Rounded Back SSDI

Massachusetts Disability Lawyer Outlines How Severe Kyphosis Sufferers May Qualify to Receive SSDI Benefits

The prospect of applying for Social Security Disability Insurance (SSDI) can seem daunting. Uncertainty concerning the eligibility of certain medical conditions can leave many applicants feeling confused and overwhelmed. Characterized by an excessive rounding of the upper back, severe kyphosis may qualify for disability benefits in some cases, but approval is hardly guaranteed. The legal professionals at Keefe Disability Law provide valuable support and guidance to clients applying for SSDI for severe kyphosis. We can help build the strongest application possible for your SSDI claim. 

The Basics of Kyphosis Explained

The human spine has a natural curvature to it. An excessive rounding of the upper back characterizes a medical condition called kyphosis. A person with kyphosis presents with an abnormal “hunchback” or “humpback” appearance, often with their head and neck pushed further forward than normal. People with kyphosis can develop chronic back pain over time due to poorly conditioned muscles. 

Doctors most commonly diagnose kyphosis with physical examinations and X-rays. A normal, healthy spine may curve 20 to 45 degrees in the upper back. The spine of someone with kyphosis curves 50 degrees or more. Kyphosis can range from mild to severe, with varying levels of discomfort and disability, including neck pain

Spinal deformities related to kyphosis include lordosis and scoliosis. Lordosis is characterized by an excessive forward arch in the lower back. Scoliosis refers to a sideways S-shaped or C-shaped curve in the spine. 

Types of Kyphosis

Kyphosis is categorized into five main types.

  1. Postural kyphosis develops from consistently poor posture, slouching, or osteoporosis. It may improve with exercise and lifestyle changes. 
  2. Congenital kyphosis is present at birth and can worsen as the child gets older. It may be corrected with surgery and is sometimes comorbid with cerebral palsy. 
  3. Metabolic kyphosis, also called nutritional kyphosis, develops from disorders affecting the body’s ability to process bone-strengthening minerals. Fragile bones can fracture, compress, or collapse. 
  4. Post-traumatic kyphosis results from acute injuries like severe falls or car accidents. Fractured vertebrae can cause the spine to curve.
  5. Scheuermann’s kyphosis features trapezoid or wedge-shaped vertebrae, indents in the bone causing Schmorl’s nodes, and a hunchback position of the spine. 

Kyphosis Signs, Symptoms, and Risk Factors

The most obvious sign of kyphosis is the presence of a “hunched back.” The curvature of the upper back is abnormally exaggerated, exceeding a curve of 50 degrees. When standing, the head may bend forward more than usual. If the kyphosis is not visually apparent when standing up straight, you may notice that the upper back is higher than normal when the person bends forward. 

Other kyphosis symptoms may include:

  • Chronic neck and back pain and stiffness
  • Mobility issues, including difficulties walking, standing, or sitting
  • Weakened muscles from lack of activity
  • Bone loss or abnormally shaped vertebrae
  • Reduced flexibility in movements involving the back and shoulders
  • Differences in shoulder blade height or position
  • Tightness in the hamstring muscles at the back of the thighs
  • Visibly poor posture or “slouching”

One of the most common causes of kyphosis, much like stenosis, is the natural aging process. Specifically, older individuals with osteoporosis may develop kyphosis due to lower bone density and weakened muscles. Kyphosis may also be congenital, inherited from a family history of spinal deformities and conditions. Acute spine injuries and spinal infections may also cause forms of kyphosis. 

Severe Kyphosis Can Affect Substantial Gainful Employment

Mild forms of kyphosis may be treatable. In some cases, over-the-counter (OTC) medication like ibuprofen may be enough to overcome occasional bouts of minor back pain. Physiotherapy treatments like the Schroth Method can further reduce symptoms. If the applicant or workplace can make suitable accommodations and the person can work, they would not qualify to receive disability benefits. Sometimes, ergonomic workplace changes can be enough. 

To be eligible for SSDI, applicants must prove that their kyphosis is severe enough to prevent them from participating in substantial gainful activity (SGA). There must be an objective basis for these claimed restrictions. They must have been unable to work due to their medical condition for at least 12 months, or the condition must be expected to result in death. Severe chronic pain and significant impaired mobility may prevent someone from working some jobs but not others.

