Back Pain Health Center

Font Size  Below is a great article about making the decision whether or not to have surgery.  JEFF SWANEY FREE CONSULTATION 314-481-7778

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Interactive Tool: Should I Consider Surgery for My Low Back Problem? – What does this tool measure?

Click here to find out whether surgery may help reduce the symptoms of a back problem.

This interactive tool will not diagnose a back problem, but it will tell you whether surgery might help reduce or get rid of symptoms related to your low back problem. There are always risks with any surgery, so most people don’t want to have surgery unless there is a very good chance it will help them. Although research shows that surgery is very likely to be effective for some problems, it rarely helps with others.

This tool will help you find out whether your own low back problem might be helped by surgery. After you use this tool, you can show the results to your doctor when you talk to him or her about surgery and your other options.

This tool is not meant for people in emergency situations. Talk to your doctor immediately if you have any of the following problems:

• Bladder and/or bowel problems, including not being able to go to the bathroom as you normally do or not being able to control bowel movements or urination
• Loss of feeling or rapidly decreasing feeling over your feet and heels or in your “saddle area,” which includes any part of your body that might touch a saddle if you were on a horse, including your buttocks, your inner thighs, and the backs of your legs
• Increasing pain, weakness, numbness, or problems with coordination in one or both legs
• A fever for 2 or more days
• A serious injury, an accident, or a big fall in the last 2 weeks
• A history of spinal stenosis
• A history of cancer

When someone becomes disabled, starting the process of filing for Social Security Disability benefits can be overwhelming.  You should expect to fill out numerous forms and questionnaires.  You can start the process in one of two basic ways.  You can look up the site for the Social Security Administration and begin your application online.  For some, this may be preferable because it gives you time to think and carefully consider your answers to the questions that are being put forth. 

On the other hand, you may decide that you would prefer to go to the local Social Security office and have someone assist you with your application.  This may result in some inconvenience and you may end up waiting for quite some time before you are helped.  You may also feel rushed, but if you have a good assistant working with you, then you may ultimately be glad that you took the extra time.  At some offices, you can call ahead in order to schedule an appointment.  This may be preferable to just walking in and catching an assistant who isn’t having a good day. 

Once you have filed the application, one of the problems is that no one seems to be directly responsible for your claim.  You can contact the Social Security Administration and you will likely talk to a number of different people.  While many of these individuals will do the best that they can in order to be helpful, they are basically looking up information on a computer and they are usually not personally familiar with your case.  One thing to keep in mind, the individuals who are helping in the application process are not the decision-makers when it comes to your case.  Frustrated individuals often want to blame the assistant who is helping them .  The decision-makers at the initial stage of review are insulated from contact and the people who are on the front lines are simply trying to give you status information which they may be finding on their computer. 

If your case is denied initially, it is important that you understand that you have 60 days in order to file an appeal.  At this stage, you can obtain a face-to-face hearing with an Administrative Law Judge who will give your case a fresh look.  You may decide to go it alone, or you can obtain the services of an experienced attorney.  If you win, you may be drawing disability benefits for the rest of your life.  It seems that going it alone perhaps means that you can save yourself a little money if you are successful, but if you lose, you may be forfeiting years of benefits which you would have obtained if you had a better understanding as to how to present your case.

When you enter the Social Security office, you should be prepared to provide them with a list of all of your doctors and hospitals, including their addresses and the reason that they are treating you.  The disability examiner will ultimately want to request all of these records.  If you have a good relationship with your treating doctors, you should tell them to expect requests for information and perhaps a disability questionnaire from the Social Security Administration.  Your doctor should understand that the Social Security Administration will be interested in the work restrictions which he provides.  You can also offer lay evidence which might consist of letters from friends, or a letter from your former employer. 

I know that the intitial paperwork can be overwhelming, but do not put off filing your claim because you may have to wait a considerable amount of time before a decision is made.

Submitted by:     Jeff Swaney

Free Consultation:  (314) 481-7778

At our office, we typically meet with individuals after their disability has been denied by the government.  We will usually set up an initial appointment in order to go over all of the pertinent information regarding the individual’s claim.  As an attorney, my starting point is looking at the denial.  This gives me information as to the basis of the government’s denial of the claim and it tells me whether the only issue is disability, or whether there are other issues such as eligibility for benefits.  In the initial interview, I  like to find out the names of all of the treating doctors and hospitals and I can then compare the decision that was made by the government in order to see whether they have obtained all of the records, or whether there may be important missing records. 

