Disability for Central Cord Syndrome

Central Cord Syndrome and SSDI/SSI
By Kimberly BishopSeptember 24, 2023

This post discusses Social Security Disability Benefits for Central Cord Syndrome. If you or someone you care for is unable to work due to spinal cord injury read on for how Social Security will evaluate your claim for disability.

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Types of Social Security Disability Benefits

The first step is to apply for benefits online or at your local SSA office. If you are unable to work due to your Central Cord Syndrome apply for SSI and/or SSDI benefits as soon as possible. Delay may cause you to lose benefits!

SSA offers two types of benefits for disability claimants: Social Security Disability Insurance Benefits (SSDI) and Supplemental Security Income (SSI). SSDI is based on the credits from the work you have done in your life while SSI is a need based program.

Also watch: Who can apply for Social Security Disability?

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You also must be found disabled under SSA’s Five Step Sequential Evaluation before you are entitled to either benefit.

  1. Step 1 – Are You Working?  The Social Security Administration defines work as “Substantial Gainful Activity” (SGA). SGA is roughly defined as work from earnings that average more than $1,470 (2023) a month. If you are making that amount you generally will not qualify for disability.
  2. Step 2 – Is Your Condition “Severe”? Severity is key when it comes to what qualifies as a disability. Severe is defined by the Social Security Administration as: your condition must interfere with basic work-related activities for your claim to be considered.
  3. Step 3 – Is Your Condition on the List of Disabling Conditions? The Listings are very hard to meet in most cases and not always interpreted as a common reading would suggest. If you meet a listing you are gravely ill. The listings are found here.
  4. Step 4 – Can You Do the Work You Did Previously? The Social Security Administration will look at your past work and determine if it was sedentary, light, medium, or heavy. They also will evaluate the skill level: unskilled, semi-skilled and skilled. For instance, an attorney would be sedentary skilled work. The Dictionary of Occupational Titles is found here.
  5. Step 5 – Can You Do Any Other Type of Work? If the Social Security Administration finds that you cannot do what you used to do, they then look to see if you can do anything else. This is where the “grids” come into play. The grids are the Medical-Vocational Guidelines. The grids are only for exertional impairments. Non-exertional impairments are not considered by the grids. If you are found to be capable of any other work, you will be found not disabled. Read The Grids and Your Social Security Disability Case.

What is Central Cord Syndrome?

According to NIH, Central Cord Syndrome is the most common form of incomplete spinal cord injury characterized by impairment in the arms and hands and to a lesser extent in the legs. The brain's ability to send and receive signals to and from parts of the body below the site of injury is reduced but not entirely blocked. This syndrome is associated with damage to the large nerve fibers that carry information directly from the cerebral cortex to the spinal cord.

Central Cord Syndrome can be caused by trauma to the neck (car accidents are an prime example) or from herniated cervical discs. In addition, as we age, the spine weakens which can narrow the spinal column and lead to spinal cord compression. This compression (or trauma) can result in nerve damage.

The extent of the nerve damage determines the extent of loss of function. There can be total loss of function in the hands, arms and legs. However, many people with this form of spinal cord injury recover use of their legs but not that of the arms and hands.

Men tend to be more affected by Central Cord Syndrome and younger individuals generally seem to recover better (Via AANS).

Diagnosing Central Cord Syndrome involves testing neurological functioning through an EMG (nerve conduction study), MRI, CT scan or x-rays. Treatment depends on severity of the condition. A cervical collar, physical therapy, occupational therapy, surgery are all options. (Via WebMD).

How will SSA evaluate my claim for disability based on Central Cord Syndrome?

The first question to be asked is: how severe are your symptoms? Quick recovery may eliminate a claim for disability benefits due to the duration requirement. But if recovery is slow (or non-existent) you may win your Social Security Disability cases in one of three ways.

At the above STEP 3, The Social Security Administration can evaluate your case under Listing 1.15 Disorders of the skeletal spine resulting in compromise of a nerve root :

1.15 Disorders of the skeletal spine resulting in compromise of a nerve root(s)

A. Neuro-anatomic (radicular) distribution of one or more of the following symptoms consistent with compromise of the affected nerve root(s):

1. Pain; or

2. Paresthesia; or

3. Muscle fatigue.

AND

B. Radicular distribution of neurological signs present during physical examination (see 1.00C2) or on a diagnostic test (see 1.00C3) and evidenced by 1, 2, and either 3 or 4:

1. Muscle weakness; and

2. Sign(s) of nerve root irritation, tension, or compression, consistent with compromise of the affected nerve root (see 1.00F2)

3. Sensory changes evidenced by:

a. Decreased sensation; or

b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or

4. Decreased deep tendon reflexes.

AND

C. Findings on imaging (see 1.00C3) consistent with compromise of a nerve root(s) in the cervical or lumbosacral spine.

AND

D. Impairment-related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following:

1. A documented medical need (see 1.00C6) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i)); or

2. An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 1.00E4), and a documented medical need (see 1.00C6a) for a one-handed, hand-held assistive device (see 1.00C6d) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii)); or

3. An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 1.00E4).

To meet this listing, you need compromise of the spinal cord with symptoms (subjective), appropriate imaging demonstrating the compromise (objective) and a doctor will need to have prescribed an assistive device or you must not be able to use your hands independently.

In simple terms, if you are unable to walk without significant aid or unable to use your hands you may meet this listing. This, like most listings, is difficult to meet.

In my practice, I find that being approved on the Medical Vocational Guidelines is more common than meeting the above listing. The Medical Vocational Guidelines (aka "Grids) direct a finding of disabled if you are of a certain age and limited to sedentary or light exertion. Unfortunately, the Grids only help people over the age of 50 (or those aged 45-49 if Illiterate or unable to communicate in English).

Another way that SSA may find you disabled is based on the combination of your impairments. For example, if you have depression with anxiety, the combination of your central cord syndrome and depression with anxiety may eliminate the possibility of work for you.

Can I do anything to help win my Central Cord Syndrome and SSDI/SSI case?

The most important thing you can do for your case is to go to the doctor and follow his/her advice. This creates medical evidence that the Social Security Administration can use to find your disabled. I advise my clients that doing everything that they can to get well is the most practical way to win. Also having an attorney who is NC State Bar Board Certified, familiar with your impairments and you helps!

The Bishop Law Firm represents Social Security Disability clients in RaleighDurhamFayettevilleCary, Rocky MountWilsonSmithfieldLouisburgChapel HillRoanoke Rapids , Winston SalemGarner, GreensboroGreenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095. 

Also read NC Social Security Disability Lawyer

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