Social Security’s rules recognize a wide variety of musculoskeletal conditions which, if severe enough, may qualify for disability benefits from the Social Security Administration.
Your musculoskeletal system is comprised of all of the bones and the muscles in your body that allow movement, including the body’s bones (the skeleton), muscles, cartilage, tendons, ligaments, joints, and other connective tissues. Because this system includes so many different parts and areas of your body, a severe problem within the musculoskeletal system can disable you from working.
The following is a list of how the Social Security Administration evaluates the most common bone, muscle and connective tissue impairments in Social Security Disability Insurance (SSDI or SSD) claims and in Supplemental Security Income (SSI) benefit claims:
Joint Problems
SSDI or SSI Disability for Osteoarthritis
Although osteoarthritis can affect any joint in the body, the most common affected areas are the joints in the hips, knees, and spine intended to carry your weight. As the cartilage wears away and the joints lose their flexibility, the stress put upon them by standing or walking is what causes the pain that can be debilitating. The usual symptoms of the condition are a continuous, stinging pain in the muscles around the affected area and stiffness in the joints that can hinder the ability to move. When a claimant’s arthritis starts to severely limit his or her mobility or use of his or her hands, the claimant may qualify for disability benefits.
Social Security Disability (or SSI) for Shoulder Pain & Shoulder Dysfunctions
Social Security does not have a specific Listing of Impairment for shoulder injuries. Whether you qualify for disability due to a shoulder impairment depends on the problem, the resulting limitations the impairment causes, and your long term prognosis.
Can I Qualify for SSDI or SSI with Degenerative Joint Disease?
Social Security evaluates degenerative joint disease depending on whether the degenerative disease is in your spine (typically called Degenerative Disc Disease) or in your joints.
Degenerative joint disease (DJD) is a term used to describe the condition in which the soft discs that separate interlocking bones in your spine begin to wear down and deteriorate. This condition affects everyone with age, but can sometimes cause severe pain. Symptoms most often occur in the neck or lower back, and can also stretch to the arms and hips. Since the spinal discs are what allow you to bend and twist your back and neck, with degenerative disc disease these actions will cause an increase in pain.
Can I Get Social Security Disability Benefits for Neck Pain
Yes. You may be approved for disability benefits on the basis of neck problems.
Back Pain
To win disability benefits for a back pain condition, you must have a medically determinable back impairment, such as
- spinal stenosis,
- evidence of spinal cord or nerve root impingement or compression (a pinched nerve verified by an MRI,
- a herniated disc (if it is chronic and not treatable), or
- arachnoiditis.
Even then, you must satisfy Social Security’s severity requirements for the particular spinal condition, which is not easy.
Bilateral Hip Replacement and Disability
Whether you can receive SSDI or SSI disability after double hip replacement surgery depends upon many variables, such as whether your recovery is expected to keep you from working for at least one year.
Disability Benefits for Ehlers-Danlos Syndrome
If you have vascular (or regular) Ehlers-Danlos Syndrome (EDS) with severe symptoms that keep you from working full time, you may qualify for disability.
Spinal Stenosis
Lumbar spinal stenosis is one type of the condition that specifically causes numbness and weakness in the lower back that can stretch to the legs, buttocks and feet. Cervical spinal stenosis, which affects the neck, is another. In most cases, the condition initially causes mild pain and increases with time. Normal symptoms of the disease include pain in the back and hip or neck and shoulders, cramping in the legs or arms and a lack of balance as the limbs become weaker. Stressing the spine through walking, leaning or stretching will cause an increase in pain. Severe cases include a loss of control of the bladder and bowels.
Problems Affecting Muscles and Ligaments
Qualifying for Social Security Disability Benefits With Carpal Tunnel Syndrome
Many disability examiners do not approve carpal tunnel syndrome (CTS) upon initial application or on reconsideration. However, many applicants with carpal tunnel syndrome have been successful in winning disability benefits on appeal, especially when combined with other impairments.
Can You Qualify for SSDI or SSI Disability Benefits for a Torn ACL?
If you are over 50 years old, have a history of manual labor, and you can no longer do things like stoop, squat, kneel, crawl, or lift heavy items, you may qualify for disability benefits under the GRIDs.
Does My Sciatica Qualify For Disability Benefits?
It is difficult to qualify for disability benefits based on sciatica alone, unless you have other severe impairments to combine with it in the evaluation process.
Disability for Soft Tissue Injuries
Soft tissue injuries that leave extensive skin lesions or take longer than one year to heal may qualify you for Social Security disability benefits.
Disability for Fibromyalgia
Fibromyalgia is a disorder that causes muscle pain and fatigue (feeling tired). People with fibromyalgia have “tender points” on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.
People with fibromyalgia may also have other symptoms, such as:
- Trouble sleeping
- Morning stiffness
- Headaches
- Painful menstrual periods
- Tingling or numbness in hands and feet
- Problems with thinking and memory (sometimes called “fibro fog”).
