I was diagnosed with cervical radiculitis and spondylosis, lumboscral radiculitis and lumbar dis degeneration. The problems I am experiencing are getting worse (doctors are aware of it) and I am unable to function doing normal daily activites. I was terminated from my job due to my symptoms. Social Security has denied me on both levels and now I am on the third stage of appealing. Do I have a case to get ssi? Or are they trying to discourage me from proceeding with the process. I do take morphine and norco for minium pain relief and been advised that surgery will be needed but not guaranteed to work. I am 43 years old and a certifed medical assistant.
Here's how Social Security decides a disability claim:
Social Security reviews cases using the five-step sequential evaluation process to decide is a person is disabled. Here are the 5 questions that make up the sequential evaluation process:
(1) Does your impairment keep you from being able to perform a substantial gainful activity (SGA), generally full-time, competitive, work?
(2) Is your impairment severe? AND, is your impairment expected to remain severe for at least 12 months?
(3) Does your impairment “meet or equal” one of Social Security’s “Listing of Impairments?” A listing of medical conditions, acceptable medical evidence, and the severity necessary for an impairment to be considered disabling. There are separate listings for adults and for children.
(4) Does your impairment prevent you from being able to perform any job you performed over the last 15 years which was also a substantial gainful activity?
(5) Does your impairment prevent you from being able to perform any other type of work which exists in substantial numbers of the national economy?
One can win at step-3 if the medical evidence shows:
1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:
A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);
B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;
C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.
Even if one does not meet or equal the criteria to win at step-3, many 40-year-old claimants with the severe impairments you listed ultimately prevail on their claims.
recent nationwide statistics from the Social Security Administration show that:
a) Initial Applications are denied approximately 65% of the time and these take 3-4 months on average to process, but can take six months or more.
b) Requests for Reconsideration (the first appeal) are denied about 78% of the time and these also take 3-4 months on average to process, but can take six months or more.
c) Hearings before a Social Security ALJ (the second appeal) are approved about 65% of the time - the wait to get to a hearing varies greatly depending on which hearing office you are dealing with (they time varies from 10 to 24 months), in our area the current wait is approximately 16 months (it has been as high as 25 months in the past five years).
In my opinion you should get an attorney as early in the process as possible as there is no fee unless you are awarded benefits (contingency) and the fees are set by Social Security law and would be the same regardless if you hire the attorney the week before your hearing or the day you applied originally.
Contact NOSSCR to find a Social Security attorney in your area, look for one offering a free no-obligation initial consultation (most do) then meet with one or more and sign up with one you are comfortable with.
NOSSCR Lawyer Referral Service - For help in finding attorney representation, contact its lawyer referral service during Eastern business hours:
If you have a work history and have worked full time and regularly for the past 5 years, I hope you have applied for both SSI and Social Security Disability (SSDI). Nationally, statistics show that many, many people are denied twice before getting to a hearing and winning. So, I would suggest you keep fighting.
At this point you probably want to get an attorney to help you if you do not already have one. An attorney will make sure your medical records are in, document your pain medications, get necessary letters and/or forms from treating doctors and be prepared to cross-examine any expert doctors the Judge has at the hearing.
If you do not already have an attorney, you may contact your local city, county or state bar association to see if they have a lawyer referral program, or you may contact the National Organization of Social Security Claimants' Representatives (NOSSCR) for the name and email address or telephone number of attorneys in your area. Most attorneys who do any amount of Social Security work are members of NOSSCR and provide a free initial consultation. In any event, no attorney may charge a fee for work on a social security claim until it has been approved by Social Security. The fee limit is a maximum of 25% of past due or back due benefits you are owed, and many lawyers charge less than the full 25%, and the money is not paid until your claim has been approved.
The telephone number for the lawyer referral service of NOSSCR is 1-800-431-2804. NOSSCR's website is www.nosscr.org.
I hope this helps. Good luck to you!
Please remember to designate a best answer to your question.
Get free answers from experienced attorneys.
31,465 answers this week
3,227 attorneys answering
Get answers from top-rated lawyers.
31,465 answers this week
3,227 attorneys answering
Don't speak legalese? We define thousands of terms in plain English.Browse our legal dictionary