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

1. A

   Neuro-anatomic (radicular) distribution of one or more of the following: pain, paresthesia, or muscle fatigue.

   In plain terms: Does your back or neck pain shoot down into one of your arms or legs in a specific pattern?

2. B

   Radicular distribution of neurological signs (any one): muscle weakness, sensory changes, decreased deep tendon reflexes, OR a documented herniated disc, spinal stenosis, or nerve root compression on imaging.

   In plain terms: Has any imaging — like an MRI or CT — shown nerve compression, a herniated disc, or spinal stenosis in your back or neck?

   Evidence required:MRICT scanX-rayTreating physician report
3. C

   Findings on imaging consistent with compromise of a nerve root, AND a physical exam noting impaired motor, sensory, or reflex function in a corresponding distribution.

   In plain terms: Did your doctor connect the imaging findings to specific physical exam results — like weakness in a particular muscle or loss of a specific reflex?

   Evidence required:Treating physician reportConsultative exam
4. D

   Documented medical need for a walker, bilateral canes, bilateral crutches, or a wheeled-and-seated mobility device involving the use of both hands; OR an inability to use one upper extremity to independently initiate, sustain, and complete work-related activities.

   In plain terms: Do you use a walker, two canes, two crutches, or a wheelchair to get around — or has your doctor said you need one of those?

   Evidence required:Treating physician reportRFC (residual functional capacity) assessment

Note · All four paragraph criteria (A–D) must be satisfied. Paragraph D is the gating functional-limitation criterion; absent imaging + exam + functional limitation, the listing is rarely met and the case pivots to grid-rule analysis.

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