Disability for a Torn Meniscus
The question is whether you can obtain disability benefits for such an injury. The answer, as usual, is “it depends”. A torn meniscus is not he type of injury that, by itself, is a significant enough impairment to qualify one for Social Security benefits. However, it may justify an award of benefits if the tear is in addition to other significant impairments, which, in combination, leave the claimant unable to perform full time work.
Moreover, it may be sufficient where the claimant is over 50 years old and has primarily a manual labor background. In such a situation, the “GRID Rules” may come into play, and may justify an award of benefits.
Problems Affecting the Bones
Disability Benefits for Herniated Discs
How much pain one experiences with a herniated disc entirely depends on its position. If it presses on a nerve, constant pain in the neck, back, arms or legs can appear. It could also cause only occasional pain in affected areas, or only get worse with any straining. In extreme cases, loss of bladder and bowel control may be experienced, which is probably a sign of cauda equina syndrome, which should be treated immediately. However, if a ruptured disc is not pressing on a nerve, little or no pain may be experienced.
Social Security Disability (SSDI & SSI) for Avascular Necrosis
Also known as osteonecrosis, it occurs when poor blood supply to an area causes bone death. This lack of blood can cause bone tissue to die and may also result in the collapse of the bone
If you can show that your avascular necrosis is so severe as to prevent you from working on a full-time continuous basis, Social Security may approve your disability claim and pay cash benefits.
Disability Benefits For Bone Spurs
When bone spurs impact your ability to use your arms or your ability to walk effectively, you may qualify for Social Security disability benefits.
Listings of Impairment
The following Musculoskeletal System conditions are listed in Social Security’s Listings of Impairment: gross anatomical deformity of a joint (e.g., subluxation, contracture, bony or fibrous ankylosis, instability); Disorders of the spine -lumbar, thoracic, or cervical (e.g., herniated nucleus pulposus, HNP, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture); amputation; hemipelvectomy or hip disarticulation; fracture of the femur, tibia, pelvis, or one or more of the tarsal bones with nonunion; fracture of an upper extremity with nonunion of a fracture of the shaft of the humerus, radius, or ulna; severe burns; and carpal tunnel syndrome.
The Social Security Administration breaks musculoskeletal disorders down into several categories:
- Joints. Disorders involving joints, including the knees, hips, ankles, shoulders, elbows, wrists, etc., are judged based upon how they affect the claimant’s ability to walk, push, pull, stand, sit, lift, grip and manipulate objects. Social Security will seek to determine whether the claimant could continue to work with reasonable accommodation.
- Spine. The SSA will determine whether a spinal disorder affects the claimant’s ability to move, perform standard work tasks, sit, stand, or concentrate.
- Amputations. Two limbs typically need to be amputated to qualify for SSDI or SSI (though a claimant may qualify with one amputated limb in some instances). The claimant will need to show that prosthetic devices could not be used to help him or her work again.
- Fractures. Fractures can qualify for disability benefits in some instances, but the claimant must be able to show that the fracture is expected to make it impossible for him or her to work for a year or longer.
For most musculoskeletal conditions, you will need to provide medical records as evidence to support the claim. Medical imaging – such as an X-ray, CT scan (sometimes called a “cat scan”), MRI, etc. – is generally accepted as one piece of evidence or proof of the disability. Depending upon the type of musculoskeletal condition, the claimant may also have to undergo a physical consultative examination.
Some musculoskeletal conditions may actually improve with time. To qualify for Social Security disability benefits, you will need to demonstrate that your disability has lasted or is expected to last twelve months or longer. It is important that those who are claiming disability benefits due to musculoskeletal conditions continue treating with their doctors. As parts of its decision, the SSA will consider whether you have been following your doctor’s prescribed treatments and whether they have had an impact on your condition.
Detailed List of Musculoskeletal Conditions
The following is a more detailed list of musculoskeletal conditions:
- Amputation
- Anterior Poliomyelitis
- Back Pain
- Bone Spurs
- Bursitis
- Degenerative Disc Disease
- Gout
- Major Dysfunction of a Joint
- Spine Disorders
- Paralysis
- Carpal Tunnel Syndrome
- Fibromyalgia
- Joint Pain
- Knee Replacement
- Fracture of the Femur, Tibia, or Pelvis
- Fracture of an Upper Extremity
- Herniated Disc
- Hip Replacement
- Inflammatory Arthritis
- Lumbar Stenosis
- Muscular Dystrophy
- Spinal Arachnoiditis
- Osteoarthritis
- Reflex Sympathetic Disorder
- Rheumatoid Arthritis
- Ruptured Disc
- Soft Tissue Injury (Burns)
- Torn ACL
- Undifferentiated and Mixed Connective Tissue Disease
- Shoulder Replacement
- Whiplash
- Neck Pain and Neck Problems
- Shoulder Pain and Shoulder Problems
- Club Foot Deformity
- Piriformis Syndrome
- Avascular Necrosis
If you have a disabling musculoskeletal disorder and need help with your Social Security Disability claim, we can help. Mr. Ortiz is a Board Certified Social Security Attorney that represents Social Security Disability claimants nationwide. Call Ortiz Law Firm at (888) 321-8131 to schedule your free case evaluation.