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Multi Level Fusion and disability

NaptownGirlNNaptownGirl Posts: 56
edited 06/11/2012 - 8:53 AM in Health Insurance Issues
Hello Spine-land! I had to return to work because my employer of 10years let me go. I needed 6 more weeks (probably more like 4) to recover and they fired me when FMLA ran out. Needless to say I needed to get some insurance. It was suggested that I apply for disability so that I could be turned down and then get state coverage. Is anyone actually receiving disability that has had multi-level fusion? I'm fused form T8-S1. Working, at first, wasn't too bad but now I'm exhausted and sore. I walk like the hunch-back of Notre Dame. Since I've gone off the meds I can't sleep and have terrible insomnia. Some mornings I'm so tired that the thought of just breathing wears me out. My brain says "get up, enjoy the day" and my body says "nope".

The paint management doctor was shocked that I take nothing for pain so now I'm back to 1 norco a day. I had several complications as a result from my first surgery and my family doctor says it is amazing that I still have a smile on my face. LOL. I almost feel like a wuss for even cosidering it.


  • Hi; and it made me sad reading your post.
    Have to applied for SSD in the past?
    1st thing is you need to be off work for 5 months before you will even be considered.
    Then you need the support and backing of all your doctor's, as they will have to send in their reports stating because of your condition you are unemployable.
    The older you are makes it easier to get approved, and your education and work history will also be considered.

    I know because i was approved for SSD, and i had a 2 level fusion, which now it appears 1 of the levels failed to fuse and i might need another surgery.

    Best of luck to ya.
    (hint) google search ultimiate disability secrets, and you will find alot of useful info.
  • I hate to do it, but I called one of those cheezy disability lawyers you see on TV. I was off work almost a year total. When I got turned down I took this job because of the health insurance. At the time I was on a blood thinner and needed checked every week.

    I'm only 36 and received my BS degree about 3 months before my first surgery. That is what I think hurt my chances. When I lost my job I realized, degree or not, it was hard finding a position that I qualified for physically. Most people are scared away by my medical history.

    It looks like I missed my 60 day window to appeal and will need to reapply. I've been told they can back date the claim. I don't want to quite my job with no back up plan. My hubby is still out of work and his unemployment runs out in June.
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  • definitely reapply.

    But unfortunally your age, and your education level are gonna hurt your approval.
    I understand exactly what your saying about needing to work, but the system is not always fair.

    Once someone has back surgery, employers treat them like they have the plaque. They will not risk the liabilties that come with a person with a history of back surgery.

    Good Luck
  • Well, the good thing is my LTD provider was very accomodating and I have 6 months to go back on to it if the doctor says I need to. Only bad thing is insurance doesn't come with LTD through a private carier.

    As you mentioned, with my age and education I think I am going to have to get a lawyer. I also made the mistake of not getting my doctors involved and will be sure to contact them next time.

    Thanks Jim! :-)
  • SpineAZSpineAZ WiscPosts: 1,084
    Does your employer offer STD and/or LTD. Even if you are fired you are still eligible for LTD if the employer offers it (eligibility is based on the date you became disabled and as long as that is prior to date of release from employment you are fine).

    Apply for SSDI as soon as possible to retain your right to apply. People sometimes wait too long thinking they'll get a job or won't be disabled too long, and then find out their SS credits have expired.

    Allsup and Binder&Binder are two of the most used, and very successful, SS firms.

    In order to be awarded SSDI you would need to be able to show that you have a significant impairment. And if that impairment involves chronic pain SS wants to see that you are in active Pain Management and complying with Pain Mgmt meds, treatments, etc. All of your doctors have to be supportive of pursuing SSDI.

    It's okay to pursue SSDI, possibly get awarded, and then if able to return to work in 1 yr or 10 yr you can return to work and then be eligible for SSDI again later in your working life if your are again unable to work.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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  • I was feeling pretty good when I initially went through the SSD process, but I realize now that I was coming off of a lot of meds. There was almost a euphoric feeling because I just came out of withdrawal and my pain was better...well, better compared to before surgery. Almost 6 mos later and I saw my family physician this week. He said he thought we would be having a conversation much sooner, about how I was feeling mentally. I love my family doc! He said he would support whatever I needed to do, as far as going on leave.

    I am not active in pain management because I lost my insurance when I lost my job. Now I have a pre-existing condition and my current employer won't cover it. It is very depressing. Between being a constant month behind on my mortgage, and now owing 2 years worth of state taxes, I can't possibly afford pain medicine, let along therapy. Loosing my job really put me in a hole.
  • i had a multi-level fusion and was approved for Canada Disability Pension (Federal) today ... so yes, you can get disability following a multi-level fusion.

