Can someone with cervical radiculopathy (pinched nerve) receive Social Security Disability Benefits? This article is not offered as medical advice regarding cervical spine disability or spinal stenosis. Please consult your medical provider if you are having symptoms.
What is Cervical Radiculopathy?
"Cervical radiculopathy is the damage or disturbance of nerve function that results if one of the nerve roots near the cervical vertebrae is compressed. Damage to nerve roots in the cervical spine can cause pain and the loss of sensation in different parts of the upper extremities, depending on where the damaged roots are located." via Cervical Radiculopathy: Symptoms, Causes, and Treatment. According to John Hopkins Medicine, stenosis, among other conditions, is a common cause of radiculopathy.
Cervical radiculopathy can be caused by trauma, degenerative changes or anything that puts pressure on the nerve root. While you may have neck pain, you may also have symptoms in your hands. You can have radicular symptoms such as numbness, tingling and loss of coordination in your fingers in your upper extremity.
If you are having lower extremity pain (lumbar radiculopathy), that may be related to your lumbar spine. Read Back Pain and Social Security Disability
Pain medication, steroids, collars or physical therapy (cervical traction) can be used to help with your neck pain. Unfortunately, you can have chronic pain and muscle weakness. If your cervical radiculopathy does not improve, a cervical fusion may be recommended.
Types of Social Security Disability Benefits Available
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2023, SSI is $914.00 per month for an individual and $1,371 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death. Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.
Is Cervical Radiculopathy a disability?
The Social Security Administration evaluates whether a medical condition is a disability by its severity, not by its name. Simply being diagnosed with Cervical Radiculopathy will not qualify a claimant for benefits. If your symptoms and how those symptoms affect your ability to work are severe, you may be found disabled.
After applying for Social Security Disability, your case is evaluated under the Five Step Sequential Evaluation Process. At Step 3, SSA can evaluate your cervical issues under Listing 1.015, Disorders of the skeletal spine resulting in a compromise of a nerve root. This listing requires pain, paresthesia or muscle fatigue AND neurological signs on physical exam (i.e. muscle weakness, signs of nerve root involvement) AND objective testing demonstrating nerve root compromise (CT, MRI or x-ray) AND the need for bilateral assistive devices OR the inability to use one of the upper extremities while needing to use the other extremity for the assistive device.
In simple terms, in order to meet 1.015, you have to have pain symptoms, tell your doctor about your pain, have a diagnostic test showing the cause of your pain and have problems ambulating or using your hands. This, like many listings, is difficult to meet. It should be noted that x-rays only show bone so it usually will not show nerve compression. MRIs are expensive.
What happens if someone is unable to afford an MRI? The listing also requires documentation for the use of an assistive device, meaning a prescription from a doctor. Many doctors instruct their clients verbally to get a cane or walker because insurance doesn't always pay for these expenses. Without a MRI or prescription for an assistive device, you will not meet this listing.
If you meet all the above criteria, you may meet this listing. In many cases, a cervical disc fusion can alleviate your symptoms. But some people fail to improve even after having surgery.
Even if you do not meet Listing 1.015, your disability claim could still be approved on the grid rules. The Medical-Vocational Guidelines (grids) may help you be found disabled if you are age 50 or older and your cervical radiculopathy has affected your ability to lift and carry.
During my Social Security Disability hearings, clients with cervical radiculopathy are often asked the below questions:
- What makes your cervical pain and numbness better? Worse?
- Has your pain gotten worse, stayed the same or gotten better since you filed for disability?
- How much weight can you lift without pain?
- Do you frequently drop items? Examples...
- Does your pain stay in your neck or does it radiate? Which arm, or both? How far down your arm does the pain radiate?
- Do you have spinal pain with looking up, down or to the side?
- Have you tried pain medications, physical therapy, injections, a pain stimulator, etc.?
- Did any of the above therapies help you as a patient?
- Have your doctors discussed a cervical spine surgery with you?
- Have you had a previous cervical surgery?
- Did your prior cervical surgery help?
- Did your symptoms return?
If you are unable to work due to your cervical radiculopathy, file a claim for disability benefits as soon as possible and give the Bishop Law Firm a call.
We represent Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Garner and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095.
