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Back Pain and the Disability System - A First Person Perspective

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By: Timothy Moore

One of the most commonly listed impairments on social security disability and ssi disability applications is lower back pain. Why is this condition so "common"? Well, it's simply due to the way humans are built. The lower back area (particularly L5-S1) is the point at which we bend to pick up things and we often use it as a fulcrum to lift heavy objects.

Unfortunately, because lower back problems are seen so often on disability applications, they tend to be viewed by disability examiners in a dismissive way. The typical examiner will look at a disability app that lists back pain as the only allegation and will think to themselves, "Back pain, is that all?". From day one, when the file lands on the examiner's desk, the examiner will have it in his or her mind that the case will ultimately be denied.

Having been an examiner, I am sad to say that this is how the evaulation process usually begins for such cases. And it sucks. Extreme lower back pain (I don't mean simply "pain". I mean pain of the kind that prevents you from even being able to get off the bed and onto your feet to go to the bathroom without breaking into a sweat and wanting to scream) is something that one cannot imagine...unless one has experienced it firsthand. And without having experienced it personally, it is difficult for others to really understand how back pain can be so severe that it impairs a person's ability to work.

Unfortunately, most DDS examiners--the individuals who slap decisions on ssd and ssi claims--are relatively young people who have NEVER experienced this kind of pain. Typically, probably due to relatively low pay, most examiners in a DDS unit will be in their early to late twenties. Yes, you do see people in their thirties, forties, even fifties at a DDS, but most DDS units will be composed of younger workers.

I have no doubt in my mind that this fact alone has a bearing on the decisions rendered for some claims. I mean, how can a person understand how debilitating or painful a situation can be if they've never experienced at least something similar? I'm sure they can't. And with so many examiners belonging to a relativly young age-set, this "builds" a certain insensitivity into the process.

I'll give you an example of what I mean. About eight years ago, I injured my back and was out for 3 straight days. How did this happen? I simply got out of the shower. I must have stepped the wrong way as I got out, because as I was closing my front door I could feel pain tingling down my right leg. Thirty minutes later at a christmas eve party I was on the floor and unable to move. I spent the next three days in bed, on flexeril and pain killers, unable to move much at all. Getting up to go to the bathroom felt like a spike was being hammered into my tailbone.

How does this personal bit of information relate? When I got back to the job (DDS), I tended to look at back cases a lot differently than before. Even though my condition had been relatively short-lived, the memory of the awful pain I felt in those three days made me more acutely aware of how debilitating back pain can be. And how restrictive and limiting a back condition can be for people who have chronic and ongoing back pain.

Now, why am I writing this particular post today? Well, once again I find myself in bed, on percocet and flexeril, after simply crouching (this was a crouch, not a stoop, which you would think would be safer) down to do something. As before, neither the muscle relaxant nor the pain pill seem to do the trick (though I wonder how bad it would feel without these meds) and I expect the situation to last for probably 2-3 days.

Am I disabled? No, of course, not. The likelihood is that sometime in the next 24-48 hours I will be able to walk again, with some residual pain. But...what if I had a condition that caused this level of pain, yet was chronic and ongoing? Frankly, I don't know what I would do. I certainly wouldn't be able to work. And feeling that kind of pain for so long would undoubtedly make me depressed and anxious (a lot of claimants with back problems also cite depression as an impairment). And, for me, knowing what I know about the disability system, the situation would seem even more depressing because "pain" is given very little consideration in the disability evaulation process.

What do you do if your major allegation on a claim is back-related? Here's a tip that really applies to all cases. Seek regular medical care and try to make sure your physician fully documents all the limitations you have as a result of your condition. Medical record documentation on a federal disability claim is essentially the gas that powers the engine.

The author of this article is Timothy Moore, who, in addition to being a former food stamp caseworker, medicaid caseworker and AFDC caseworker, is a former disability claims examiner. He publishes a website that addresses the disability process at http://www.disabilitysecrets.com

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