Social Security Disability and Back Pain: The Importance of Remaining in Treatment with Specialists

Having practiced Social Security disability law throughout Maine, Massachusetts and New Hampshire over the course of the last 31 years, I can say that one of the most frequently discussed issues that arise when speaking with potential claimants and existing clients is whether they are in the right type of treatment given their particular condition.  That being said, many of those experiencing low back or neck difficulties who consequently remain disabled from working are at a loss as to available treatment options that remain available.

From a human standpoint, and not just from the standpoint of my work as a Social Security disability lawyer, I want to ensure that my clients are getting the help they need from a medical standpoint so as to not to mention a Social Security disability standpoint, it is always in one’s best interest to exhaust treatment avenues for getting better.  But that being said, 20 C.F.R. §404.1529 provides:

There must be objective evidence from an acceptable medical source that shows you have a medical impairment(s) which could reasonably be expected to produce the pain or other symptoms alleged and that, when considered with all of the other evidence (including statements about the intensity and persistence of your pain or other symptoms which may reasonably be accepted as consistent with the medical signs and laboratory findings), which lead to a conclusion that you are disabled.

And so if one is failing to exhaust treatment avenues, they are in essence doing both themselves and their case a disservice.  Without availing oneself of treatment options, one cannot be said to be doing everything possible to get better.  And by the same token, there will not be 1) the objective evidence necessary to show that a condition remains which would be expected to cause persistence of pain or other symptoms and 2) the treatment evidence making evident the complaints of continued pain or other symptoms.

With regard to treatment for persistent low back and/or cervical disk-related symptoms, including pain, many individuals are not aware of the many treatment options that remain available.  Many are rightly wary of taking opioid medication for fear of addiction issues.  And yet, there are medications such as neurolytics (gabapentin/name brand Neurontin, duloxetine/Cymbalta, pregabalin/Lyrica, Savella) which can provide substantial relief of nerve pain with no addiction issues.  Additional treatment modalities may include various forms of injection therapy that might include steroid injections or potentially nerve blocks, not to mention physical therapy, prescription of a TENS unit or implantation of a spinal cord stimulator.

What we make clear to our clients, however, is that pain management through specialist care and not simply their primary care physician is certainly both appropriate and essential if they believe their problems truly remain severe and disabling (and wish to argue so in support of a claim for long term disability benefits).   If recommended for a pain management evaluation for potential injection therapy and/or physical therapy or for one of a number of different treatment modality options, then at the very least one should be particularly interested in learning more about the different treatment options  available that might indeed make them better.  And, in keeping with this, the Social Security regulations, and, most recently, Social Security Ruling 18-3P, require that one follow prescribed treatment (that is, the recommendations of their doctor) .   This means exploring available treatment options: and that means, at the very least showing an interest in, and looking into, options that their providers might feel would assist them.  It is certainly understood that some treatment options may come with inherent risks or potential side effects to medications, for instance, which can be discussed with the specialist at the time so that a considered decision can be made as to whether to proceed with perhaps one option over another.

If you or someone you love has been long-term disabled from working and simply is at a loss where to turn next for either their treatment or for disability benefit assistance, suggest they call the Law Offices of Russell J. Goldsmith at 1-800-773-8622 for the guidance they need.

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