Suffering an Unfair Job Loss is Tough, our california employment attorneys can help.

Musculoskeletal System Disorders

How Do I Get Social Security Disability Benefits for a Musculoskeletal Disorder or Growth Impairment?Musculoskeletal Disorder or Growth Impairment and Disability?

This area of Social Security Disability refers to disorders that affect the bones, muscles, tendons, ligaments, and joints. Musculoskeletal Disorders can be hereditary, congenital, or acquired.

If you are suffering from a Musculoskeletal Disorder or Growth Impairment, are unable to work and have been denied Social Security Disability benefits, call the experienced Anaheim Social Security Disability Attorneys at Howard Law and let us fight to get you the benefits you deserve.

Major Dysfunction of a Joint

This disability refers to severe functional loss caused by any type of joint dysfunction, regardless of the medical diagnosis by your doctor. The problem could have resulted from trauma or from one of the many types of arthritis. By the time an obvious deformity of the joint is present, there usually has been a joint disorder for some time.

To qualify for social security disability due to a major dysfunction of a joint, you must have major dysfunction of a joint characterized by an obvious anatomical deformity and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s). In addition you must have either;

  1. Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively, or
  2. Involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively.

Reconstructive Surgery or Arthrodesis of a Major Weight Bearing Joint

Reconstructive surgery often involves placing an artificial joint into a person. Surgical arthrodesis refers to the process of fusing an arthritic joint with a healthy, living bone to relieve the pain and make it more stable. This disability applies to patients who have had reconstructive surgery or surgical arthrodesis but have had complications such as to render the patient disabled.

To qualify for social security disability benefits having had reconstructive surgery or arthrodesis of a major weight-bearing joint, following surgery, you must have experienced an inability to ambulate effectively, and return to effective ambulation did not occur, or is not expected to occur, within 12 months of onset.

Disorders of the Spine

This disability refers to various spinal disorders such as a herniated disk, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture.

To qualify for Social Security Disability benefits due to a disorder of the spine, your disorder must result in compromise of a nerve root (including the cauda equina) or the spinal cord with either;

  1. Evidence of nerve root compression, characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine); or
  2. 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; or
  3. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively.

Amputation

There are many reasons why a patient may require amputation such as, trauma, diabetes mellitus, and atherosclerosis. The Social Security Administration is not concerned as to the reason why amputation occurred, but rather is concerned with your ability to work after amputation occurs.

To qualify for Social Security Disability benefits due to amputation, you must have had amputation of either;

  1. Both hands; or
  2. One or both lower extremities at or above the tarsal region, with stump complications resulting in medical inability to use a prosthetic device to ambu-late effectively, which have lasted or are expected to last for at least 12 months; or
  3. One hand and one lower extremity at or above the tarsal region, with inability to ambulate effectively, or
  4. Hemipelvectomy or hip disarticulation.

Fracture of Femur, Tibia, Pelvis, Tarsals

Many broken bones heal within 12 months and therefore such injury will not qualify a person for Social Security Disability benefits. However, where a person has a history of fractures not healing, the Social Security Administration will predict the current fracture not to heal within 12 months. Absent such a history, a person attempting to collect Social Security Disability benefits for a broken bone, must have documentation from his or her doctor providing medical reasons why the doctor believes the current fracture will not heal within 12 months.

To qualify for Social Security Disability benefits for a fracture of the femur, tibia, pelvis, or one or more of the tarsal bones, you must show;

  1. Solid union not evident on appropriate medically acceptable imaging and not clinically solid; AND
  2. Inability to ambulate effectively and return to effective ambulation did not occur or is not expected to occur within 12 months of onset.

Fracture of an Upper Extremity with Non- Union

Many broken bones heal within 12 months and therefore such injury will not qualify a person for Social Security Disability benefits. However, where a person has a history of fractures not healing, the Social Security Administration will predict the current fracture not to heal within 12 months. Absent such a history, a person attempting to collect Social Security Disability benefits for a broken bone, must have documentation from his or her doctor providing medical reasons why the doctor believes the current fracture will not heal within 12 months.

To qualify for Social Security Disability due to a fracture of an upper extremity with non-union of a fracture of the shaft of the humerus, radius, or ulna, you must be under continuing surgical management, directed toward the salvage or restoration of major function, and such major function was not restored or expected to be restored within 12 months of onset.

Soft Tissue Injury

Soft tissue injuries alone may not qualify you for Social Security Disability benefits, but the Social Security Administration looks at the limiting effects of treatment and possible complications of the soft tissue injury. Your injury must have remained unhealed for at least six months and likely to remain unhealed for at least a total of 12 months. Your doctor must provide medical reasons why he or she believes your soft tissue injury will not be healed within 12 months.

To qualify for Social Security Disability due to a soft tissue injury of an upper or lower extremity, trunk, or face and head, you must be under continuing surgical management, directed toward the salvage or restoration of major function, and such major function was not restored or expected to be restored within 12 months of onset.

