How To Get Social Security Disability & SSI: Neck/Cervical

Winning A Neck/Cervical Disability Case

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Neck & Cervical Conditions

General

A large volume of Social Security and SSI disability cases are determined involving neck or cervical conditions. Social Security will evaluate your neck condition generally, but it primarily evaluates your neck condition according to your specific medical diagnosis which commonly includes the following:

1. Degenerative disc disease;
2. Herniated, bulging, or ruptured cervical discs;
3. Cervical spinal stenosis;
4. Cervical arachnoiditis;
5. Cervical ankylosing spondylitis;
6. Cervical spondylolisthesis;
7. Cervical scoliosis; or
8. Cervical spine fractures.

Neck/Cervical Neuropathy, Radiculopathy, & Myelopathy

Many of the aforesaid neck conditions may aggravate a nerve root or the spinal cord in the cervical spine which is called cervical neuropathy, radiculopathy, or myelopathy. Generally, the worst cervical impairments involve nerve root or spinal cord aggravation. The aggravation of a nerve root or spinal cord may affect the upper extremities. If so, Social Security will consider your upper extremity neuropathy, radiculopathy, or myelopathy to be a separate and additional medical impairment from your cervical impairment. If you have cervical neuropathy, radiculopathy, or myelopathy of the upper extremities, you actually have two impairments - a neck impairment and an upper extremity impairment. Cervical neuropathy, radiculopathy, and myelopathy can cause significant pain, numbness, and loss of function, and therefore, Social Security can consider these three impairments very severe.

What Medical Evidence Does Social Security Want?

Testing. When Social Security first opens your medical file, it will look for diagnostic evidence of your neck or cervical impairment, and there are four types of diagnostic tests:

1. X-ray (generally insufficient to establish the full extent of your impairment),
2. MRI (the best diagnostic test available),
3. CT (only used in special circumstances), and/or
4. EMG (testing to determine if your neck/cervical condition is causing neuropathy or radiculopathy - pain and numbness in the upper extremities radiating from the cervical spine).

Social Security usually determines that your neck/cervical or upper extremity impairment may constitute disability only when your diagnostic testing shows "marked," "severe," or "extreme" findings; or you have nerve root or spinal cord impingement. Social Security does not often find you are disabled with "moderate" test findings, and Social Security will nearly never find your disabled with "mild" test findings.

Treatment. 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.

If a cervical surgery has been recommended or performed (good results or bad), it matters a great deal - Back & Neck Surgeries And How They Affect Your SSDI/SSI Social Security Disability Case.

Functional Limitations & Evidence

Limitations in your functioning is the essence of disability. A neck impairment is essentially a whole body impairment as it affects - the whole body. Many suffers need to lie down to rest the neck and head. This is a limitation that usually precludes all work - your disabled. Many suffers have limited cervical range of motion which affects, like lying down, nearly all work-related tasks. As noted above, cervical neuropathy, radiculopathy, and myelopathy can affect the use of your arms and hands. It is important these limitations are reported in your medical records, forms you fill out for Social Security, and in all other evidence you submit to Social Security which is discussed on the next page.

Social Security & SSI Listings Related To A Neck Or Cervical Impairment

Social Security organizes the medical listings by medical impairments. They are not organized by body part. Hence, if you suffer a medical impairment that affects your neck/cervical spine, you must look up your particular medical impairment in Social Security's listings:

1. Degenerative disc disease, arthritis of the facet joints, ruptured disc, stenosis, arachnoiditis, vertebral fracture, or spondylolisthesis - Adult Listing 1.04.
2. Childhood cervical lysosomal conditions, metabolic conditions, osteomyelitis of the vertebrae, fracture of the vertebrae, achondroplasia - Child Listing 101.04.
3. Ankylosing spondylitis - Adult Listing 14.09 and Child Listing 114.09.
4. 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 conditions & myelopathy - Adult Listing 11.08 and Child Listing 111.08.
6. Cervical radiculopathy/neuropathy - Adult Listing 11.14 and Child Listing 111.14.

A Neck/Cervical Spine Case - A Failed Surgery

Mr. Henderson lived in Anchorage, AK. He was 54 years old and had exclusively worked as a welder for the last 15 years (his past relevant work). He suffered a neck injury in a taxi accident and had a cervical diskectomy. His surgery had been unsuccessful (a failed surgery), and he was unable to return to work. He had been turned down at the initial level (there is no reconsideration level in Alaska). He had been also been diagnosed with mild diabetes, mild right knee osteoarthritis, and mild to moderate depression. He had applied for both Social Security disability and SSI disability benefits.

We did a number of things to ready his case for hearing. We ordered medical records from his primary doctor, his orthopedist, and his orthopedic surgeon. We obtained his surgery records and his post-surgery treatment records from his chiropractor and physical therapist. He also had a consult with a second surgeon and a mental health counselor; we obtained those records as well. Though we tried, his doctors were unwilling to assist him with a statement of his functioning - something that is unfortunately very common. We took a written statement from both his wife and son. He had an unusual bulge in his cervical spine after his first surgery that we photographed and submit to the hearing office. Mr. Henderson also took several pictures of modifications he made to his home, and we submitted those also. Mr. Henderson had sold his beloved truck, boat, and motorcycle as his neck condition precluded him from using them any more. We obtain the bill and sale and receipts and submitted them to the ALJ. We had been assigned to a conservative administrative law judge (ALJ), and I felt we would likely not have time to call a witness, but I prepared his wife to testify at his hearing.

At that time, there was no hearing office in Alaska, and Alaska residents had their hearings heard by ALJs in Seattle. At that time, Seattle ALJs flew to Alaska to hold hearings or claimants had video hearings with the claimants in Alaska and the ALJs in Seattle. Mr. Henderson's hearing was arranged such that he appeared in Anchorage via video, and the ALJ and I were in Seattle. The ALJ had not called for a vocational expert to be present at the hearing.

By the time the hearing was held, Mr. Henderson had undergone a second cervical surgery - a fusion. He appeared on video from Fairbanks with a large neckbrace. He could barely move. I still remember how he looked - disabled as anyone could imagine. However, his testimony was problematic as he had difficulty explaining his limitations. His wife was unable to attend the hearing, but his oldest daughter (mid-thirties) did. I had never spoken to her, but I decided to take her testimony since the testimony as it stood couldn't be much worse. Luckily, she was well-spoken and testified as well as any witness I have questioned. After she gave her final answer, I look at the ALJ wowed, and he looked at me wowed, and there was no doubt she had convinced us both Mr. Henderson was disabled. The ALJ had no further questions. The hearing was completed at the end of her testimony. A fully favorable decision awarding both SSDI and SSI benefits came in the mail about two months later.

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