By the end of the initial interview, I have made a determination as to whether the case is winnable and what the appropriate strategy is going to be.  We will then file our Request for Hearing, along with some other forms which are required by the Social Security Administration.  We additionally take a look at whether other records need to be requested and we attempt to obtain a copy of the Social Security Disability file which is now on a computer disk. 

Eventually, the case will be set for a hearing.  There is usually between 30-90 days notice and we like to set up another appointment in the office in order to go over all of the questions that are likely to be asked and to further plan strategy. 

In some cases, we will find individuals who, because of their financial circumstances, have not been seeing any doctors regularly.  We may recommend medical services through a facility that treats low-income individuals.  This may help to provide us with further evidence of the individual’s disability.  As a lawyer, when I prepare an individual for their hearing, I need to make sure that their testimony is consistent with every form that  they have ever signed, questionnaire they have filled out, and every statement that they have made to a doctor.  Sometimes there will be statements that appear on the surface to be contradictory, but really aren’t.  For example, I recall one client who said that he would walk 45 minutes at the mall for exercise.  However, upon further questioning, he did so by breaking up his walk into 10 minute segments and was normally out of breath and in pain by the time he finished.  He was determined to try to do his best to get some exercise, but he suffered greatly.  It is important to get your arms around these apparently contradictory statements which simply need to be further explained. 

Finally the big day comes when the case is set for hearing.  There are two main offices in the St. Louis area.  One is located in Creve Coeur and the other office is in downtown St. Louis.  You will be assigned a judge and each judge has their own record and reputation in terms  their approval rates.  Each judge also has a different style in terms of the approach that they may take under differing circumstances.  A lawyer who is familiar with the reputations of the various judges will have a better chance of knowing how to present your case.

Some judges will take control of the hearing by starting out with questions that they want to have answered first.  Other judges will allow the attorney to approach the case based on the format that he or she has set up with his client.  Still other judges will let the attorney lead off with the questions, but will frequently interrupt with questions of their own.  As an attorney, I prepare differently based upon which type of judge I am going to encounter.

The determination as to which judge is assigned to your case will not be determined until you receive your hearing notice. Sometimes a judge may be ill or other circumstances may occur which cause a last minute reassignment. As an attorney, it is important to be able to quickly readapt.

During the course of the hearing, a Hearing Assistant will be recording everything that is said on a tape recorder.  Just like anywhere else, judges vary in friendliness, temperment, attention to detail, and their desire to take in testimony.  As an attorney, I find that it is important to recognize that the judge’s time is important.  Being prepared helps the judge because it results in efficiently presenting sharp, crisp, clean testimony.  Unprepared testimony often sounds rambling and unfocused and it is difficult for a judge to get his or her arms around testimony which is undefined and sloppy.  Expect that the judge will most likely want to hear all of the testimony within a 30 to 40 minute period.   If time allows, there may be room for some additional elaboration and some hearing may last for about an hour and a half.  Your attorney should be able to explain to you what the basic strategy is with respect to trying to win your claim.  A judge does not want to hear everything about you, but only what is important.  Minor “problems” such as broken toes and fingers, or, for example, frequent nasal congestion, should be left out in order to make time for things that matter. 

Most judges will not say how they are going to rule at the end of the hearing.  There are occasions when a judge may seem negative, but will ultimately rule in your favor.  There may be other cases where the judge seemed friendly, but didn’t think that your claim warranted approval.  There are also some instances in which a judge will take time at the end of the hearing to tell the claimant that he is going to approve the claimant’s case.  This is done in order to alleviate anxiety on the part of the claimant.  There are also cases where the judge may be on the fence and wants to thoroughly review all of the evidence and exhibits before making a final determination. 

Whenever a judge finally rules on your case, there will be a decision in writing that will be mailed to you and your attorney.  The decision can either be fully favorable, partially favorable, or it could be a denial.  A partially favorable decision often occurs in cases where the judge finds that there may be a long period of disability, but ultimately believes that the claimant recovered and is capable of working.  Whenever you get your decision, you should contact your attorney in order to make sure that you understand the judge’s ruling. 

Submitted by:    Jeff Swaney

Free Consultation:    (314) 481-7778   �CBS NEWS STORY ABOUT SOCIAL SECURITY DISABILITY
 http://www.cbsnews.com/video/watch/?id=3713125n

Many individuals who contact my office are severely disabled, but are working when they contact me.  They often have questions as to whether or not they can work and collect Social Security Disability benefits.  The purpose of this article is to address that question. 

