Is Spinal Stenosis a Permanent Disability?
Spinal stenosis can cause permanent damage to your spine. Stenosis can occur in the cervical or c-spine (neck) and lumbar (lower back) areas of the spine. It can cause muscle weakness and pain or cramping extending from the buttocks down through the leg. It may also cause bladder and bowel issues.
Because c-spine stenosis is a degenerative illness, a person’s condition will continue to deteriorate over time. The resulting pain, numbness, tingling, or weakness can impact a person’s ability to carry out meaningful employment.
Those who are unable to work due to cervical or lumbar spinal stenosis may qualify for Long Term Disability benefits and Social Security Disability Insurance (SSDI) benefits. In this article, we’ll focus on cervical spinal stenosis and how you can qualify for disability benefits such as Social Security Disability or Long Term Disability insurance benefits for your c-spine disorder.
Is Cervical Spinal Stenosis a Disability?
Cervical spinal stenosis is a medical condition that affects the spine, causing narrowing of the spinal canal, compression of the spinal cord and nerves, and neck pain.
The word stenosis stems from the Greek word for “choked,” which is an example of what happens to the spinal cord in those who suffer from this condition. The nerves in the spinal cord are literally choked off causing discomfort in the leg, difficulty walking, tingling, weakness, or numbness that radiates from the neck and back down into the legs.
Because stenosis is typically a degenerative condition. Most people who receive a diagnosis of spinal stenosis are over age 50. It is less common for younger people to experience it, but it can happen in cases where a person has a curvature of the spinal cord or a spinal injury. The younger you are, the less likely you are to qualify for benefits due to your condition. However, anyone can be approved for disability due to this condition if it is severe enough to prevent work activity.
What are the Symptoms of Cervical Spinal Stenosis?
The severity and effects of stenosis are different for each person. For some, the pain, weakness, and numbness tend to come and go. People affected with this condition may have relatively pain-free periods with flares of pain or discomfort based on a number of different factors including physical activity or strain. Generally, symptoms that accompany a diagnosis of spinal stenosis include:
- Weakness of the limbs (upper and lower);
- Neck pain;
- Reflex abnormalities;
- Radicular pain in the arms;
- Sensory deficits;
- Wasting of the muscles;
- Leg pain; and
- Trouble walking.
It is important that your doctor document the effects of your condition and your resulting limitations in your medical records so that you may qualify for disability.
How is Spinal Stenosis Diagnosed?
When a patient presents with leg pain (with or without back pain) that is aggravated by walking, or episodes of weakness or numbness in the legs, a physician will generally order medical imaging such as x-rays, MRI scans, or CT scans to make a diagnosis. The type of spinal stenosis that is found may fall into one of the following categories:
- Lateral Stenosis– This is the most common type of stenosis that occurs when a nerve root is found to have left the spinal column and is then compressed by a bulging disc, herniated disc, or bone protrusion.
- Central Stenosis– This condition occurs when the central canal in the back is compressed and “choked” off.
- Foraminal Stenosis– This occurs when nerve roots in the lower back are pressed on and trapped by a bone spur in the opening where the nerve root leaves the spinal canal.
Treatment options for spinal stenosis often include anti-inflammatory NSAID pain relievers, physical therapy, steroid injections, and chiropractic care. In severe situations, back surgery may be necessary.
How Cervical Spinal Stenosis Can Impact a Person’s Ability to Work
Many patients with c-spine stenosis experience comfort while sitting but become symptomatic when standing upright. That is because the space that’s available for the nerve roots blocks the flow of blood from around the nerve. This congested blood irritates the nerve and ultimately causes pain when standing.
For that reason, your Long Term Disability (LTD) insurance provider will seek to determine if there are alternative jobs that you may be able to perform that do not aggravate your condition, such as sedentary desk work. If desk work is not an option, or if you cannot sit longer than six hours without pain, your insurance company will further evaluate how well you can sit, stand, or walk and if there are any other jobs that you may be able to perform. If it is determined that your condition is severe enough to prevent meaningful employment, you may be entitled to LTD benefits.
You must also meet specific medical criteria to qualify for Long Term Disability benefits. Again, in the case of disorders of the spine, you must have severe, chronic pain, and your movement or ability to walk must be limited or result in severe pain.
To prove the extent of your condition, you will likely need doctor and hospital records, laboratory test results, and sometimes a questionnaire that should be completed by your doctor. In general, the records must include the following:
- A confirmed diagnosis of cervical spinal stenosis;
- A doctor’s note detailing the frequency and severity of your symptoms, including how your condition impacts your ability to sit or stand over the course of an 8-hour workday;
- An MRI or CT scan documenting degeneration in the spine;
- A history of any treatments tried; and
- Any other test results such as imaging studies or those that measure the range of motion of the spine.
