment for stenosis might include:
- Apply cold (ice)
- Apply heat
- Electrical stimulation (use of a TENS unit)
- Epidural Steroid Injections (Corticosteroids)
- LIfestyle modifications (weight loss, quit smoking, use a seated cushion)
- Light exercise
- Lumbar brace
- Gentle stretching to improve your flexibility and balance
- Medications: Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen or other medications such as gabapentin, tricyclic antidepressants, muscle relaxants, and hydrocodone. Opioids are prescribed in some cases.
- Physical therapy
- Surgery (less common for thoracic stenosis)
During the treatment for stenosis, you will likely interact with the following types of healthcare professionals:
- Acupuncturist
- Neurologist
- Neurosurgeon
- Orthopedic doctor
- Pain management specialist (also called a physiatrist)
- Primary care provider
- Radiologist
- Rheumatologist (if you have arthritis)
What are the Potential Spinal Stenosis Surgeries?
Spinal surgery is complicated.
Therefore, orthopedic surgeons and neurosurgeons typically recommend it only when other treatment options (called conservative care) have failed and your stenosis symptoms impact your ability to work and perform daily living activities.
Potential surgeries for stenosis include:
- Decompression
- Foraminotomy (removing bone or tissue in the area where the bone compresses the nerve root)
- Interlaminar implant (maintains height between the discs to allow the nerve roots to exit freely)
- Interspinous spacer
- Laminectomy (removal of a portion of the vertebra or a bone spur)
- Laminoplasty (for cervical stenosis)
- Laminotomy
- Percutaneous image-guided lumbar decompression (PILD) procedure if thickening of the ligamentum flavum caused your spinal stenosis
Any surgery aims to remove the pressure on the spinal canal or nerve roots from the stenosis. And your surgeon may decide to use one or more of these procedures at the same time to reduce your stenosis symptoms.
How Long Does it Take to Recover from Spinal Stenosis Surgery?
Every case varies.
But it will likely take several months or longer for you to recover as well as you are going to (reach maximum medical improvement (MMI)).
And even then, you may have permanent impairment or light duty restrictions that prevent you from returning to your pre-injury job.
Can I Work with Spinal Stenosis?
Maybe.
Some people with mild symptoms can work with cervical or lumbar stenosis.
But others might find it challenging to continue working if your job requires lifting, carrying, standing, walking, or getting up and down. For example, truck drivers, construction workers, nurses who must transfer (or control) patients, or employees who stock or pick items at grocery stores or in warehouses for Amazon, Walmart, or Target, may have to stop.
Your ability to work depends on how much pressure the spinal stenosis puts on your spinal canal or nerve roots, how physically demanding your employment is, and how well your medical treatment works.
If you have problems performing all your regular job duties, then Social Security Disability for stenosis is an option.
Methods to Qualify for Social Security Disability for Spinal Stenosis
Applying for Social Security Disability is an option (or reapplying if you have received a denial) if spinal stenosis and related medical treatment prevent you from working for a continuous period of twelve months or more.
In other words, the SSA considers spinal stenosis to be permanently disabling if it will affect your ability to work for at least one year.
There are two steps to qualifying for disability for spinal stenosis.
First, you must satisfy the technical (non-medical) requirements of the SSDI or SSI programs.
Typically, you meet the non-medical requirements for SSDI if you have enough work credits. And you earn enough work credits through employment and paying FICA taxes for 20 of the last 40 quarters.
In contrast, the SSI program is a means-tested welfare program. Therefore, typically you satisfy the non-medical requirements for SSI if you are under the asset or income limit for the period in which you apply.
There are two ways to qualify medically for SSDI or SSI for spinal stenosis:
- Meet a disability listing for stenosis
- Prove that symptoms of stenosis (and other severe medical impairments) prevent you from performing your past work or any other work that exists in the national economy in significant numbers
Let’s look at these methods of qualifying medically.
Disability Listings for Spinal Stenosis
First, you will receive disability for stenosis if you meet one of the Social Security Administration’s (SSA’s) Blue Book Listings for the condition.
The Blue Book is the informal name for the SSA’s Disability Under Social Security. It describes the medical impairments the SSA considers severe enough to prevent gainful employment when a claimant meets the detailed medical criteria.
Two disability listings may apply to spinal stenosis:
Listing 1.15 Disorders of the Skeletal Spine Resulting in Compromise of a Nerve Root
To meet this listing, you must have documentation of:
A. Neuro-anatomic (radicular) distribution of one or more of the following symptoms consistent with compromise of the affected nerve root(s):
1. Pain; or
2. Paresthesia; or
3. Muscle fatigue.
AND
B. Radicular distribution of neurological signs present during physical examination or on a diagnostic test and evidenced by 1, 2, and either 3 or 4:
1. Muscle weakness; and
2. Sign(s) of nerve root irritation, tension, or compression, consistent with compromise of the affected nerve root
3. Sensory changes evidenced by:
a. Decreased sensation; or
b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or
4. Decreased deep tendon reflexes.
AND
C. Findings on imaging consistent with a compromise of a nerve root(s) in the cervical or lumbosacral spine.
AND
D. Impairment-related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following:
1. A documented medical need for a walker, bilateral canes, bilateral crutches, or a wheeled and seated mobility device involving the use of both hands; or
2. An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements, and a documented medical need for a one-handed, hand-held assistive device that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand; or
3. An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements.
Listing 1.16 Lumbar Spinal Stenosis Resulting in Compromise of the Cauda Equina
You must have documentation of A, B, C, and D to meet this listing.