First of all, you cannot be working full-time, regardless of how disabled you are, and receive Social Security Disability benefits.  By virtue of working full-time and earning a significant income, you are proving that you are not disabled.  In order to have a chance to recover Social Security Disability benefits, you must either stop working, or have your hours reduced.  We do not recommend reducing your hours just to apply for benefits, but this should only be done by those who truly are disabled.  However,there are many individuals who may damage their health if they continue working and there are others who are so disabled that they risk further injury. 

Under the present law, a person can work as long as their income is not defined as “substantial gainful activity”.  If you earnless than $980.00 a month before taxes in 2009, you can apply and potentially receive Social Security Disability benefits.  If you are earning more than the amount which Social Security defines as substantial gainful activity, regardless of how severely disabled you are, then you  will not be eligible for benifits.  The amounts that Social Security defines as constituting substantial gainful activity can change from time to time.  Consequently, it is important to check with the Social Security Administration in order to make sure that you are under the appropriate amount.  In fact, you can continue working, even while you are on disability, provided that you do not exceed the amount that you are allowed to earn. 

It should be understood, however, that the Social Security Administration can look at the type of work that you are doing in order to determine whether they believe you are disabled.  If you are working ten hours a month, but you are a jackhammer operator, they may contend that your work is rigorous and is inconsistent with your claim.If you work full-time, but for a short period, a judge may classify this as an “unsuccessfu work attempt.” 

If you decide that you are going to reduce your hours, or leave your employment, you must keep in mind that it may be quite some time before a decision is ultimately rendered in your case.  If the decision is favorable, then you may have gone through a lot of financial hardship, even though you will eventually begin receiving benefits.  On the other hand, Social Security operates by stringent standards and, if you are not approved, you may never be in a position to make up the lost income which you received. 

Submitted by:    Jeff Swaney

Free Consultation -  (314) 48l-7778

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As an attorney handling Car Accident Injury cases, “Work Comp” cases and Social Security Disability claims, I find it challenging to balance the demands which are made on my time.  First, it is important to accomplish results.  As an attorney, you may be a nice guy, but you were hired to accomplish the best possible result for your clients.  This requires meticulous attention to detail.  Every day pages and pages of medical records run across my desk for review.  In addition, time needs to be made to think through a game plan for determining how each case needs to be approached.  You must be more prepared than your opponent, and not paying attention to detail can cause heartache to an attorney, or perhaps, even worse, a heart attack!  Also, a lot of time must be spent when legal research needs to be done.  Secondly, time has to be spent reading and keeping up with developments in your field because the law is constantly changing and being reinterpreted by the courts.  When you meet with someone, they aren’t interested in what the state of the law was six months ago, they want to know how good their case is now.   Thirdly, it takes time to manage your own personnel,  to make sure that you are complying with all of the requirements of running a law office, and to evaluate the directions and trends in your field.  After all, you must manage people, pay their salaries and benefits, pay your taxes and make sure that you are in compliance with numerous requirements of running a law office.  Fourthly, you must allow time for evaluating new cases and meeting with new people.  Unfortunately, what is often missing is giving personal attention to clients.  There is no easy way to put the “personal“ back in personal injury claims.  It requires a consistent effort to take time out of every busy day in order to report back to the people who are placing their trust in you.  Any true personal injury attorney will only get this done working long days, including weekends.  In short, the only way to put the personal in personal injury  is through dedication and hard work.  Come to think of it, this is no great secret and it is the common ingredient in all successful businesses.  So the question is “Is your attorney too busy to call you back?” Submitted by Jeff Swaney FREE CONSULTATION 314-481-7778

