Facet Arthritis and Filing for DisabilityFacet arthritis is a valid medical condition if you are considering an application for SSD or SSI disability benefits. This condition is considered under the body system classification of musculoskeletal impairments. Facet arthritis is addressed in the SSA Blue Book adult impairment listing 1.04. Social Security defines musculoskeletal impairments as disorders of the musculoskeletal body system that may be the result of hereditary, congenital or acquired pathological processes. Infectious, inflammatory, or degenerative processes, traumatic or development events, or neoplastic, vascular, or toxic/metabolic diseases may cause musculoskeletal impairments. When does facet arthritis get disability awarded? While facet arthritis of the spine is a commonly listed condition on a disability application, it may or may not result in an approval for disability. The Social Security Blue Book impairment listing indicates that facet arthritis of the spine could meet the listing if it results in a compromise of the nerve root or the spinal cord. This must be characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with muscle weakness or muscle weakness) along with sensory and reflex loss. If the facet arthritis involves the lower back there must also be a positive straight-leg raising test. Your medical records must verify that all of these requirements are met in order for you to meet or equal the impairment listing. If you do not meet the impairment listing requirements, you still be approved for disability on the basis of facet arthritis. You may qualify for a medical vocational allowance. Medical vocational allowances consider your age, education, functional limitations, and the transferability of your job skills to other work. If you have severe limitations that prevent you from performing the functional requirements of each of your past jobs and your job skills do not allow you to transition to another type of work, you may be awarded disability benefits. More on qualifying for disability benefits with Facet Arthritis Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records. This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy. In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits with facet arthritis will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work. The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels? There are several reasons but here are just two: 1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge. Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level. 2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens. These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits. Facts about Facet Arthritis 1. Facet arthritis affects the facet joints in the spine, located in the lower back. The lumbar region of the spine is responsible for supporting the upper back and protecting the spinal cord. The facet joints are located at the back part of each lumbar bone, which are called vertebrae, and help each vertebrae move properly with the ones above and below it. 2. There are two facet joints, one for each side, for every vertebrae. Together, all the elements of each vertebrae work together to protect the spinal cord and act as a weight-bearing platform for everything above the buttocks. 3. Just like the other joints in the body, the facet joints are surrounded by cartilage, which is smooth and allows for easy movement between bones. There are also strong ligaments and lubrication fluids for each joint. 4. In addition, just like all other joints, the facet joints will be affected by the inflammation and pain that characterizes arthritis. The pain caused by this arthritis is different than back pain caused by other problems, because it is localized just to the affected joint or joints. The pain is usually worse when twisting to the side or bending backward. 5. Arthritis in the facet joints can lead to bone spurs which can also affect the nerve roots, ultimately causing more radiating pain as well as numbness and weakness in the legs. 6. Those with arthritis in the facet joints may feel like they have a stiff back, making moving from sitting to standing position difficult. They may also feel like they have to bend forward when walking. 7. Injections of anesthetic and anti-inflammatory medications in the location of the affected joint gives fast and dramatic improvement of the pain, confirming that it is facet joint arthritis and not another condition. 8. However, those with facet joint arthritis usually are experiencing other back problems, including degenerative disc disease, spinal stenosis and other types of spinal arthritis. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. 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