Nancy Withers, Michelle Parsons, and Maureen Nowak
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Listing 1.04 B Spinal pain from arachnoiditis

Listing 1.04B addresses spinal arachnoiditis. The diagnosis must be confirmed by acceptable imaging such as an MRI of the spine. In addition, medical notes indicating the need to change positions frequently will also be needed to meet this listing. The information below outlines what is needed to meet listing 1.04B

“1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:
“B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;
“You will meet listing 1.04B if you have:
• If you have a disorder of the spine (examples; herniated nucleus pulposus, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture),
• With spinal arachnoiditis,
• Confirmed by an operative note or pathology report of tissue biopsy, or by MRI or other imaging,
• With severe burning or painful dysesthesia, resulting in the need to changes position from sitting to standing and walking frequently. ”
For part B of the listing an MRI of the spine showing the cause of the pain is needed. An X-ray or CT scan will not show the soft tissue.
Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surrounds and protects the nerves of the spinal cord. A person would has arachnoiditis may have severe stinging and burning pain, Pain is the most common symptom of arachnoiditis other symptoms are tingling, numbness or weakness in the legs, the feeling of insects crawling on the skin, shooting pain, muscle cramps, spasms and uncontrollable twitching, and bladder or bowel problems.
Dysesthesia is the pain when the skin is touched. Documentation in your doctor’s medical records detailing your complaints of pain will be very helpful in meeting this listing. The doctor’s notes should also include the need to change positions frequently or changing from sitting to standing then walking every hour for more than a few minutes. Social Security will also ask you about your activities of daily living by sending you questionnaires about your day to day activities, when answering Social Security’s questions give as many examples as possible of your day to day struggles with standing, walking, sitting, and lifting.
It helps your claim greatly if your treating physician provides longitudinal medical records supporting the allegation of painful dysesthesia and your need to change position or posture more than once every 2 hours. The Social Security Administration should try to obtain the needed information regarding your time-tolerance for body position and posture from your treating doctor if the medical records are not clear. A detailed analysis of your activities of daily living can also be helpful. It is important to provide specific examples of the pain and the need to change positions.
Changes in body position or posture needs to be significant, an example is the need to stand up after sitting then walking around before returning to a seated position, not merely moving around in a chair to get more comfortable.
Many people with back pain do not meet a Social Security listing. Most people approved for Social Security Disability benefits are approved because of their limitation in their ability to sit, stand, walk, lift and carry through out an 8 hour work day. For more information give us a call or send us an email. We are happy to answer your questions free of charge.

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