A. Symptom(s) of neurological compromise manifested as:
1. Nonradicular distribution of pain in one or both lower extremities; or
2. Nonradicular distribution of sensory loss in one or both lower extremities; or
3. Neurogenic claudication.
AND
B. Nonradicular neurological signs present during physical examination or on a diagnostic test and evidenced by 1 and either 2 or 3:
1. Muscle weakness.
2. Sensory changes evidenced by:
a. Decreased sensation; or
b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or
c. Areflexia, trophic ulceration, or bladder or bowel incontinence.
3. Decreased deep tendon reflexes in one or both lower extremities.
AND
C. Findings on imaging or in an operative report consistent with compromise of the cauda equina with lumbar spinal stenosis.
AND
D. Impairment-related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following:
1. A documented medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device involving the use of both hands; or
2. An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements, and a documented medical need for a one-handed, hand-held assistive device that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand.
Proving that Your Residual Functional Capacity (RFC) Prevents You from Returning to Past Relevant Work or Other Jobs in the Economy
You can still receive disability payments for spinal stenosis if you do not satisfy one of the listings.
If you do not meet a listing, the SSA will determine your residual functional capacity (RFC). Your RFC is the most you can do (physically and mentally) during a 40-hour workweek (five days per week, eight hours per day).
Next, the SSA compares your RFC to the requirements of your past work. If those requirements exceed your RFC, the SSA moves to step five of the sequential disability evaluation process.
In step five, the SSA uses a vocational expert to determine if there is other work you can perform in significant numbers in the national economy given your age, education, transferable job skills, and RFC. The answer to this question determines whether you qualify for SSDI or SSI.
You can strengthen your disability claim for spinal stenosis by presenting evidence and testimony on how the condition affects you and prevents you from performing past job duties or activities of daily living.
What Evidence Should I Provide to Prove Disability under the Listings of Impairment for Spinal Stenosis or My Residual Functional Capacity (RFC) Assessment?
To satisfy either disability listing for stenosis or prove your disability claim at steps four and five of the sequential evaluation, I recommend that you present:
- Functional Capacity Evaluation (FCE) reports assessing your work capabilities and comparing your abilities to your pre-injury job requirements. Usually you will have undergone an FCE if you filed a workers comp claim for an occupational injury that caused or accelerated your stenosis.
- Objective medical evidence from an acceptable medical source (surgeon, doctor, nurse practitioner, physician’s assistant, etc.) confirming that you have spinal stenosis affecting a nerve root or the cauda equina. Typically the diagnostic imaging reports (MRIs, CT scans, X-rays) and your treating physician’s statements on the imaging are the best evidence to confirm the diagnosis.
- Office visit notes. Request the medical records from your treating medical providers for the period starting one year before you allege disability for stenosis and continuing.
- Operative (surgical) reports if you underwent spinal surgery
- Statements from medical and nonmedical sources (including yourself) that describe how you function, the length and severity of your symptoms, and whether you need assistive devices (wearable, hand-held, or wheeled and seated).
- A disability letter from one or more treating physicians identifying all positive signs and symptoms of stenosis and explaining how pain, sensory changes, and muscle weakness from the stenosis impact your ability to stand or walk during an eight-hour workday. The goal is to have the SSA adopt the RFC from one or more of your treating physicians (so long as the RFC supports disability).
- Pharmacy printouts showing the medication (and dosage) you have taken for back pain since the date you allege you became disabled from stenosis
- Letters from past employers describing your work attempts and how the stenosis affected your performance
The more evidence you offer on how spinal stenosis and accompanying pain impact your ability to sit, stand, ambulate (walk) without assistance, or lift, the greater the likelihood you get approved for SSDI or SSI for lumbar or cervical stenosis.
Often you will need to present evidence at a disability hearing before an administrative law judge to prove one of these listings applies.
Auto Accident and Workers Comp Settlements for Spinal Stenosis
The same principles for negotiating car accident settlements and valuing workers comp claims for low back injuries and neck problems apply to spinal stenosis cases. I recommend you read these linked articles for more information.
Other Sources for Information on Spinal Stenosis
The following articles provide valuable information on the medical aspects of spinal stenosis (how to treat and recover from the condition).
Get Help Understanding Your Legal Options for Disabling Spinal Stenosis
Our law firm has extensive experience and the needed skill to resolve lawsuits and disability claims for spinal cord injuries and conditions such as lumbar or cervical stenosis.
And we want to put our knowledge and abilities to work for you.
You may have several legal remedies (in addition to Social Security Disability benefits) depending on the cause of your stenosis.
For example:
- A product manufacturer or distributor may be liable for damages for stenosis caused by a defective product.
- Your employer and its insurer (Travelers, Hartford, etc.) or claim administrator (Sedgwick CMS, Gallagher Basset, etc.) may have to pay workers comp benefits for stenosis caused or worsened by an occupational injury.
- The U.S. Department of Veterans Affairs (VA) may pay compensation if you receive a disability rating based on spinal stenosis.
- The Virginia Retirement System (VRS) may find you qualify for service-connected disability payments because your spinal stenosis prevents you from working.
- A private insurance company may pay long-term disability (LTD) benefits under a private or employer-provided policy.
No matter how you developed spinal stenosis, our injury law firm can help. We will evaluate your legal options and determine the merits of any claims based on the medical evidence.
And you can focus on your health while we look for ways to improve your finances and access to medical care.
Contact us if you are disabled by spinal stenosis and would like help getting approved for SSDI, negotiating a workers comp settlement, or pursuing an insurance claim against a negligent party.
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