Is Herniated Disc A Disability?

A herniated disc can potentially be considered a disability if it significantly impairs your ability to work and perform substantial gainful activity. However, whether or not a herniated disc qualifies as a disability depends on various factors, such as the severity of symptoms, functional limitations, and the impact on your ability to engage in work activities.

To qualify for disability benefits due to a herniated disc, the Social Security Administration evaluates the condition under its Listing of Impairments, specifically listing 1.04 for disorders of the spine. Meeting the specific criteria in the listing requires demonstrating certain medical evidence, such as nerve root compression with specific findings and persistent pain, among other factors.

What is a herniated disc?

A herniated disc, also known as a slipped or ruptured disc, is a common spinal condition that occurs when the soft inner core of a spinal disc protrudes through the tough outer layer. The spinal discs are rubbery cushions between the vertebrae (bones) of the spine, acting as shock absorbers and providing flexibility.

When a disc herniates, the inner gel-like material (nucleus pulposus) pushes out through a crack or tear in the disc’s outer layer (annulus fibrosus). This can occur due to age-related wear and tear, injury, or excessive strain on the spine. Herniated disc can cause:

• Chronic back pain
• Irritable bowel syndrome
• Bladder dysfunction

Can you get disability benefits for herniated disc?

Yes, it is possible to receive disability benefits for a herniated disc, but it depends on various factors, including the severity of your condition. In the United States, the two main disability programs that provide benefits for individuals with disabilities are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

To qualify for disability benefits, including SSDI or SSI, due to a herniated disc, you must meet the eligibility criteria set by the Social Security Administration. Meeting the medical criteria for a herniated disc, such as having diagnostic imaging and medical records documenting the condition, is not sufficient. You must also demonstrate that your functional limitations have prevented you from working for at least 12 months.

What are the symptoms of herniated disc?

Herniated discs most commonly occur in the lower back (lumbar spine) or the neck (cervical spine), but they can also affect the middle back (thoracic spine). The symptoms of a herniated disc can vary depending on the location and severity of the herniation, as well as its impact on nearby nerves and spinal structures. Common symptoms of a herniated disc may include:

• Pain: Sharp or dull pain in the affected area, which may radiate to the buttocks, legs, arms, or shoulders, depending on the location of the herniation.
• Numbness and Tingling: Sensations of numbness, tingling, or pins and needles in the area served by the affected nerve.
• Muscle Weakness: Weakness or difficulty in moving the affected area, such as the leg, arm, or hand, due to nerve compression.
• Changes in Reflexes: Diminished or exaggerated reflexes in the affected area.
• Difficulty with Fine Motor Skills: In some cases, herniated discs in the neck region may affect dexterity and coordination, leading to difficulty with tasks requiring precise hand movements.

VA Disability Ratings for Herniated Discs

The Department of Veterans Affairs in the United States uses the VA Schedule for Rating Disabilities (VASRD) to assign disability ratings for various medical conditions, including herniated discs. The VASRD provides a framework for evaluating the severity of disabilities and determining the corresponding disability ratings.

For herniated discs, the VA assigns disability ratings based on the range of motion and functional limitations caused by the condition. The specific rating depends on the affected area of the spine (cervical, thoracic, or lumbar) and the extent of impairment.

The herniated disc disability ratings range from 10% to 60%, with higher ratings indicating more severe impairment and functional limitations outlined under 38 CFR § 4.71a.

• 10%: the problem has lasted only for 1 week and less than 2 weeks during one year.
• 20%: Veterans who have been struggling with the problem for at least 2 weeks but less than 4 weeks in one year. These individuals may qualify for the ratings depending on their medical condition.
• 40%: the episodes will last at least 4 weeks but less than 6 weeks for the past 1 year.
• 60%: The episodes have lasted for at least 6 weeks, causing them to be unable to work for the last 12 months.  

Questions to ask yourself before applying for herniated disc disability benefits?

Before applying for herniated disc disability benefits, it can be helpful to ask yourself the following questions:

•  How does the herniated disc impact my ability to work?
•  Have I received appropriate medical treatment?
•  How long have I been experiencing symptoms?
•  Can I provide medical evidence to support my claim?
•  Have I exhausted other options for accommodations or work adjustments?

These questions are intended to help you assess your situation and make an informed decision.

I meet the criteria for herniated disc disability benefits. Now what is the next step?

Your next step is to apply for the herniated disc disability benefits. Some steps on how to apply for disability benefits for a herniated disc are:

• File an application with the Social Security Administration (SSA): You can do this online at ssa.gov if you want to apply online or by offline means by calling 1-800-772-1213.
• Collect medical records: This includes your medical records, doctor’s reports, and any other documentation that shows how severe your medical condition is.
• Complete the disability application form: This form asks for information about your medical condition, your work history, and your education.
• Attend a disability hearing: If your initial application is denied, you may be able to request a hearing. At the hearing, you will have the opportunity to present your case to an administrative law judge.

What if you do not meet the eligibility criteria of the SSA?

If your herniated disc does not meet the specific listing criteria, you may still be eligible for disability benefits by demonstrating the condition and other related factors. The SSA will assess your residual functional capacity, which evaluates your remaining abilities to perform work-related tasks despite the limitations caused by the herniated disc. The SSA will consider factors such as physical restrictions, pain levels, and ability to sit, stand, lift, and perform other employment-related activities.

What happens when your disability benefits are denied?

Follow the appeals process outlined in the denial letter. Typically, the first step is to request reconsideration, which asks the agency to review your case again with additional evidence. If the request for reconsideration is also denied, you can proceed to the next level of appeal, such as a hearing before an administrative law judge.

If your case progresses to a hearing, thoroughly prepare for the hearing by organizing your evidence, gathering witness statements if applicable, and understanding the issues that led to the denial. 

How much is the disability check for herniated disc?

The actual benefit amount may be different based on your work history, income, and herniated disc disability severity. If you are eligible for the SSI program, $914 will be the maximum monthly benefits and if you are eligible for the SSDI program, $3,627 will be the maximum monthly benefits.

Need Legal Assistance? Contact Chermol & Fishman, LLC

A disability attorney can assist you in this preparation and represent you during the hearing. Schedule a free consultation with an experienced New Jersey disability law firm such as Chermol & Fishman, LLC by calling 888-774-7243 if you have more questions about your herniated disc disability claim.