By Robert J. Osborne, Esq.

The listing of impairments include disorders of the spine. Disorders of the spine include herniated nucleus pulposus (herniated disc), spinal arachnoiditis (inflammation of the arachnoid, one of the membranes that surrounds and protects the nerves of the spinal cord), spinal stenosis (narrowing of the open spaces within your spine), osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture. To meet a listing, the disorder of the spine must result in compromise of a nerve root or the spinal cord. In addition, a person with a disorder of the spine must have either evidence of nerve root compression, spinal arachnoiditis or lumbar spinal stenosis to qualify for Social Security Disability benefits.

Evidence of nerve root compression must be characterized by distribution of pain along the nerves, limitation of motion of the spine, and motor loss accompanied by sensory or reflex loss. Motor loss involves wasting of the muscle and associated muscle weakness, or muscle weakness, itself. If there is involvement of the lower back, evidence of nerve root compression also requires a positive straight-leg raising test (sitting and supine).

Spinal arachnoiditis must be confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, clearly demonstrated by severe burning or painful impairment of sensitivity, resulting in the need for changes in position or posture more than once every 2 hours.

Lumbar spinal stenosis must result in painful cramps, chronic pain and weakness. Additionally, an individual must provide medically acceptable imaging (such as an MRI) that establishes the existence of the lumbar spinal stenosis. Further, the lumbar spinal stenosis must result in an inability to ambulate effectively. An inability to ambulate effectively means an extreme limitation of the ability to walk. Generally, a person must have such poor lower extremity functioning that the individual cannot walk independently without the use of a hand-held assistive device(s) that limits the functioning of both arms.

Pain or Other Symptoms

In order for pain or other symptoms to be found to affect an individual’s ability to perform basic work activities, medical signs or laboratory findings must show the a medically determinable impairment(s) that could reasonably be expected to produce the pain or other symptoms.

Examination of the Spine

An examination of the spine should include a detailed description of an individual’s gait, range of motion of the spine, any tension signs, motor and sensory abnormalities, muscle spasm (if present), and deep tendon reflexes. Additionally, an examining physician should report how an individual gets on and off the examination table. Any report of wasting of the muscles requires circumferential measurements of both thighs and lower legs, at a stated point above and below the knee given in inches or centimeters. Additionally, a report of muscle wasting should include measurement of the strength of the muscles in question generally based on a grading system of 0 to 5, with 0 being complete loss of strength and 5 being maximum strength.