A Lumbar fusion is the surgical joining of two vertebrae in the lumbar spine, or lower back. The fusion of these vertebrae permanently stops movement between the vertebrae to help decrease pain and provide stability in the region. There are a number of different spine conditions that may qualify you for a lumbar fusion surgery including:
- Degenerative disc disease
- Fracture of a vertebrae
- Spinal stenosis, or narrowing of the spine
- Congenial back deformities
Typically, the lumbar fusion surgery requires several months of recovery. However, while you may be missing out on a few paychecks, do you qualify for disability benefits after the surgery?
Qualifying for Social Security Disability Benefits
While there are several ways to qualify for SSDI benefits, the easiest to earn approval for Social Security disability benefits is for your condition to meet a listing in the “blue book.” Unfortunately, lumbar fusion surgery itself is not a listed impairment, but the condition that causes the need for surgery may be covered. If you lumbar fusion surgery was unsuccessful, you may also qualify.
In the blue book under the Disorders of the Spine section you will find that the following back issues that may have required your lumbar fusion are covered:
- Spinal stenosis
- Degenerative disc disease
- Facet arthritis
- Vertebral fracture
- Nerve or spinal cord damage
However, you must also be able to demonstrate that you suffer from at least one of the following:
- Compression of the spinal nerve which results in pain, limited range of motion, muscle weakness, or sensory loss;
- Inflammation of the lumbar membranes that protect the nerves of the spinal cord, causing severe pain and sensitivity; or
- Narrowing of the spinal canal which causes chronic pain, weakness, and extreme limitation to walk
If you don’t necessarily have more than one or two of the above symptoms, it might be difficult to qualify. However, if you underwent a lumbar fusion and it failed to fix the problem, you may still be able to qualify.
I Don’t Qualify, What Now?
If your condition doesn’t fall under the impairments listed in the blue book, all hope is not lost. After deciding that you don’t meet the listing, you can have Social Security evaluate your condition to determine you Residual Functional Capacity (RFC). Your RFC basically determines you ability to perform work-related activities with your lumbar fusion and other back conditions. The main purpose of the test is to determine whether you can do sedentary, light, medium, or heavy work.
This test will determine whether you can go back to your prior job or if your company has a less demanding job you could do. While it won’t qualify you for full disability benefits, taking the RFC exam may qualify you for some benefits based on your remaining limitations that prevent you from doing your job.
So what does the RFC exam entail? It is basically a medical exam that requires a physical exam of your spine, range of motion tests, X-Rays, MRIs, and CT Scans that all prove your inability to return to regular work. Essentially, you want your doctor to attest to how long you can sit, how long you can stand, if you are able to bend or squat, and how much you can lift. These are all essentials to almost every job.
A lumbar fusion is a serious surgery and while it might not give you disability benefits, if the injury happened at work or even because of a lifetime on the job, you should at least qualify for workers’ compensation. If you need help navigating the twisted routes of workers’ comp and disability benefits, contact us today.