There is a myth that the Missouri Worker’s Compensation system is a liberal, give-a-way system which is laden with all kinds gratuitous perks for anyone who happens to be” lucky enough” to strain their back a little after a hard days work. The image that insurance companies have created is that of lazy employees being coddled by doctors until eventually they are served up with  “pot of gold” settlements on the backs of struggling bussinesses and honest insurance companies. It is clear that no industry  in this country does a better job of promoting their propaganda than insurance companies. Do we really believe that  adjusters are out there handing  checks to  homeowners just before a tornado is ready to hit their homes. These are the same adjusters who won’t return my phone calls for three weeks when my client’s comp check is late. These companies  would have us believe that we need to drastically limit work comp benifits  to those who end up in wheelchairs, but will defend twenty-five million dollar executive bonuses because “we need to provide incentives to retain good people”. The gap between myth and reality us especially clear in the Missouri Work Comp system. For example , an insurance adjuster gets to pick your doctor with no say-so whatsoever on your part!  If the adjuster doesn’t like the doctors’s opinion, then he can choose another doctor. However, if you question the doctors opinion, be aware that you are not legally entitled to  a second opinion. In addition, when it comes to scheduling appointments, the adjuster can choose to set up a time when you will   miss work. The best part is that you won’t get paid for it!  You may be able to use your own vacation time or personal time, but you will have no control over that either! If you have a twenty-five year old chid, for example, who has no wife or children and they are killed on the job because of company negligence, you will not, with few exceptions, be able to bring a civil suit against the company. Furthermore, under the Work Comp Law , you will be given burial expenses and well- thats about it!  Under the new law , almost everyone over thirty-five years of age will hear that their back injury should be discounted due to natural “degeneration”, even if the injured worker never sought any treatment before or ever had any complaints. In criminal cases, people are presumed innocent until proven guilty.Not necessarily in work comp. In fact, some work comp judges will discount what  injured workers say based on the sole reasoning that  workers have an “incentive” to exaggerate. Meanwhile, the motives of  doctors who receive hundreds of thousands of dollars of bussiness every year  is overlooked. In addition, all of the Legal Advisor positions have now been eliminated and judges are prevented from telling claimants when they getting an unfair settlements. Despite the great number of  things which are tilted against the injured worker , the propaganda machine just keeps rolling and we are told that “something needs to be done” to protect us from  injured workers who get their own attorney. Obviously, what a terrible thing it is when an adjuster can’t keep and injured worker in the dark and then simply steamroll them!  �Submitted by Jeff Swaney  FREE CONSULTATION 314-481-7778

Very few injuries that we commonly see can change a claimant’s life as dramatically as a “herniated disc”. Many similar terms are used almost interchangeably like “ruptured disc” , “disc protrusion” and “herniated nucleous pulposis”.Doctors often describe disc as being like a”jelly donut” between the vertebrae.When the disc material inside of the disc leaks out and touches on the”sciatic nerve”, severe pain often travels down the injured worker’s leg. Sometimes other structures are affected, like the “spinal cord” or the “spinal canal” .Disc injuries are most common found in the low back and neck and rarely occur in the mid-back. We see alot of lumbar “laminectomies”in workers who do alot of heavy lifting. A laminectomy or a micro -discectomy will often produce good results and in many instances injured workers will be able to return to rigorous  work. If surgery is unsucessful,  a lumbar or cervical “fusion” may be needed. This often occurs with a condition called “spondylolithesis” which involves a slippage o   a vertebrae. In order to diagnose a disc problem an “MRI” is usually needed. If a condition is diagnosed as a “disc bulge” doctors wil normally try treating the condition with physical therapy or steroid injections.If the MRI is negative, doctors may determine that they are dealing with a strained or sprained back or neck. Where surgery is contemplated, doctors will normally do a test called a “myelogram’ with a “cat scan” in order to get the best possible look at the problem. In those cases where multiple surgeries have been performed and a “fusion’ is the ultimate outcome, some injured workers may become “permantly totally disabled” which means that they are unable to work or compete in the “open labor market”. Everyone is different and it is difficult to generalize. I once had a client who had five surgeries, including a disc fusion,who had a body like Charles Atlas and was running 5 miles a day! In any event, if you are confronted with a serious back or neck injury, it is important to ask your attorney about the reputation of the doctor who is treating you.  submitted by Jeff Swaney FREE CONSULTATION 314-481-7778

As a Missouri and Illinois “work comp” attorney, I have reached thousands of settlements on behalf of “claimants” (Missouri) and “petitioners” (Illinois) . Many claimants and/or petitioners will often compare their settlements to other injured employees when a comparison may not be appropriate. It is important to first understand that there are two types of “permanant  disability” settlements under the Missouri and Illinois Workers’ Compensation laws. A “permanant partial disability” settlement is based on the injured worker being able to “compete for employment” in the “open labor market”. These settlements are based on the injured employee being able to earn a livelhood, even if it is in a diminished capacity. llinois has some “wage differential” provisions which can enhance the value of an employee’s case where the employee has a “diminished earning capacity”. Missouri has no similar provisions which take into account “lost earning capacity” , but “Missouri Workers’ Compensation Administrative Law Judges” will generally be sympathetic and will usually take into the claimant’s circumstances.”Illinois Arbitrators”, however, can directly consider lost earning capacity. On the otherhand, Permanant total disability means that the injured worker cannot compete for employment in the open labor market. As attorneys representing “total disability” clients, we will usually also file for Social Security Disablity on their behalf. In the vast majority of these cases , our clients will be adjudicated as being totally disabled under both systems. Oftentimes we will try to settle Permanant total Disability cases in Missouri and Illinois “work comp” cases in order to avoid a potential “offset” reduction in “Social Security Disability” benifits. Ask your attorney to explain the potential settlement value of your case versus letting a judge decide and whether you may have a “Social Security offset” problem .You may also ask your attorney whether you may benifit from “vocational rehabilitation” if you cannot return to your former employment. Submitted by Jeff Swaney FREE CONSULTATION 314-481-7778

