Failed Back Surgery Syndrome (FBSS) describes persistent or new pain experienced by individuals after spinal surgery, where the intended relief was not achieved. This condition can significantly impact a person’s physical abilities and overall quality of life.
Understanding Failed Back Surgery Syndrome
Failed Back Surgery Syndrome (FBSS) is a generalized term describing ongoing back or leg pain following one or more spinal surgeries, where the intended relief was not achieved. This pain can persist immediately after surgery or develop weeks, months, or even years later. It is not necessarily an indication of a technically failed surgery but rather that the desired patient outcome of pain reduction and improved function was not met.
Common symptoms of FBSS include chronic pain, which can manifest as dull, aching, sharp, or stabbing sensations in the back or legs. Patients often experience neuropathic pain, characterized by numbness, tingling, or a “pins and needles” feeling, resulting from nerve damage or irritation. Reduced mobility, muscle weakness, and difficulty with daily activities like sitting or standing for extended periods are also frequently reported.
Several factors can contribute to FBSS. These include incomplete decompression of a nerve, new spinal conditions, or increased stress on segments adjacent to the treated area, known as adjacent segment disease. Scar tissue formation around nerve roots, recurrent disc herniation, persistent pressure on a spinal nerve, incorrect initial diagnosis, or surgical complications like nerve damage can also play a role.
When FBSS Qualifies as a Disability
For Failed Back Surgery Syndrome to be recognized as a disability by the Social Security Administration (SSA), it must meet specific criteria. The SSA defines disability as the inability to engage in any “substantial gainful activity” (SGA) due to a medically determinable physical or mental impairment. This impairment must have lasted, or be expected to last, for a continuous period of at least 12 months, or result in death. The focus is on the individual’s functional limitations and their impact on the ability to work.
While chronic pain, a hallmark of FBSS, is not specifically listed as a qualifying disability in the SSA’s “Blue Book” (Listing of Impairments), it can be considered if it stems from an underlying medical condition recognized by the SSA. FBSS often falls under musculoskeletal disorders, detailed in Section 1.00 of the Blue Book. This section focuses on how the disorder affects a person’s ability to move, perform tasks, and sustain work-related activities.
Individuals with FBSS might experience restricted range of motion, difficulty walking or standing for extended periods, and an inability to sit comfortably for long durations. These limitations can affect the capacity to perform basic work activities such as lifting, carrying, bending, or maintaining a consistent work presence.
If FBSS leads to nerve root compression, muscle weakness, or sensory deficits, it can align with the criteria for spinal abnormalities under the musculoskeletal listings. The impact of the condition on a person’s functional capacity determines whether it meets the SSA’s definition of a disabling impairment.
The Disability Application Process
Navigating the disability application process for conditions like Failed Back Surgery Syndrome involves several distinct steps, beginning with the initial application. This phase requires detailed information about your medical condition, work history, and how symptoms impact daily life. Providing comprehensive and accurate information from the outset is important for a successful claim.
If the initial claim is denied, applicants can request a reconsideration. This involves a new review by a different examiner, often with additional medical evidence. Many initial claims are denied, making reconsideration a common part of the process.
If reconsideration is also denied, the next step is typically a hearing before an Administrative Law Judge (ALJ). This stage allows the applicant, often with legal representation, to present their case directly, offer testimony, and have medical records and functional limitations thoroughly reviewed.
Comprehensive medical evidence is fundamental throughout the application process. This includes diagnostic tests like MRI and CT scans, which can reveal structural issues such as nerve compression, scar tissue, or recurrent disc herniation. Detailed physician notes, surgical reports, physical therapy records, and a complete list of all medications and treatments received are also crucial. These documents provide objective evidence of the diagnosis, severity, and ongoing nature of FBSS.
It is important to document how FBSS affects daily activities. This can include limitations in personal care, household chores, social interactions, and any difficulties with sitting, standing, walking, or lifting.
Strengthening Your Disability Claim
A strong disability claim for Failed Back Surgery Syndrome hinges on the quality and consistency of the evidence presented. Objective medical evidence is paramount and includes diagnostic imaging such as MRIs, CT scans, and X-rays that can reveal underlying issues like nerve root compression, disc problems, or hardware complications. Nerve conduction studies and electromyography (EMG) can further document nerve damage or dysfunction related to pain.
Consistent medical treatment history also provides compelling support for a claim. Regular doctor visits, adherence to prescribed medications, and participation in recommended therapies, such as physical therapy, demonstrate the ongoing nature and severity of the condition. Gaps in treatment can suggest improvement or a lack of commitment to managing the condition, potentially weakening the claim. Medical records should accurately reflect all symptoms, treatments, and their effectiveness.
A crucial component of a disability claim is the Residual Functional Capacity (RFC) assessment. This evaluation details what physical and mental activities an individual can still perform despite their impairments. For FBSS, this might include limitations on how long one can sit, stand, walk, lift, carry, or engage in fine motor skills. The RFC also considers non-exertional limitations like pain, fatigue, or cognitive issues that might arise from chronic pain and medication.
Vocational factors, including age, education, and past work experience, also play a significant role in the Social Security Administration’s decision-making process. If an individual’s RFC prevents them from performing their past work, the SSA considers whether they can adjust to other work, taking these vocational factors into account. For older claimants, particularly those over 50, these factors can be influential in determining disability under the SSA’s Medical-Vocational Guidelines, often referred to as “the grids.”
Detailed and specific notes from treating physicians are invaluable. These notes should thoroughly describe the patient’s functional limitations, pain levels, and how FBSS impacts their ability to perform work-related tasks and daily activities. Doctors can provide specific measurements of range of motion, muscle strength, and sensory deficits, offering concrete evidence to substantiate the claim.