Social Security Disability & SSI: Back Pain - Lumbar/Thoracic

Legal Author - Travis Hansen, Esq.
Updated - April 19, 2025

Necessary Criteria To Win Your Back Case

Video

Social Security's Evaluation Of Your Back Pain

Overview

The lumbar or thoracic spine is one of the most common physical medical conditions Social Security adjudicates for disability benefits. A lumbar or thoracic back condition can develop due to any number of accidental or medical reasons. The lumbar spine is the low back, and the thoracic spine is the mid back. The lumbar spine consists of the bottom seven spinal vertebrae starting at the L5 vertebrae at the bottom of the spine and ending at the L1 vertebra where the thoracic spine begins. The thoracic spine consists of the middle twelve spinal vertebrae starting at the T12 where the lumbar vertebrae end and ending at the T12 where the cervical spine begins. It is far more common to see lumbar impairments than thoracic impairments. This is because the lumbar spine, as compared to the thoracic spine, is weaker, handles more weight, is more flexible, and is located where the body hinges.

In adjudicating your Social Security & SSI disability case, the administration will evaluate your back generally. But, more specifically, Social Security will evaluate your back according to your particular back impairment, or medical diagnosis. Each specific back condition has specific considerations in a Social Security disability case. The most common back impairments are as follows:

1. Degenerative disc disease;
2. Herniated, ruptured, or bulging discs;
3. Spinal stenosis;
4. Arachnoiditis;
5. Ankylosing Spondylitis;
6. Spondylolisthesis;
7. Scoliosis; or
8. Spine fractures.

Neuropathy, Radiculopathy, & Myelopathy

Many back impairments cause Neuropathy, Radiculopathy, or Myelopathy which is abnormal nerve or spinal cord functioning caused by the back impairment. Common symptoms are pain, numbness, tingling, muscle atrophy, and functional limitations. Symptoms can occur along the spine where the back nerve or spinal cord is distressed or in either the upper or lower extremities the nerve or spinal cord affects. In this case, Social Security can find you have functional limitations in both your back and in your extremity.

Medical Records - Diagnosis, Symptoms, & Treatment

The most important information Social Security will request about your lumbar or thoracic back condition is your medical records which will include information about your diagnosis, symptoms, and treatment.

In your Social Security disability case, your diagnostic medical evidence is critical. With any back impairment, x-rays are not tests that can clearly determine the extent of a spine injury, except for a fracture. Therefore, it is critical you obtain a MRI or a CT to establish the diagnosis and the severity of your back impairment. If you have either upper or lower extremity neuropathy, radiculopathy or myelopathy symptoms, you will need to obtain an EMG to establish that diagnosis and severity of your extremity impairment. With any of the aforementioned tests, Social Security usually will only find you disabled if your test findings show "marked," "severe," or "extreme" abnormalities. "Moderate" abnormalities are usually not considered disabling by Social Security. "Mild" findings are almost never considered disabling by Social Security.

Social Security will also critically review your ongoing medical treatment to determine the severity of your lumbar or thoracic disability. In any filing for disability benefits, you must show to Social Security you have disabling back symptoms which generally include pain and numbness as well as other symptoms consistent with your doctor's clinical findings. As to those findings, it is important your doctor indicates in your medical file your 1) overall condition; 2) clinical findings regarding your strength, range of motion, reflexes, degree of tenderness, gait, and muscle atrophy; and 3) your need for any assistive devices (e.g. cane, brace).

Treatment varies depending on your specific back condition, but most commonly, treatment consists of physical therapy; medications, injections, TENS units, and spinal stimulators for your symptoms; and surgery in more severe cases.

Tip. Back surgeries are a very significant factor which deserve special attention - Back & Neck Surgeries And How They Affect Your SSDI/SSI Social Security Disability Case.

Back & Extremity Limitations

The second important information Social Security will request will be about your limitations. Limitations will be determined from your medical records, and it will also be determined from statements and additional evidence. Social Security will request statements (forms and also testimony if you have a hearing) from you and perhaps a third party (a friend or family member) about how well you are able to function with your back and how your back limitations affect your life. Social Security will also request a statement about your functioning from one of its medical providers. There is a significant amount of additional information you can submit in your case that establishes the severity of your medical condition and your limitations which is discussed on our next page.

The Back Social Security & SSI Listings

Social Security listings are arranged by medical diseases or conditions rather than by body part. Therefore, if you have a specific condition related to your back, you need to look up the listing that is specific to that condition. There are many back conditions, and therefore, many back-related listings. The most common are as follows:

1. Lumbar or thoracic degenerative disc disease, facet joint arthritis, herniated disc, spinal stenosis and arachnoiditis, vertebral fracture, or spondylolisthesis - Adult Listing 1.04.
2. Lumbar or thoracic lysosomal and metabolic disorders, vertebral osteomyelitis and fracture, and achondroplasia - Child Listing 101.04;
3. Lumbar or thoracic ankylosing spondylitis - Adult Listing 14.09 and Child Listing 114.09;
4. Lumbar or thoracic scoliosis - Adult Listing 1.02 and Child Listing 101.02, Adult Listing 1.04 and Child Listing 101.04, and Adult Listing 14.09 and Child Listing 114.09;
5. Spinal cord disorders - Adult Listing 11.08 and Child Listing 111.08; and
6. Radiculopathy/Neuropathy - Adult Listing 11.14 and Child Listing 111.14.

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Disability Criteria

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Functional Limitations

 

Do you suffer another medical condition? If so, visit our Site Menu-Home page to find that review. You may have another way to prove disability.

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