The Social Security Administration (SSA) mentions kyphosis in its Program Operations Manual System (POMS). Subsection L of Section 1.00 (Musculoskeletal System) lists abnormal curvatures of the spine, including scoliosis, kyphosis, and kyphoscoliosis. The SSA recognizes these conditions can “result in impaired ambulation.” They “may also adversely affect functioning in body systems other than the musculoskeletal system.” 

How to Qualify for Disability Benefits With Kyphosis

Despite recognizing and naming kyphosis its POMS, the SSA does not include kyphosis in its Blue Book of qualifying conditions. Without specific named criteria and with a broad range of severity, it can be difficult to qualify for SSDI for kyphosis alone. 

Back pain is one of the most commonly cited causes of disability, but proving this level of disability to the SSA is a different matter altogether. Hiring an experienced disability lawyer can help improve your chances of getting SSDI approval. We can assess your case, collecting the vital evidence you need for a successful application. This includes exploring different avenues to prove you are disabled and should qualify for disability benefits. 

Meeting or Equaling a Blue Book Listing

Since the SSA does not include a Blue Book listing for kyphosis, applicants must equal a listing to qualify for SSDI. This means you must demonstrate that your level of impairment is of equivalent “medical value” as the requirements set out for an existing Blue Book listing. Your condition must be medically equivalent in its level of disability. 

The musculoskeletal conditions in Blue Book Section 1.00 may be a good place to start. For example, Section 1.15 describes “disorders of the skeletal spine resulting in compromise of a nerve root(s). Depending on the exact symptoms you are experiencing, other Blue Book listings may be more relevant.

Activities of Daily Living Questionnaire

An important component of a successful SSDI application is the Activities of Daily Living (ADL) form. While technically voluntary and optional, the ADL form can offer compelling evidence in support of your disability claim. Failing to include an ADL form may result in the SSA denying your claim. 

The ADL questionnaire asks questions about how your limitations affect a regular day. It looks at your ability to complete daily chores and how your disability may impact your ability to perform them. Physical symptoms can impact your psychological and emotional well-being, too. Your ability to complete daily living tasks reflects your ability to maintain full-time employment. 

Residual Functional Capacity Assessment

Similar to the Activities of Daily Living (ADL) form, a Residual Functional Capacity (RFC) assessment describes an applicant’s ability to perform daily tasks. To complete this form, a doctor evaluates a patient’s medical limitations and capacities relating to occupational demands. 

Even if the SSA excludes severe kyphosis from its Blue Book listings of qualifying conditions, a compelling RFC form can help to demonstrate the extent of disability experienced by the applicant. It would describe how much weight you can carry, how far you can walk, how long you can maintain a standing position, your ability to bend and lift, and so on. 

Possible Comorbidities to Strengthen Your SSDI Application

It is a misconception that applicants must qualify for SSDI based on a single medical condition. The SSA considers the big picture, recognizing the combined impact that secondary conditions may have on an applicant’s ability to work. 

Severe kyphosis can negatively impact other body systems beyond the excessive curvature of the upper spine. As a result, common comorbidities can affect a person’s breathing, myocardial function, and intestinal movement. They may experience heart, nerve, and digestion problems. Sections 4.00 and 5.00 of the SSA Blue Book outline cardiovascular and digestive conditions, respectively. 

Applying for SSDI With Skilled Legal Help

Whether you’re applying for the first time and you’ve been denied Social Security disability benefits for back pain, asking an experienced SSDI lawyer can help tremendously with the viability of your claim. The SSDI application process can be complex and nuanced, filled with significant forms and paperwork.

The skilled SSD lawyers at Keefe Disability Law can help you throughout the application process. We will help you collect the necessary medical evidence to back up your claim, including suggestions for laboratory tests and doctor’s notes. The SSA requires objective evidence to support your subjective complaints of pain. Other helpful documentation includes full copies of your medical records, medical imaging results, your personnel file at work, an official copy of your job description, and a personal pain journal. 

Avoid common mistakes and ensure your SSDI application is accurate and complete. Let our experienced disability attorneys in Massachusetts guide you through every step of the way. 

Patrick Hartwig
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Managing Attorney, Keefe Disability Law
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