Adjacent Segment Disease (ASD) is a complex spinal condition that develops following a previous spinal fusion surgery, a procedure designed to permanently connect two or more vertebrae. Many individuals living with ASD question whether the resulting pain and functional limitations qualify as a disability. Qualification depends less on the diagnosis itself and more on how the condition limits a person’s ability to perform routine activities and maintain gainful employment.
What Adjacent Segment Disease Is
Adjacent Segment Disease is a degenerative process occurring at the vertebral levels directly above or below a surgically fused segment. When one section of the spine is locked together, the adjacent segments must compensate for the loss of motion, significantly increasing mechanical stress on the intervertebral discs and facet joints. This accelerated stress causes the adjacent segments to degenerate faster than normal, manifesting as new bone spurs, herniated discs, spinal stenosis, or facet arthritis. These resulting conditions can compress the nerve roots or spinal cord, leading to ASD symptoms. Common symptoms include localized pain in the neck or back, pain radiating into the arms (radiculopathy) or legs, numbness, tingling, and muscle weakness.
How Disability is Legally Defined
In the United States, disability status is established by the Social Security Administration (SSA) under Title II (SSDI) and Title XVI (SSI). A diagnosis alone is not sufficient to qualify for benefits; the primary requirement is that the individual must be unable to engage in Substantial Gainful Activity (SGA) due to a medically determinable impairment. SGA is defined as earning above a certain monthly amount. This impairment must have lasted, or be expected to last, for a continuous period of at least 12 months or be expected to result in death. The SSA uses a five-step sequential evaluation process to assess the applicant’s work activity, the severity of the medical condition, and their ability to perform past or other work.
Meeting Disability Criteria with ASD
Adjacent Segment Disease is not listed as a separate impairment in the SSA’s Blue Book, but it is evaluated under Listing 1.15 for disorders of the skeletal spine resulting in nerve root compromise. To qualify, the applicant must demonstrate objective evidence of nerve root or spinal cord involvement, showing degeneration caused by ASD that results in specific neurological deficits. Meeting Listing 1.15 requires medical evidence showing a neuro-anatomic distribution of pain, muscle weakness, and sensory loss. Crucially, this must be accompanied by extreme functional limitations in either the ability to ambulate effectively or the ability to use the upper extremities for fine and gross motor movements. An inability to ambulate effectively means a documented need for bilateral assistive devices or a wheeled mobility device.
Necessary Medical Evidence
To successfully claim disability based on Adjacent Segment Disease, the application must be supported by comprehensive objective medical evidence. This documentation must be longitudinal, showing the severity and duration of the condition over time, and must come from acceptable medical sources, such as licensed physicians. Imaging results (MRIs, CT scans, or X-rays) are necessary to demonstrate structural changes like spinal stenosis or disc degeneration, and operative reports from the initial fusion and subsequent ASD procedures must be included. Detailed physician notes are required, describing specific functional restrictions, such as measured limitations in range of motion, motor loss, and sensory deficits. Evidence of consistent treatment failure (e.g., unsuccessful physical therapy or injections) helps establish chronicity, and a Residual Functional Capacity (RFC) assessment is highly important to describe the maximum work-related activity the applicant can still perform.