SSDI for Herniated Disc in Delaware

A herniated disc can be a devastating injury that makes it impossible to sit at a desk, stand on a factory floor, or perform the physical demands of virtually any job. When conservative treatment fails and surgery does not restore your ability to work, Social Security Disability Insurance (SSDI) may be the financial lifeline you need. Delaware residents filing for disability based on a herniated disc face the same federal evaluation process as applicants nationwide, but understanding how the Social Security Administration (SSA) assesses spinal conditions — and how to build the strongest possible claim — significantly improves your chances of approval.

How the SSA Evaluates Herniated Disc Claims

The SSA does not award benefits based on a diagnosis alone. A herniated disc on an MRI is not, by itself, enough to qualify for SSDI. What matters is how your condition limits your ability to function. The agency uses a five-step sequential evaluation process to determine whether your impairment prevents you from performing any substantial gainful activity (SGA).

Spinal disorders, including herniated discs, are evaluated under Listing 1.15 of the SSA's Blue Book — the official list of impairments that automatically qualify as disabling if certain criteria are met. To meet Listing 1.15, your medical records must document all of the following:

• Neuro-anatomic distribution of pain, muscle weakness, or sensory loss consistent with the affected nerve root or spinal cord
• Radiculopathy confirmed by nerve root compression on imaging (MRI or CT myelography)
• Findings on physical examination such as positive straight-leg raise, muscle atrophy, or diminished deep tendon reflexes
• A documented medical need for a walker, bilateral canes, bilateral crutches, or a wheeled or seated mobility device — OR an inability to use both hands for fine and gross manipulation

Meeting a Blue Book listing results in an automatic approval at step three of the evaluation. Most herniated disc claimants, however, do not meet this listing precisely and must instead win their case through a Residual Functional Capacity (RFC) assessment.

Winning with a Residual Functional Capacity Assessment

If your condition does not satisfy Listing 1.15, the SSA's disability examiner prepares an RFC — a detailed document describing the maximum work-related activities you can still perform despite your limitations. For herniated disc cases, the RFC typically addresses:

• How long you can sit, stand, or walk during an eight-hour workday
• How much weight you can lift and carry on an occasional versus frequent basis
• Whether you can bend, stoop, crouch, kneel, or climb stairs and ladders
• Whether you experience chronic pain that causes off-task time or would require unscheduled breaks
• Whether you need to alternate between sitting and standing throughout the day

A sedentary RFC — meaning you can only do desk work with minimal standing and lifting — does not automatically mean approval. The SSA will then determine whether jobs exist in significant numbers in the national economy that someone with your RFC, age, education, and work history could perform. This is where age becomes critical: Delaware applicants who are 50 years old or older benefit from the SSA's Medical-Vocational Guidelines (the "Grid Rules"), which favor approval for older workers with physical limitations who have done heavy or skilled manual labor their entire careers.

Medical Evidence That Strengthens Your Delaware Claim

The quality and consistency of your medical records can make or break an SSDI claim for a herniated disc. The SSA will request records from every treating provider listed on your application, including Delaware hospitals, spine specialists, pain management clinics, and physical therapists. Gaps in treatment — periods where you did not seek care — are frequently used to argue that your condition is not as severe as claimed.

To build a strong evidentiary record, focus on the following:

• Imaging studies: MRI is the gold standard. CT scans and myelography are also acceptable. Ensure your imaging reports specify the level of herniation (e.g., L4-L5, L5-S1, C5-C6) and describe nerve root compression, foraminal stenosis, or cord impingement in clinical terms.
• Neurological testing: EMG and nerve conduction studies that document radiculopathy objectively corroborate your subjective pain complaints and significantly strengthen your claim.
• Treating physician opinion: A detailed RFC questionnaire completed by your treating spine specialist or pain management doctor — explaining specifically what you can and cannot do — is among the most powerful evidence available. Under current SSA rules, the agency is required to articulate reasons if it does not follow your doctor's opinion.
• Consistent treatment records: Documented medication management, physical therapy, epidural steroid injections, and surgical history all demonstrate that your herniated disc is a serious, persistent condition rather than an acute injury.

Delaware residents have access to major healthcare systems including ChristianaCare and Beebe Healthcare. If you have been seen at a federally qualified health center or a University of Delaware–affiliated clinic, those records are equally valid and should be included.

The Delaware Disability Determination Process

Initial SSDI applications in Delaware are processed by the Delaware Disability Determination Service (DDS), a state agency that contracts with the Social Security Administration to make initial and reconsideration-level decisions. According to SSA data, initial denial rates for musculoskeletal conditions like herniated disc are high — nationally, fewer than one in three initial applications are approved.

If DDS denies your claim, you have 60 days to request reconsideration, and if denied again, another 60 days to request a hearing before an Administrative Law Judge (ALJ). ALJ hearings are held at the SSA's hearing office in Wilmington, Delaware. Statistically, claimants who appear at an ALJ hearing with legal representation are approved at significantly higher rates than those who appear without an attorney.

At your hearing, the ALJ will likely call a vocational expert (VE) to testify about what jobs — if any — someone with your specific limitations could perform. Your attorney can cross-examine the VE and pose alternative hypothetical scenarios that better reflect your actual functional restrictions. This questioning often determines the outcome of the hearing.

Common Mistakes That Lead to Denial

Many herniated disc claimants in Delaware make avoidable errors that result in unnecessary denials. The most common include:

• Inconsistent statements: Describing your condition differently to your doctor, to the SSA, and at your hearing raises credibility concerns. Be accurate and consistent in all communications.
• Failing to follow prescribed treatment: If your doctor recommends surgery or physical therapy and you decline without a documented medical reason, the SSA can use that refusal against you.
• Missing deadlines: The 60-day appeal window is strictly enforced. Missing it typically requires starting the entire application process over, losing any protective filing date you established.
• Applying without legal help: SSDI law is technical and procedurally demanding. Attorneys who handle disability cases work on contingency — meaning no fee unless you win — so there is rarely a financial barrier to getting representation.

A herniated disc that prevents you from working is a serious condition deserving serious legal attention. The right evidence, properly presented through the correct procedural channels, gives you the best chance of obtaining the monthly benefits and Medicare coverage you are entitled to under federal law.

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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