Cervical Degenerative Disc Disease can qualify for Disability Benefits

Sarah gripped the armrests of her chair, wincing as a jolt of pain shot through her neck and down her arm. It had been like this for months, a constant dull ache punctuated by sharp, debilitating spasms. Cervical disc degenerative disease, the doctor had said, is a result of years of wear and tear. The once-simple tasks of typing at her desk or driving to work had become herculean efforts. Now, facing increasing medical bills and the daunting reality of her limited ability to work, Sarah knew she had to make a difficult decision: apply for disability benefits. It was a path she never imagined taking, but the time had come to pursue every avenue possible to make her life better.

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If you are suffering from the effects of Cervical degenerative disc disease and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are.

Unfortunately, Sarah’s situation is not uncommon.

Cervical degenerative disc disease (or CDDD) is a common cause of neck pain, as well as pain that radiates down the shoulders to the arms and hands. In more severe cases this condition can go beyond mere discomfort and lead to a loss of mobility that significantly affects a person’s professional and personal life. Roughly 60% of individuals above the age of 40 experience some level of degenerative disc disease. While CDDD itself is not uncommon, the related symptoms, like cervical radiculopathy, affect a smaller percentage of people, with an estimated point prevalence of 3 individuals out of 1,000 (Bigos et al., 1992). These statistics paint a picture of a widespread condition, though the severity of symptoms and their impact on daily life vary considerably.

If you are one of the unfortunate few who have struggled to maintain employment due to CDDD, you may wish to explore whether to apply for disability benefits or not, and what you will need to qualify.

Qualifying for SDDI with Cervical degenerative disc disease

To qualify for Social Security Disability (SSDI) you will need to satisfy both the financial and medical requirements set forth by the SSA. If you do not meet those requirements, you will be denied benefits.

Financial Requirements:

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements.

You must: 1) have a disability that has lasted or is expected to last 12 months; 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than $1,550 per month in 2024. This figure is referred to as SGA or Substantial Gainful Activity. However, if you are visually impaired, the SGA threshold increases to $2,590 per month. If you earn more than SGA, your claim will be denied, and if you have not accumulated enough work credits due to insufficient recent work history, your claim will be denied. (go here for an explanation of work credits ->)

If you think you meet the financial requirements, you should then check SSA’s medical requirements to see if you satisfy those criteria.

Medical Requirements:

The Social Security Administration has a listing of disabling impairments called the Blue Book.

This manual contains a list of medical conditions and illnesses Social Security considers severe enough to impact one’s ability to work. This guide is divided into sections, each providing information on different health conditions and the level of impairment necessary to be eligible for disability benefits. While some disabling conditions are fairly easy to prove, others can be more challenging. The criteria to qualify can be confusing, but fortunately there are medical professionals and legal advocates available to provide guidance and assistance in navigating this complex process.

In April 2021, the Social Security Administration updated its listings under Section 1 Musculoskeletal Disorders.

Cervical disc degenerative disease is now evaluated under Section 1.15 Disorders of the skeletal spine resulting in compromise of a nerve root(s). A person with a compromised nerve root of the cervical spine may experience numbness, tingling, or pain in the neck, shoulder, arm, hand, or fingers, called “cervical radiculopathy.” If the inflammation or impingement of the nerve root is severe, it could impact an individual’s fine motor skills, making it difficult for them to use their hands and fingers to type, write, or hold and lift objects. In order to qualify for Social Security Disability Income under this listing, you must prove that a nerve root is compressed, and that you have radiating pain, tingling, numbness, muscle fatigue and poor reflexes. Also, you must not be able to use either hand for fine and gross motor movements like those described above.

Social Security will want to see the following medical evidence:

•    Results of a spinal examination that tests range of motion, strength and sensations.
•    Tests specific to the cervical nerve root affected, such as a Spurling test (a test that reproduces symptoms by compressing the affected nerve root).
•    Medical imaging such as MRIs, x-rays, and CT scans showing compromise of a cervical nerve root.
•    Records of treatments received, including how long treatments lasted and results of treatments.

With your application you should also submit:

•    Statements from your medical providers summarizing your condition and detailing its effects on your daily activities, particularly work-related tasks;
•    Employment records listing sick days, short-term disability leave, and family medical leave; and
•    Statements from employers, co-workers and family members.

