Understanding Social Security Disability Eligibility

To qualify for SSDI or SSI, you must meet the SSA's strict eligibility criteria:

• SSDI: You need to have a sufficient work history and have paid into Social Security for a certain number of years. Generally, you need to have worked for at least 5 out of the last 10 years before your disability started.
• SSI: SSI benefits are based on financial need, and you do not need to have a work history to qualify, but you must have limited income and resources.

In both cases, your back condition must prevent you from performing substantial work for at least 12 months or be expected to result in death.

Meeting the SSA’s Criteria for Back Conditions

Back surgery itself may not automatically qualify you for Social Security Disability, but the complications or the long-term effects from the surgery can. The SSA evaluates back conditions (including after surgery) based on the Listing of Impairments in the Blue Book.

Back problems can qualify if they result in severe limitations. The SSA looks at the following factors:

• Spinal disorders: The SSA recognizes certain spinal disorders that could qualify for disability, such as:
• Degenerative disc disease or herniated discs
• Spondylolisthesis (when a vertebra slips out of place)
• Spinal stenosis (narrowing of the spinal canal)
• Failed back surgery syndrome (pain or complications after surgery)
• Severity of your condition: The SSA will look at the severity of your symptoms, including:
• Pain: Chronic back pain that prevents you from sitting, standing, or walking for long periods.
• Loss of function: If the surgery results in reduced mobility, such as difficulty bending, lifting, or walking, this could affect your ability to work.

For SSDI approval, your back condition must result in severe restrictions to your ability to perform basic tasks, such as standing, sitting, or walking for prolonged periods, lifting or carrying objects, or maintaining a work schedule.

The Role of Medical Evidence

To have your claim approved, it’s crucial to provide strong medical evidence showing how your back surgery and resulting condition limit your ability to work. This includes:

• Detailed medical records from your doctor, surgeon, or any specialists involved in your care.
• Surgical reports: Include any details about your back surgery, such as the procedure, the outcome, and any complications you’ve had.
• Post-surgery care: Documentation of your recovery and any ongoing treatment or therapy, including physical therapy, pain management, or follow-up visits.
• Medical tests: Include results from MRI scans, CT scans, or X-rays that show the extent of the injury or the failure of the surgery.
• Doctor’s opinion: A statement from your treating physician explaining how your back condition limits your ability to work can be very helpful. They should describe the nature of your condition and how it impacts your daily activities.

Applying for Social Security Disability for Back Surgery in Colorado

Once you’ve determined that your condition meets the SSA’s criteria, you can apply for SSDI or SSI benefits. Here's how:

• Online Application: The easiest way to apply is through the SSA’s website at www.ssa.gov. You can apply online for SSDI and SSI, and the process is straightforward.
• Phone or In-Person Application: If you prefer, you can apply over the phone by calling the SSA at 1-800-772-1213, or you can visit your local SSA office in Colorado. You can use the SSA office locator tool to find the nearest office.

Make sure to submit all medical documentation that supports your claim and accurately describes how your back condition limits your ability to work.

The Disability Evaluation Process

The SSA evaluates claims using a five-step process:

• Step 1: Substantial Gainful Activity (SGA): If you’re working and earning above a certain amount, you may not qualify. For 2025, the SGA limit is $1,470 per month ($2,460 for blind individuals).
• Step 2: Severe Condition: The SSA will determine if your back condition is severe enough to limit basic work activities.
• Step 3: Listed Impairment: If your back condition is listed in the SSA’s Blue Book, or if it is equal in severity to one of the listed conditions, you may automatically qualify.
• Step 4: Past Work: The SSA will consider whether you can perform any of your previous jobs despite your condition.
• Step 5: Other Work: If you can’t do your previous job, the SSA will evaluate whether you can do any other type of work based on your skills, education, and age.

What to Do if Your Claim is Denied

Many initial Social Security Disability claims are denied, even for valid cases. If your claim is denied, you have the right to appeal. The appeal process involves the following steps:

• Request Reconsideration: The SSA will review your case again to see if any new information can change the decision.
• Request a Hearing: If your reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is an opportunity for you to present your case in person and submit additional evidence.
• Appeals Council: If the ALJ denies your claim, you can request a review by the Appeals Council, which can take additional time.