Our office has been working with “Social Security Claimants” for over two decades. Most Social Security applicants don’t understand what is involved in successfully presenting their case in front of an administrative law judge. First, it is important to understand that it is normally not enough to prove that you can’t work at your last job. Instead you must prove that you have a “medically determinable disability” which prevents you from engaging in any “substantial gainful employment”. The word “substantial” is important because you can earn a small amount of wages and still be eligible for disability benifits. The amount is set by the Social Security Administration and can change from time to time. If you are already engaging in substantial employment, then you are not eligible to obtain disability benifits.Secondly, there are regulations which Social security attorneys refer to as “the Grid”. The Social Security Administration recognizes different standards for claimant’s of different ages, levels of education and  work backgrounds. Once the appropriate standards are determined,  an attorney can determine whether the medical recods are adaquate to support the claim for disability. If not, an attorney may pose specific questions to a claimant’s treating doctor[s]. Thirdly, it is  important for an attorney to help his client quantify his complaints in a specific manner. A claimant may be asked, “How much can you lift”. A bad answer would be “not very much”. An answer like this doesn’t help to describe the claimant’s limitations. It should be noted that  Social Security judges refer to something called “The Dictionary of Occupational Titles” for job information. This source describes the exertional requirements of all classified jobs which exist in the national economy. It is up to the claimant’s attorney to prove that his client can’t perform any substantial work for which he is qualified. In addition, “Social Security Judges” will often bring “vocational rehabilitation counselors” into a hearing in order to get clarifications as to the claimant’s “work background”, “work restrictions” and the requirements of various jobs. An attorney must be prepared to effectively challenge the vocational counselor’s testimony through effective cross-examination.Finally,  Social Security Hearings are informal and usually take about an hour, although they can vary in length , depending on the judges fomat and the complexity of the case. Your attoney will know the various judges at the “Downtown SSA Office” and the “Creve Couer SSA Office”.  Be sure to dress appropriatly, as it is important to create a favorable impression.  In short, preparation is the key to winning your case, so talk to your attorney ask him what you can do to help your cause. Submitted by Jeff Swaney FREE CONSULTATION 314-481-7778

Over the years, I have handled numerous Missouri and Illinois “work comp” injury cases. It often surprises injured workers to find that they can pursue their case in both states.  Sometimes we will have an injured worker who is employed in St. Louis, but who is injured, for example, in Belleville, Alton, or Granite City, Illinois. Under these circumstances, the worker can pursue their case in both Illinois and Missouri. As an attorney, I will usually file a claim in both states and eventually determine which state is most favorable.  In Illinois Workers’ Compensation cases, a worker can choose their treating doctor, which is certainly an advantage.  There are also more favorable circumstances where an emloyee can’t return to their former employment and needs vocational rehabilitation.  In addition, there are higher maximum rates for temporary total disability, permanent partial disability and permanent total disability benefits.  However, for employees who are not as highly paid, the permanent partial disability rates are based on 60%, rather than 66 2/3%, as is the case in Missouri.   Missouri Workers’ Compensation also has a special benefit called the “Missouri Second Injury Fund” which often provides extra compensation for a wide variety of pre-existing conditions.” Illinois Comp” tends to favor highly compensated workers who are seriously injured.  “Missouri comp” tends to favor less highly compensated workers and workers with significant pre-existing disabilities.  If you qualify for benefits in both states, it may be helpful to hire an attorney who is licensed in both states. There are a multitude of other factors which may come into play, such as attorney’s fees which are 20% in Illinois versus 25% in Missouri.  Also the venue, or place where your case comes up for hearing, will influence your attorney’s strategy.  My advice- ask your attorney if he practices in both states! Submitted by Jeff Swaney FREE CONSULTATION 314-481-7778