If you do not meet the requirements of the listing, you may still qualify for disability benefits if you are unable to work.

Social Security will conduct a residual functional capacity assessment (RFC) to evaluate your limitations. Social Security will also consider your age, education, and job experience to see if there are any jobs you are capable of performing.

Among the functions they will test are

•    Your ability to turn or bend your neck (for example, to look at a computer screen);
•    Your ability to lift objects that weigh more than 20 lbs.;
•    Your coordination and ability and use your arms and hands;
•    If and how much pain interferes with your concentration.

Additionally, you may be eligible for Social Security Disability benefits if you have another impairment; for example, arthritis.

Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks.

If you are 55 or older or have another medical condition you may get approval.

Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, if you are a 55-year-old applicant with no transferable skills you might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.

Should you file a claim?

If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits.

If you are still unsure or would like to talk to someone, please contact us at 512-454-4000. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.

How do I file for Social Security Disability benefits?

Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.

After you have applied, a claims examiner will review your application and might contact you for an interview or request further documentation, such as medical records. When the claims examiner has enough information, Social Security will make a decision and notify you by mail. Normally, this takes three to four months, but could take longer. Don’t be discouraged if your initial application is denied – most are – and you will have the opportunity to appeal.

There are four steps to the Social Security appeal process:

1.    File a Request for Reconsideration with the Social Security Administration to completely review the case.
2.    If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). If you are not represented by an attorney at this point, now is the time to obtain legal counsel. This is a critical point in the process and will raise your chance for success.
3.    If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
4.    Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

What will happen in court – >

Do I need a disability attorney for SSDI?

If you have cervical disc degenerative disease and cannot work, you may be eligible for Social Security Disability benefits, but qualifying is complicated and most initial applications are denied.

You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation. At each potential stage of the process, from the initial application stage to the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney will not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf, and question any doctors or vocational experts selected by the ALJ to testify at the hearing. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

If you are suffering from cervical disc degenerative disease and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are. Have some questions? just give us a call, we love to help folks just like you!

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury. You can check eligibility requirements and begin the application for SSI online or by calling Social Security at 1-800-772-1213. https://www.ssa.gov/ssi/text-apply-ussi.htm. In addition to SSDI and SSI benefits, you may be able to get financial assistance from a privately purchased long-term disability policy or a policy through your employer.

I have long-term disability insurance – should I file a claim?

Yes – you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. However, do not quit your job before you file a claim because LTD coverage is good only as long as you are employed, and be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use.

Do I need a disability attorney for a long-term disability insurance claim?

It doesn’t matter if you have a long-term disability insurance policy purchased through a private insurance broker or a group policy purchased with your employer; filing a claim for long-term insurance is a complex process.

The wording of LTD policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.

Filing a claim for disability benefits and getting approval can be a long journey, but you can take the first steps today.

Feel free to call us for a free consultation to discuss your case and options. Even if you don’t hire us, we are happy to help you make the best choices for your own individual situation.

One client, from Wichita Falls, Texas, stopped working due to a degenerative spinal condition and filed for short term disability through AT&T, which was both her employer and her LTD insurance provider.

She was under the medical care of a board certified neurologist and remained on short term disability until those benefits expired. At that time, her claim was transitioned to long term disability under AT&T’s Disability Income Plan. Her doctor determined she was totally disabled, both from her own occupation at the phone company, as well as any occupation within the open labor market in which she resided. Her employer was acquired by another which reviewed and denied her claim.

She hired us, and we were able to settle her claim.

An Austin client suffered from severe back pain resulting from L4-5 disc disease, as well as bilateral facet/SI joint pain.

His medications included Celebrex, Sanaflex, Norco and others. He is permanently disabled and will never be able to return to work. Indeed, that is what each of his physicians had stated and this was the finding reached by the Social Security Administration. In its denial letters and the appeal denial letters, Reliance Standard showed a lack of deference to the findings of our client’s doctors and surgeons and, in fact, a total reliance on its internal claims review personnel to support its denial. He was unable to sit or stand for more than 30 minutes at a time and spent most of his days in bed due to pain. He was unable to drive due to pain and medication.

We won after taking his case to trial, with benefits reinstated.