    Good luck with whatever happens. keep is posted.
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778

    Having just gone through the gauntlet of SSD, I have grown to have a respect for the substantial methodology they employ in their determination.

    I will share the highlights with you:

    A. Common statements include: Do you have a Condition/Illness or disorder that will (or is expected to) last greater than one year.

    B. Does it impair your ability to perform ADL's (activities of daily living).

    Now for the heavy stuff: Applicable Law(s)(abridged)

    The Social Security Administration has established a 5 step sequential evaluation process for determination whether an individual is disabled. The steps are followed in order. If it is determined that the claimant is not disabled at a step of the evaluation process, the evaluation will not go to the next step.

    At step one the ALJ (Administrative Law Judge) must determine whether the claimant is engaging in substantial gainful activity (currently working) if he/she is.... then they are not disabled regardless of what their physical or mental limitations maybe. They will not proceed to step two.

    At step two, the ALJ must determine whether the claimant has a medically determinable impairment that is "severe" or a combination of impairments that is "severe" within the meaning of the regulations.
    (Significantly limits the ability to perform basic work activities). If the claimant does not have a "severe" or combination of "severe" medical impairments ... then they are not "disabled" and can not proceed to step three.

    At step three, the ALJ must determine whether the claimant impairment or condition or combination of impairment meet of exceed the criteria of impairments listed in 20 CFR part 404 Subpart P Appendix 1. If the impairment or combination of impairments meets or medically equals the criteria and meets the duration requirement then the claimant is disabled if it does not, the analysis proceeds to the next step.

    Before considering step four of the sequential evaluation process, the ALJ must first determine the claimant’s residual functional capacity. An individuals RFC is his/her ability to do physical and mental work on a sustained basis despite limitations from his/her impairments. In making this finding the ALJ must consider all of the claimant’s impairments, including those that are not severe. Next at step four the ALJ must determine whether the claimant has residual functional capacity to perform the requirements of his/her past relevant work. If the claimant has the residual functional capacity to do their past relevant work, the claimant is not disabled. If not then proceed to step 5.

    At the last step of the sequential evaluation process the ALJ must determine whether the claimant is able to do any of work considering his/her residual functional capacity considering age, education, and work experience. If the claimant is able to do other work, he/she is not disabled. Although the burden of proof of proving disability at this step, a limited burden of proof shifts to the SSA. The SSA (Social Security Administration is responsible for providing such evidence that work exists in significant numbers within the claimants RFC considering age, education, and work experience.

    The SSA may also bring in other criteria to be considered on a case by case basis to arrive at a final determination. In those cases the SSA must determine the extent that the other criteria are a factor in the determination of the above criteria and could use those factors to allow or disallow the determination of "disability".

    My case had 5 1/2 pages of determinations and justifications covering each of the 5 points ....After 16 months - 2 obligatory denials a date hearing was set. The ALJ finally got my case and gave me a fully favorable determination without an actual hearing. Interesting!?

    Power of prayer? (or I'm just a mess).

    I hope this summary helps - You may want to google or Bing - Disability Secrets for more information and tips.

    The govenment site is WWW.SocialSecurity.gov and has a ton of information. (as it should)

    As always ... Warmest Regards to all,


  • Funny thing, after 13years of being a paralegal I understood most of that! LOL. Well, that does help quite a bit. Thanks!

  • I'm sorry to answer this so many years late! But, for the benefit of any who read this years later, I will answer. I had a one level fusion at C5-6 about 15 yrs ago, then 2 yrs later, 3 artificial discs done in GY at C3-4, C4-5 and C6-7 - so in total, 4 levels surgically repaired. Tried working after that, but had to stop, which was heartbreaking to me, as I had my own business. Was told I'd never get SSDI. Was turned down twice, hired an attorney, went to court, within 5 minutes got two years full back pay and full SSDI benefits. So yes, it is possible, if your diagnostic tests, diagnoses and primary treating docs all confirm that you're in bad shape. The very most important thing is an excellent letter written by one of your primary treating docs (there's a specific type of form letter the judge is looking for - that lists a variety of things - if you can't find it online, PM me). This is THE most important thing you can do to win your case. The judge even told us this is more important than any report from a doc that they send you to, as your treating doc knows YOU. 

    Wish any of you reading this, the very best. 

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