Approximately 65 million Americans experience back pain out of which 16 million struggle with chronic back pain which makes it impossible for you to hold a job or do day-to-day activities.  

If you are also experiencing back pain, you must know that you can apply for the disability benefits. If we go by the numbers, in the year 2020 nearly 2.9 million people were approved for disability benefits for chronic back pain and other suffering from musculoskeletal system. 

Qualifying for disability benefits based on chronic pain can be challenging because pain alone is subjective and difficult to measure. To qualify for disability benefits due to chronic pain, you must demonstrate that your pain is severe and significantly impairs your ability to work and perform daily activities. 

Is Chronic Pain A Disability?

Chronic pain is not considered a standalone disability for Social Security Disability benefits. However, if chronic pain is caused by an underlying medical condition that meets the criteria outlined in the Social Security Administration’s (SSA) Blue Book or has lasted for at least 12 months or more. 

Moreover, it must also significantly impair an individual’s ability to work and perform daily activities; it may qualify as a basis for disability benefits. Qualification typically depends on demonstrating the severity, persistence, and functional limitations imposed by chronic pain and its underlying condition.

Can You Get Disability Benefits For Chronic Pain?

Yes, it is possible to obtain disability benefits for chronic pain, but it can be challenging due to the subjective nature of pain and the specific criteria required by the Social Security Administration (SSA). 

To apply for disability benefits based on chronic pain, you must demonstrate that your chronic pain is severe enough to prevent you from engaging in substantial gainful activity (SGA). 

What Is Chronic Pain?

Chronic pain is persistent and ongoing pain that lasts for an extended period, often beyond the expected healing time of an injury or illness. Various underlying conditions, such as injuries, medical conditions, or diseases, can cause it. 

Unlike acute pain, a temporary sensation triggered by specific injuries or conditions, chronic pain persists over time and can significantly impact a person’s quality of life, mobility, and ability to engage in daily activities.

Types Of Chronic Pain

Chronic pain can manifest in various forms, affecting different body parts and arising from a wide range of underlying causes. Some common types of chronic pain include:

  • Musculoskeletal Pain: This pain originates in the muscles, bones, ligaments, tendons, or joints. Conditions like arthritis, fibromyalgia, and back pain fall under this category.
  • Neuropathic Pain: Neuropathic pain results from damage or dysfunction of the nervous system. It is often described as shooting, burning, or tingling sensations. Conditions like diabetic neuropathy and sciatica are examples.
  • Headaches and Migraines: Chronic headaches, including tension headaches and migraines, can lead to persistent pain that affects daily functioning.
  • Visceral Pain: Visceral pain originates from the internal organs and can result from conditions like irritable bowel syndrome (IBS), endometriosis, or kidney stones.
  • Central Pain Syndrome: This pain is associated with central nervous system dysfunction, leading to abnormal pain perception. Conditions like multiple sclerosis can cause central pain.

Symptoms Of Chronic Pain

Chronic pain can present with various symptoms that extend beyond the physical sensation of discomfort. These symptoms can vary based on the underlying cause and the specific type of chronic pain. Common symptoms of chronic pain include:

  • Persistent Pain
  • Intensity Variability
  • Aching or Throbbing
  • Burning or Shooting Sensations
  • Stiffness
  • Fatigue
  • Sleep Disturbances
  • Mood Changes
  • Cognitive Difficulties

Eligibility Criteria For Getting Disability With Back Pain

To get approved for disability benefits, you first need to prove that you meet the criteria of the SSA for back pain. You will require medical and non-medical evidence. An applicant needs to prove that back pain is negatively impacting their daily life, doctors’ records of physical exams, how they responded to medical treatment, and imaging tests of the back pain. 

Some questions that you need to answer before you apply for benefits are:

  • Do you require some assistive device such as a walker, brace, or cane?
  • Does your back pain prevent you from walking a certain distance?
  • Are you facing discomfort in sitting or standing?
  • Does your back pain prevent you from completing basic tasks?
  • What other work is your back pain preventing you from doing?
  • Is your back pain affecting your mobility?
  • Does your medical condition require injections or therapy?
  • Do you require surgery to treat your back pain?
  • Will you require specialists such as an orthopedic surgeon, spine pain management specialist, neurosurgeon, or chiropractor? 
  • Does your X-ray or CAT scan confirm your back pain?
  • Are you already consulting a pain management specialist?

How To Proceed If Your Back Pain Meets The SSA’s Criteria?

If your back pain meets the SSA’s criteria and have sufficient evidence to prove the diagnosis, you may be eligible for disability benefits. According to the SSA, your symptoms of back pain are not enough. You need to prove that your symptoms are preventing you from working.

How To Proceed If Your Back Pain Does Not Meet The SSA’s Criteria?

If your back pain doesn’t meet the criteria, you may still be eligible for the benefits. However, you must be honest with your application form and narrate how your back pain is affecting your quality and productivity of working. 

Nearly 80% of the applicant’s disability claims get rejected in the initial phase. They can then file an appeal and present more medical evidence in front of the judge. It may increase your chances of approval for the disability benefits.  

Types Of Disability Benefits That You Can Apply For

There are two main types of Social Security Disability benefits offered by the Social Security Administration (SSA):

  • Social Security Disability Insurance (SSDI): Social Security Disability Insurance (SSDI) benefits individuals who have worked and paid Social Security taxes, earning enough work credits to qualify. 
  • Supplemental Security Income (SSI): Supplemental Security Income (SSI) is a needs-based program that benefits individuals with limited income and resources, including those who have not worked or earned enough work credits for SSDI.

Application Process Of Chronic Pain Disability

Some steps you can take in the application process for chronic pain and disability are as follows:

  • Medical Documentation: Obtain thorough and consistent medical documentation from healthcare professionals that detail the nature, extent, and impact of your chronic pain. 
  • Diagnosis and Underlying Condition: Identify and document the underlying medical condition(s) causing your chronic pain. 
  • Functional Limitations: Describe how chronic pain limits your ability to perform work-related tasks and daily activities. 
  • Treatment Records: Document your efforts to manage and alleviate your chronic pain, including medications, therapies, surgeries, and other treatments.
  • Specialist Opinions: Seek opinions from specialists experienced in treating your specific condition.

You can apply for chronic back pain disability through online means by visiting the official website of the SSA. You can even apply offline or go to the office of the SSA or call 1-800-772-1213.

How Much Is A Disability Check For Back Pain?

The average amount for chronic back pain disability is $1,341.63. However, the amount may vary depending on the severity of the medical condition. The maximum in a month an individual can get is $3,822 for SSDI and $943 for SSI in 2024.  

What Can A Lawyer Do When Your Benefits Are Denied?

If your Social Security disability for chronic back pain gets denied initially, an experienced Social Security disability lawyer may help. They can provide legal expertise to navigate the appeals process, gather additional evidence, and represent you at hearings to increase your chances of obtaining the benefits you deserve. 

Their knowledge of disability law and experience with complex procedures can significantly improve the likelihood of a successful appeal.