New Musculoskeletal Listing April 2021

 The new Listings involving the musculoskeletal system are more restrictive and difficult to prove. In general, meeting or equaling a listing is difficult. With these new listings, social security is certainly making a statement that if you are found to meet one of these listings then there is absolutely no question as to your physical ability. You are most certainly disabled if you have the medical evidence to support a disability under the new musculoskeletal listings. One important takeaway from the new listings is that your medical provider must properly document all of your limitations in the physical examination section of their treatment notes. It is not helpful for your medical provider to simply copy and paste notes from the prior visit. Your doctor must do an actual examination every time and note those limitations in the physical examination. It is also important if your doctor recommends the use of an assistive device for the doctor to not only include that recommendation in the treatment plan but also explain the reason for the need of the assistive device. This places a much greater focus on the doctor actually notating your treatment notes. It also places a greater need for imaging to document your medical conditions.

The biggest change to the listings is the addition of clearly defined “functional criteria” that a person needs to show to meet a listing. The old listings required disability applicants to show that their musculoskeletal condition resulted in an “inability to ambulate effectively” if the condition affected their ability to walk or that the condition resulted in an “inability to perform fine and gross movements effectively” if the condition affected their ability to use their hands. The new listings place a heavier reliance on whether an individual uses medically necessary assistive devices throughout their day.

All listings have been renumbered; now they have multiple requirements.

-Spinal arachnoiditis will be evaluated under listing 11.08 (neurological listings) rather than musculoskeletal listings.

-The SSA has introduced a new listing for pathologic fractures caused by a disease process, rather than trauma.

-There is a new listing for spinal stenosis separate from other spinal disorders.

-In the new listings, the SSA emphasizes documentation from an acceptable medical source such as a physician, surgeon, or nurse practitioner as well as medical imaging such as MRIs.

-According to the old listings, disability applicants had to show that their musculoskeletal condition resulted in an “inability to ambulate effectively” if the condition affected their ability to walk; or that the condition resulted in an “inability to perform fine and gross movements effectively” if the condition affected their ability to use their hands. The new listings place more emphasis on whether a person uses medically necessary assistive devices all through the day. Many of the new listing’s subsections include the following “functional criteria” requirement.

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

-Inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements, and a documented medical need for a one-handed, handheld assistive device that requires the use of one hand; or

-A documented medical need for a walker, bilateral crutches, or bilateral canes or a wheeled and seated mobility device involving the use of both hands; or

-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.

If you are not found disabled under the new musculoskeletal listings, you may still qualify for disability benefits. However, the evaluation of your claim will simply require the full five-step process for analysis.

People applying for disability will require the assistance of an experienced disability lawyer to get narrative statements from their doctors that explain the circumstances for which they need to use their assistive device. If you need helping applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 20 years experience with Social Security Disability cases.

Location: United States

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