Evaluating Disability for Persons with Cervical Spinal Stenosis
The insurance company’s adjudicator is the insurance adjuster assigned to your claim. The adjuster may have your file reviewed by a physician, psychologist, or another medical examiner (such as a nurse practitioner) to give an opinion as to your level of impairment. The adjuster may also send you for an independent medical examination or functional capacity evaluation. In evaluating a claim for persons with stenosis, the insurance adjuster should consider all of the available evidence including the clinical course from the onset of the illness, and should consider the impact of the illness on each affected body system.
If the insurance adjuster believes there is not enough information to make a decision, he or she may call or write you to find out if you have the needed information. If you do not, they may ask you or, in some circumstances, an independent medical source to provide the information.
Although your physician may reach a diagnosis of stenosis on the basis of your symptomatology (after ruling out other disorders), your disabling impairment should still be documented by medically acceptable clinical and laboratory findings. Statements merely recounting your symptoms or providing only a diagnosis will not usually be sufficient to be approved for Long Term Disability insurance benefits. The insurance company should have reports documenting your objective clinical and laboratory findings. Thus, it is essential that your doctor(s) submit all objective findings available concerning your condition even if they relate to another disorder or establish that you have a different condition.
How the Insurance Company Assesses Your Residual Functional Capacity
In light of your documented symptoms, the insurance company may develop a Residual Functional Capacity (RFC) profile for you that states, for example, that due to persistent leg pain or weakness, you may need to take frequent breaks throughout the day. Because most employers would not accommodate this limitation, it would be difficult for you to obtain and maintain most jobs.
If you suffer from documented leg pain, numbness, or weakness from your spinal stenosis, your RFC may include limitations on certain work-related physical activities as well such as walking distances or lifting anything over 10 pounds that could further strain the back. This limitation would prevent you from doing jobs that required physical exertion such as factory work, warehouse work, and most janitorial positions.
Living with chronic discomfort from cervical spinal stenosis can also cause mental health problems such as depression or anxiety. If you are receiving mental health treatment, you should ask your treating physician (your psychiatrist or psychologist) to fill out an RFC form that details his or her opinions of your work-related limitations.
Work With an Experienced Long Term Disability Insurance Attorney to Ensure You Get the Benefits You Deserve
Your best chance of having a Long Term Disability case approved because of a neck disorder comes from working with an experienced Long Term Disability lawyer. Your disability lawyer will not only help you to obtain your medical records and offer legal advice, but many will also prepare a custom Residual Functional Capacity form for your doctor(s) to fill out
Your LTD attorney will be familiar with how your insurance provider handles claims and will help you prepare your paperwork and collect essential evidence. It’s important to note that your Long term disability attorney does not get paid until you do, so you can proceed with your case without fear of upfront legal bills or costs.
Social Security Disability Benefits
Patients who suffer from cervical stenosis may qualify for Social Security Disability Insurance (SSDI) benefits. Before you can qualify for Social Security Disability the Social Security Administration will have to determine if you are eligible for Social Security. A claimant must meet the requirements, both medical and non-medical, in order to be approved for benefits.
Those who have worked 5 out of the last 10 years may have the work credits needed in order to qualify for SSDI benefits. The Social Security Administration also has the Supplemental Security Income benefits program for those who have not worked 5 out of the last 10 years, but the claimant must meet strict non-medical requirements regarding household income. As for medical requirements, you must either meet a disability listing or prove that your functional limitations prevent you from performing substantial gainful activity.
What About Lumbar Spinal Stenosis?
Lumbar spinal stenosis is another form of stenosis that might qualify for Long Term Disability insurance and Social Security Disability benefits if the claimant cannot work as a result of the resulting symptoms and limitations. Cervical and lumbar stenosis are both disorders of the spine, but the associated symptoms and limitations vary somewhat. If you have lumbar spinal stenosis, we encourage you to read our article, Lumbar Spinal Stenosis Long Term Disability Claims.
Work With an Experienced Attorney
If your disability claim has been wrongfully denied or terminated and you’d like to speak to an experienced attorney about your degenerative condition and how it may be impacting your ability to work, call us at (888) 321-8131 to schedule a free consultation to discuss your claim. We have represented claimants in claims with Cigna, Hartford, Lincoln, MetLife, Prudential, Reliance Standard, Unum, and a variety of other disability insurance companies. We can help you evaluate your disability claim to determine if you may be eligible for LTD or SSD benefits, how to move forward with the process, and how to increase your chance of being approved.