May newsletter

June 2021


Harsh New Regulations
for Back Injury Claims

New, more challenging guidelines will increase the burden of claimants suffering from back pain, arthritis, fibromyalgia, and more.
back pain

In April, Social Security implemented revised Listing of Impairments for musculoskeletal impairments. These new guidelines are more challenging and will increase the burden of claimants suffering from back pain, arthritis, fibromyalgia, Reflex Sympathetic Dystrophy (RSD) and a variety of other physical disabilities.

To obtain disability benefits, a claimant must prove the existence of medical problems producing symptoms so severe that they preclude the ability to perform “substantial gainful activity” for a period that has lasted, or is expected to last, at least 12 months or result in death. The first step in determining eligibility is “Meeting or Equaling the Listings of Impairments.” These are medical criteria issued by Social Security for many different types of medical diagnoses – one of the most used focuses on musculoskeletal issues.

A main highlight of these changes is the addition of criteria describing functional limitations required to meet the Listing. Essentially, the Listing requires that to satisfy these Listings a claimant must prove:

The key point is that claimants not requiring a walker, wheelchair or two canes or crutches will have little likelihood of meeting these standards. The focus of most applications then shifts to proving eligibility at the other steps of SSA’s analytical process.

A claimant will need to provide consistent proof over time of chronic symptoms which preclude the ability to perform work on a sustained, 8 hour-per-day 5 day-per-week basis at even the sedentary level of exertion. This will entail careful charting by medical professionals and proper communication from the patient to the doctors and therapists.

The new rules apply to every case pending in the system. Even worse, SSA has ruled that these new harsher guidelines will be applied during Continuing Disability Reviews (CDR). This means that people undergoing a CDR with spine injuries who have been receiving benefits for years will have to satisfy these harsher standards to continue their eligibility.

 



FREE Training

Our dedication to the rights and needs of the disabled in our community means that we will continue to battle for our clients despite these harsher rules. We can do these trainings via Zoom or other electronic meeting platforms and, hopefully, in person in the near future.

If your agency or community group would like a free in-service on these new rules please give us a call.

Call or email today!

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