Back & Neck Surgeries: Social Security Disability & SSI Case

Legal Author - Travis Hansen, Esq.
Updated - September 22, 2025

How A Back or Neck Surgery Affects A Disability Case

Social Security recognizes that your need for a back or neck surgery constitutes a serious medical condition and that a back or neck surgery is a serious medical procedure. In a Social Security disability case, there are three possibilities when a back or neck surgery has been recommended or performed. First, a surgery is recommended but not performed. Second, a surgery is performed, and it is successful. Third, a surgery is performed, and it is unsuccessfull - a failed surgery. Social Security responds differently in each situation.

Surgery Recommended But Not Performed

If a doctor recommends a surgery, Social Security will regard your back or neck impairment as more severe than if no surgery is recommended. This is true even if the surgery is not performed.

However, a surgery is generally expected to improve or cure your impairment. A surgery may improve your condition so that you are no longer disabled. Social Security commonly shares these opinions. Therefore, if a surgery is recommended but not performed, you need to have a good reason why it was not performed. Generally, there are five good reasons:

1. The surgery can only be performed if you lose weight. However, you cannot lose weight because of your medical condition or disability.
2. It is not covered by your insurance.
3. You cannot afford the surgery (whether you have insurance or not).
4. You have had a previous surgery that failed.
5. You are afraid to have a surgery (although this is the least convincing of the five).

If your doctor recommends a surgery, and it is not performed for one of the above five reasons, you have two responsibilities regarding this issue. First, you must do make sure the recommendation for surgery is included in your medical file that is submitted to Social Security. Second, you must communicate to Social Security the reason you did not have the surgery; the communication can either be a short written letter your testimony in a hearing.

Surgery is Successful

There are two types of successful surgeries. First, you have improvement of your symptoms, but your condition is still so severe you are unable to return to work. In this case, for all practical purposes, you have suffered a failed surgery, and that discussion is just below. Second, you have improvement of your symptoms, and you are able to return to work. In this case, there are two possibilities. Possibility one, you have not been disabled for 12 months, and therefore you do not satisfy Step 1 of Social Security's disability criteria; specifically, you do not satisfy the Durational Requirement. You will not be awarded disability benefits. Possibility two, before your surgery was successful and you returned to work, you had been disabled for 12 months or more, and you seek benefits during the period you were unable to work - a closed period.

Failed-Surgery

Some surgeries do not improve your lumbar, thoracic, or cervical impairment so that you can return to work, and some surgeries make your impairment worse. This is called a failed surgery. If you suffer a failed surgery, you will need to submit evidence to Social Security that it, in fact, failed. The best evidence for a failed surgery is a post-surgery MRI, CT, or EMG showing abnormalities. In other words, the testing itself shows that you continue to have a defect or problem with your spine even though surgery was done. In this case, Social Security will usually find you disabled. The next best evidence of a failed surgery is the combination of abnormal doctor visit/clinical evaluations and credible testimony. In other words, the testing itself shows no continuing defect or problem, or you have not had objective testing done. In this case, Social Security may or may not find that you have had a failed surgery, and it may presume your condition has improved as a result of the surgery. As discussed above, a closed period may be possible.

Common results of a failed-surgery include:

1. Infection,
2. Spinal instability,
3. Nerve root injury,
4. Spinal cord injury,
5. Continuing disk fragment,
6. Ongoing disk herniation,
7. Insufficient decompression,
8. Instrumentation complications, and
9. Arachnoiditis.

Common Back And Neck Surgeries

Common back and neck (lumbar, thoracic, and cervical) impairments that can necessitate surgeries are as follows:

• Ankylosing spondylitis,
• Congenital deformities,
• Degenerative disk disease,
• Facet joint arthritis,
• Herniated disc,
• Scoliosis,
• Spinal arachnoiditis,
• Spinal fracture,
• Spinal stenosis, and
• Spondylolisthesis.

The most common back and neck surgeries are as follows:

1. Discectomy - The ruptured or herniated disc [the material (essentially the cartilage) that sits at the top and bottom of your vertebrae] is removed in part or in whole.
2. Artificial Disk Replacement - A damaged disk is removed from in between the vertebrae, and it is replaced with an artificial disk.
3. Laminectomy (a type of decompression) - TOTAL removal of the lamina (the rear side of the verebra) to alleviate the impingement on the spinal cord or nerve root to provide more space for the cord or nerve.
4. Laminotomy/Hemilaminectomy (a type of decompression) - PARTIAL removal of the lamina to alleviate the impingement on the spinal cord or nerve root to provide more space for the cord or nerve.
5. Facetectomy (a type of decompression) - TOTAL removal of the facet joints (the "wings" on the vertebrae sides) are removed to make more room for the nerve and to relieve pressure on that nerve.
6. Foraminotomy (a type of a decompression) - PARTIAL removal of the 1) vertebra, 2) facet joints (the "wings" on the vertebra sides), or 3) tissue to enlarge the neuroforamen (the area between the upper and lower vertebraes wherein the nerve passes) to make more room for the nerve and to relieve pressure on that nerve.
7. Fusion - This is the most significant type of back and neck surgery and involves fusing two or more vertebrae with screws, metal rods, and bone grafts (four is usually the maximum number of fused vertebrae however a fusion for scoliosis is an exception). Usually fusions are effective for about 15 to 20 years, and after that, the vertebrae above and below the fusion begin to falter because the spine lacks the ability to flex and extend putting excessive pressure on the adjacent vertebrae.
8. Vertebroplasty - Fixation of a fractured vertebrae with special cement-like bonding material.
9. Kyphoplasty - A balloon-type surgical device is placed between the damaged and compressed vertebrae to raise the fractured vertebrae that has collapsed onto the one below it, and then fixation of the fractured vertebrae with special cement-like bonding material.

Your Surgical History Matters Too

Your surgical history can be relevant to your current disability case. Let's discuss this issue in two situations. First, you had a surgery years ago before you alleged disability that was performed on same body part that disables you now. Second, you had a past surgery years ago that occurred before you alleged disability that was performed on a different body part that disables you now.

In the first case, the past surgery shows that the particular body part in question is compromised. There is often the presumption that the second surgery, albeit years later, is more severe because the body part was previous damaged. Hence, the past surgery often helps prove that the current impairment and surgery is as severe as you claim.

In the second case, even though your surgery was on a different body part, and even if you have no symptoms or limitations that result from that body part, if the surgery was a major surgery, it can be relevant in your case. It shows that you have overcome a past serious medical condition. It shows you went back to work. It shows you are tough - you are credible. The past surgery you overcame ultimately therefore helps to prove that your current medical condition causes the disabling symptoms and limitations you claim.

Past surgical records (operative notes) may not be obtainable because of the passage of time. However, your current medical records may note your past surgeries. For example, your MRI shows a past surgery was performed, or a past surgery is noted in the history portion of your medical records. You should always report any past surgeries to both your doctor and Social Security even if you do not have the records, and even if they are not noted in your current medical records.