1.15: Disorders of the Skeletal Spine Resulting in Compromise of a Nerve Root

Listing 1.15 is a new musculoskeletal listing that replaced parts of the older spine-related criteria. It addresses severe spinal conditions—such as herniated discs, spinal stenosis, or osteoarthritic changes—that cause significant nerve root compromise. Meeting or equaling this listing means the claimant’s nerve-root-related spine disorder is so severe that it automatically qualifies as disabling at Step 3 of the sequential evaluation.

Listing 1.15

1.15 Disorders of the skeletal spine resulting in compromise of a nerve root(s) (including the cauda equina). With all of the following:

A. Evidence of a disorder of the skeletal spine resulting in compromise of a nerve root (including the cauda equina), documented by A1, A2, and A3, or by A1, A2, and B, or by A1, A3, and B, or by A2, A3, and B:

1. A clinically appropriate imaging test (for example, MRI) demonstrating a compromise of a nerve root(s) in the cervical or lumbosacral spine. And
   
2. A physical examination that demonstrates neurological signs consistent with nerve root compromise, such as sensory changes, motor loss (atrophy with associated muscle weakness or muscle weakness), reflex changes, or a positive straight-leg raising test (if the lumbosacral spine is involved). And
   
3. A documented need for a walker, bilateral canes, or bilateral crutches or a documented need for a wheeled and seated mobility device involving the use of both hands; or an inability to use one upper extremity due to a musculoskeletal impairment and a documented medical need for a one-handed, hand-held assistive device requiring the use of the other upper extremity;

B. An inability to use upper extremities (including fingers, wrists, hands, arms, and shoulders) to independently initiate, sustain, and complete work-related activities involving fine and gross movements. Examples of an extreme limitation include an inability to prepare a simple meal and feed oneself, an inability to take care of personal hygiene, an inability to sort and handle papers or files, and an inability to place files in a file cabinet at or above waist level.

Core Elements of Listing 1.15

1. Documented Spinal Disorder 
   • Must have clinical and imaging evidence (e.g., MRI, CT scan, or X-ray) of a pathological process affecting the spine (e.g., disc herniation, bone spur, degenerative changes).
2. Compromise of a Nerve Root 
   • Evidence of nerve root compression or irritation, which could manifest as radicular (shooting) pain, numbness, tingling, muscle weakness, or atrophy in the extremities served by that nerve.
3. Specific Clinical Findings 
   • Signs such as reduced reflexes, dermatomal sensory loss, motor weakness, or a positive straight-leg raise test (if lumbar region is affected).
4. Functional Limitation 
   • Significant difficulty performing basic tasks—such as walking, lifting, or using one’s arms—due to chronic pain, neurological deficits, or both.
5. Duration Requirement 
   • The spinal condition and associated limitations must last (or be expected to last) at least 12 months despite appropriate treatment.

Tips on Proving the Claimant Meets Listing 1.15

1. Objective Imaging Studies
   • Obtain MRI or CT scans showing the exact location and severity of the nerve root compromise. If possible, have a radiologist or orthopedic specialist clearly link those findings to the claimant’s clinical symptoms.
2. Detailed Neurological Exams
   • Secure exam notes documenting reflex changes, muscle weakness, and sensory deficits. Tests like electromyography (EMG) or nerve conduction studies (NCS) can reinforce evidence of nerve impairment.
3. Clinical Documentation of Pain and Mobility
   • Keep consistent records from treating physicians (e.g., orthopedists, neurologists) describing radicular pain, reduced range of motion, and problems standing or walking. If the lower back is involved, results of a straight-leg raise test can be pivotal.
4. Functional Capacity Evaluations
   • Encourage your client’s doctor to complete a Residual Functional Capacity or musculoskeletal questionnaire linking clinical findings to major functional limitations—especially if the claimant cannot sustain even sedentary-level activities.
5. Longitudinal Treatment History
   • Show attempts at physical therapy, pain management (including epidural injections), or even surgery that did not restore full function. Persistent disability despite proper treatment supports Listing-level severity.
6. Corroborating Daily Activity Statements
   • Include written or verbal testimony detailing everyday struggles—like needing to lean on grocery carts, difficulty dressing, or frequent rest breaks due to numbness or leg pain. Firsthand accounts can illustrate real-world impact.

Under Listing 1.15, a Social Security Disability Lawyer can help prove a severe spinal disorder that compromises a nerve root, causing notable neurological deficits and long-term functional loss. Combining compelling imaging evidence, neurological findings, and well-documented daily activity limitations will give you the best chance of meeting or equaling this new musculoskeletal listing.