Facet arthropathy (FA) is a common degenerative condition affecting the small joints in the spine. While sometimes referred to as facet arthritis, the condition is not automatically considered a disability by the Social Security Administration (SSA). Qualification depends entirely on the severity of symptoms and the extent to which they prevent a person from performing basic work functions. To qualify, an applicant must demonstrate that their condition is expected to last for at least 12 months and prevents them from engaging in Substantial Gainful Activity (SGA).
Defining Facet Arthropathy and Its Symptoms
The facet joints are located on the back of the spine at every vertebral level, providing stability and controlling the spine’s movement. Facet arthropathy is a form of osteoarthritis that develops when the protective cartilage on these joints deteriorates. This cartilage breakdown causes friction, pain, and the possible formation of bone spurs, also known as osteophytes.
The pain associated with this condition is typically localized to the spine, such as the low back (lumbar region) or neck (cervical region). Unlike the pain from a herniated disc, FA pain is often a dull ache that can worsen with specific movements. Activities that compress the facet joints, such as standing, twisting, or bending backward, tend to exacerbate the discomfort.
Symptoms frequently include morning stiffness, muscle spasms, and reduced flexibility in the spine. If degeneration or bone spurs significantly enlarge the joint, they can encroach upon the space where nerve roots exit the spinal column. This nerve root compromise can then lead to referred pain, numbness, or tingling that travels to the legs, buttocks, or shoulders, depending on the affected joint’s location.
Meeting the Strict Medical Listings for Spinal Disorders
The SSA’s Blue Book outlines specific medical criteria, known as “listings,” for various impairments that are severe enough to warrant automatic disability approval. Facet arthropathy is covered under Listing 1.04 for Disorders of the Spine, but meeting this listing is highly challenging. A diagnosis of FA alone is insufficient to satisfy the listing’s stringent requirements.
To meet Listing 1.04, the condition must cause specific objective findings that demonstrate severe nerve involvement or spinal cord damage. This requires evidence of nerve root compression resulting in measurable motor loss, such as muscle weakness or atrophy, accompanied by sensory or reflex loss. The documentation must also show a neuro-anatomic distribution of pain, meaning the symptoms follow the path of a specific nerve.
Alternatively, the listing can be met if the condition has progressed to cause spinal arachnoiditis, confirmed by imaging or surgical report. Another path involves severe lumbar spinal stenosis resulting in pseudoclaudication, which is non-radicular pain and weakness that prevents the person from ambulating effectively. Since FA often presents primarily as localized pain and stiffness without these extreme neurological deficits, most applicants do not meet the criteria of this listing.
Establishing Work Limitations Through Functional Capacity
Because few claims meet the strict requirements of a medical listing, most successful disability applications for facet arthropathy rely on the assessment of Residual Functional Capacity (RFC). The RFC is the SSA’s determination of the maximum amount of work-related activity a claimant can still perform despite their medically determined impairments. This assessment considers all physical and mental limitations caused by the condition, including pain.
For a person with FA, the RFC determination focuses on how the spinal condition limits their ability to sit, stand, walk, lift, and carry. The pain often associated with FA can make it impossible for a person to sit or stand for the prolonged periods required in a standard workday. The need to frequently shift positions, or to take unscheduled breaks to lie down, would be a significant physical restriction noted in the RFC.
Objective medical evidence must support the subjective complaints of pain and stiffness, detailing how the limitations translate to a reduced capacity for work. If the SSA determines that the claimant’s RFC prevents them from performing any of their past relevant work, the agency then considers the person’s age, education, and transferable skills. If the combined limitations and vocational factors show the person cannot adjust to any other type of work that exists in the national economy, they will be found disabled.
Necessary Medical Evidence for a Successful Claim
A successful claim for disability benefits based on facet arthropathy depends on presenting a comprehensive and objective medical record to the SSA. The evidence package must include diagnostic imaging, such as X-rays, Magnetic Resonance Imaging (MRI), or Computed Tomography (CT) scans, clearly showing the degenerative changes and bone spur formation in the facet joints. These images provide objective confirmation of the medical impairment.
The records must also document the full history of treatment, including medications, physical therapy, and facet joint injections. The detailed response to these treatments helps establish the chronic severity of the condition, especially if there is a lack of improvement or continued need for ongoing medical intervention. Neurological examination findings showing any motor, sensory, or reflex loss are necessary to assess potential nerve root compromise.
The most impactful evidence is often a detailed statement or questionnaire completed by the treating physician. This documentation must provide specific, quantifiable functional restrictions, moving beyond simply diagnosing the condition. The physician should explicitly state limitations, such as the maximum amount of weight the patient can lift, the length of time they can sit or stand, and the frequency with which they need to change position.