Herniated Disc & SSDI: Vermont Disability Guide

A herniated disc can be far more than temporary back pain. For many Vermont residents, the condition progresses into a debilitating, chronic impairment that makes sustained employment impossible. The Social Security Administration (SSA) does recognize herniated disc conditions as potentially qualifying disabilities — but approval is not automatic. Understanding how the evaluation process works, and how Vermont claimants can build the strongest possible case, is essential before filing.

Can a Herniated Disc Qualify You for SSDI?

The short answer is yes — but with important qualifications. The SSA does not approve disability claims based on a diagnosis alone. What matters is how severely the condition limits your ability to perform substantial gainful activity (SGA). In 2026, that threshold is $1,550 per month for non-blind individuals. If your herniated disc prevents you from working at or above that level, and the impairment has lasted — or is expected to last — at least 12 continuous months, you may meet the basic eligibility criteria.

Herniated discs are evaluated under the SSA's Blue Book Listing 1.15, which covers disorders of the skeletal spine resulting in compromise of a nerve root. To meet this listing, medical evidence must show compromise of a nerve root with specific clinical findings, including radiculopathy, neurological deficits, or spinal arachnoiditis. If your condition meets this listing, approval may come without needing to go through a full vocational analysis.

What Medical Evidence the SSA Requires

Documentation is the foundation of every successful SSDI claim for a herniated disc. Vermont claimants should work closely with their treating physicians to ensure the medical record contains the following:

• Imaging studies: MRI or CT scans clearly identifying the location and severity of disc herniation, nerve impingement, or spinal canal stenosis
• Neurological examination findings: Documented reflex loss, muscle weakness, sensory deficits, or positive straight-leg raise tests
• Treatment history: Records of physical therapy, epidural steroid injections, pain management, or surgical intervention
• Functional assessments: A Residual Functional Capacity (RFC) form completed by your treating physician describing what you can and cannot do physically
• Consistent complaints: A longitudinal history of reported pain, limited range of motion, and functional decline across multiple appointments

Vermont's rural geography presents a practical challenge here. Residents in counties like Essex, Orleans, or Caledonia may face longer travel distances to specialists and diagnostic facilities. Document any barriers to treatment, as the SSA is required to consider the totality of your situation.

The Five-Step Sequential Evaluation Process

When the SSA evaluates your claim, it applies a five-step sequential analysis. Understanding each step helps Vermont claimants anticipate where cases often break down:

• Step 1 – Are you working? If you are earning above the SGA limit, your claim will be denied at this stage.
• Step 2 – Is your condition severe? Your herniated disc must significantly limit your ability to perform basic work activities.
• Step 3 – Does your condition meet a Blue Book listing? If so, you may be approved automatically without proceeding further.
• Step 4 – Can you perform past relevant work? The SSA will assess whether your RFC allows you to return to any jobs you held in the past 15 years.
• Step 5 – Can you perform any other work? If you cannot do past work, the SSA considers your age, education, work history, and RFC to determine whether any other jobs exist in the national economy that you can perform.

Many herniated disc claims that don't meet a Blue Book listing are still approved at Step 5, particularly for claimants who are older, have limited education, or whose prior work was entirely physical in nature.

Vermont-Specific Considerations for Your Claim

Vermont processes SSDI claims through the federal system, but the state's Disability Determination Services (DDS) office in Waterbury handles initial determinations and reconsiderations. Vermont's approval rates at the initial application stage tend to mirror national averages — meaning a significant percentage of valid claims are denied on first submission and require appeal.

If your initial application is denied, you have 60 days plus a 5-day mailing grace period to request reconsideration. If reconsideration is also denied, you can request a hearing before an Administrative Law Judge (ALJ). ALJ hearings represent the stage at which most successful appeals are won, and having legal representation at that point substantially improves outcomes.

Vermont's vocational rehabilitation services, offered through the Division of Vocational Rehabilitation (DVR), may also interact with your SSDI claim. Participating in a vocational rehabilitation program does not automatically disqualify you from benefits, and in some cases, cooperation with DVR can actually support your claim by demonstrating documented work barriers.

Why Many Herniated Disc Claims Are Denied — And What to Do

The SSA denies a large share of herniated disc applications for predictable reasons. Recognizing these pitfalls early gives Vermont claimants the opportunity to correct them before or during the appeals process.

Gaps in medical treatment are one of the most common problems. If you stopped seeing a doctor because of cost, lack of transportation, or the assumption that nothing more could be done, the SSA may interpret that gap as evidence that your condition isn't as serious as claimed. Vermont residents who have difficulty affording care may qualify for the state's Medicaid program (Green Mountain Care), which can help maintain the continuity of treatment records critical to your claim.

Inadequate physician support is another frequent obstacle. Some treating physicians complete RFC forms that are vague or inconsistent with their own clinical notes. A well-documented, specific RFC from your doctor — one that addresses your ability to sit, stand, walk, lift, and concentrate — carries significant weight in the evaluation.

Failure to follow prescribed treatment can also result in denial. If you have been advised to undergo surgery or other interventions and have declined without documented medical justification, the SSA may deny benefits. However, fear of surgery alone is generally not considered valid justification — consult with your attorney before refusing recommended treatment.

If your claim has been denied, do not give up. Statistically, claimants who appeal — particularly those who request an ALJ hearing — have meaningfully better outcomes than those who simply refile a new application from scratch. Each new application restarts the process and can result in the loss of retroactive benefits tied to your original application date.

The backpay associated with a successful SSDI claim can be substantial. Benefits are calculated from your established onset date, subject to a five-month waiting period. For Vermont residents who have been unable to work for a year or more, retroactive awards can amount to tens of thousands of dollars.

Need Help? If you have questions about your case, call or text 833-657-4812 for a free consultation with an experienced attorney.

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