If you have been denied Social Security Disability benefits and are unable to work do to a musculoskeletal disorder or growth impairment, call the Orange County Social Security Disability Attorneys at Howard Law to help you get the benefits you deserve.

For more information on musculoskeletal disorders and growth impairments and the Social Security Administration guidelines, visit the Social Security Administration Website.

[Back to Top]

Listing vs. Residual Functional Capacity (RFC): How Does the Social Security Administration Determine Whether I Qualify for Disability Benefits for a Musculoskeletal Disorder or Growth Impairment?

Social Security Disability benefits may be available for people who suffer from a Musculoskeletal Disorder or Growth Impairment. The Social Security Administration must first determine whether your Musculoskeletal Disorder or Growth Impairment is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. The Social Security Administration will conclude that you are disabled and eligible for disability benefits if it determines that you meet or equal a listing because of your Musculoskeletal Disorder or Growth Impairment.

If the Social Security Administration decides that your Musculoskeletal Disorder or Growth Impairment is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

[Back to Top]

How Can I Meet a Listing and Win Social Security Disability Benefits for A Musculoskeletal Disorder or Growth Impairment?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your Musculoskeletal Disorder or Growth Impairment is severe enough to equal a listing.

The term "listing" refers to a compiled list of common impairments. The Social Security Administration created a set of guidelines called the Listing of Impairments that contains the most common impairments. For each listing of a particular impairment, there is an explanation regarding the degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work.

The Social Security Administration will be consider you disabled if your Musculoskeletal Disorder or Growth Impairment is severe enough to meet or equal a listing.

[Back to Top]

What is Your Residual Functional Capacity Assessment for a Musculoskeletal Disorder or Growth Impairment?

If the Social Security Administration decides that your Musculoskeletal Disorder or Growth Impairment is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

The Social Security Administration expressesan RFC for physical impairments in terms of whether the Social Security Administration believes you are able to do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

[Back to Top]

Can Your Doctor's Medical Opinion Help You Qualify for Social Security Disability Benefits for a Musculoskeletal Disorder or Growth Impairment?

The role of the Social Security Administration is to conclusivelyestablish whether you are disabled based on your education, work experience, medical evidence, and your age.

The role of your doctor is to provide the Social Security Administration with informationconcerning the degree of your medical impairment by providing the Social Security Administration medical source statement that describes your capacity for work which is part of your residual functional capacity assessment. Your residual functional capacity is what you can still do despite your limitations.

The Social Security Administration must consider your treating physician's opinion because the Social Security Administration considers it to be controlling when making its decision.

[Back to Top]

What is the 5 Step Sequential Evaluation Process?

The Social Security Administration has created a five (5) step sequential process to determine whether an adult claimant is entitled to receive disability benefits. Children have a different test to determine eligibility.

Step 1: Substantial Gainful Activity

The Social Security Administration presumes that if you are working and that you make a certain amount of money that you are engaging in what it determines to be a substantial gainful activity (SGA). The Social Security Administration considers a person to be engaged in a SGA if that person is earning more than a certain amount of money each month (i.e. net of impairment - related work related expenses).

In 2013, the Social Security Administration has determined that a statutorily blind individual is engaged in a SGA if they earn more than $1740.00 per month while a non-blind individual must earn more than $1040.00 per month. Changes in the national average wage index usually affect the aforementioned SGA amounts.

Step 2: Severe Impairment

The Social Security Administration has determined that each claimant must either have a severe impairment or a combination of impairments. The impairment or combination of impairments must drastically limit the claimant's physical or mental ability to do basic work activities without regard to age, work history, or education. For many claimants, the level of proof at this level is minimal; therefore, they usually satisfy the Step 2 requirements and proceed to Step 3.

Step 3: Listing of Impairments

The Listing of Impairments details specific impairments that the Social Security Administration considers severe enough to prevent an adult claimant from engaging in a substantial gainful activity and in the case of a minor, the impairment has to be severe enough to cause functional limitations. There is also a durational requirement. The Social Security Administration has determined that the impairment must last for 12 months or long or result in the death of the claimant. If the claimant fails Step 3 because they do not meet or equal a listing then the case will proceed to Step 4.

Step 4: Past Relevant Work

At Step 4, if your condition is severe enough to meet the requirements of Step 2 (Severe Impairment); however, your severe impairment does not meet or equal a listed impairment that is the subject of Step 3 (Listing of Impairments), then the Social Security Administration must decide whether your severe impairment interferes with your ability to do any of the work you previously performed. The Social Security Administration likes to look at the work you performed over the past 15 years prior to the onset of your disability. If the Social Security Administration determines that your impairment does not interfere with work you previously did then you must proceed to Step 5.

Step 5: Ability to Perform Other Work

A majority of disability claims are decided at this level. If you cannot perform work you did in your past, then a determination must be made as to whether you can adjust to different types of work. The determination at this level takes into consideration your education, age, and prior work and is better known as your residual functional capacity.

[Back to Top]