A major dysfunction in the shoulder joint often leads to a shoulder replacement surgery. Joint dysfunction may be caused by a degenerative disease, like arthritis, or may be due to an accident or injury. There are also congenital defects that can eventually require shoulder replacement surgery to restore function to the joint. No matter the cause of shoulder joint dysfunction, replacement surgery entails the removal of part of or all of the joint, and replacement of those parts with synthetic joint components that are intended to restore normal operations in the joint.
Applying for SSD with a Shoulder Replacement
If you’ve undergone shoulder replacement surgery and remain severely limited following the procedure, you may need to file for Social Security Disability (SSD) benefits. The Social Security Administration (SSA) uses the “Major Dysfunction of a Joint” section (1.02), listed in the Blue Book under Musculoskeletal conditions (1.00) to evaluate disability claims based on shoulder replacement surgery and shoulder joint dysfunction.
You’ll need to include extensive medical records and other documentation in your SSD application. Records should include:
- Statements from your physician(s) indicating the limitations imposed by your condition
- Notes from physical examinations showing limited range of motion in the shoulder joint
- Imaging results showing any organic defects in the shoulder joint and surrounding tissues
- Evidence that your condition has lasted, or is expected to last, 12 months of more
Shoulder Replacement and Medical Vocational Allowance
Most applications for SSD benefits based on a shoulder replacement don’t qualify for benefits under the major dysfunction of a joint listing in the Blue Book. If this is true in your claim, you may still be found eligible for SSD benefits, if you meet the requirements for a “medical vocational allowance”.
A medical vocational allowance requires the SSA to review your medical records and you work history and qualifications to determine if your condition is severe enough to prevent you from finding and maintaining gainful employment. In order to establish your disability, your application for SSD and your supporting documentation must show you’re unable to perform other common job duties, like:
- reaching and bending
- lifting and carrying
- typing, writing or operating equipment,
- sitting or standing in one location for any length of time without shifting your weight or changing position
Medical Records to Prove Shoulder Replacement
In addition to the documentation previously stated, your application for SSD benefits should include:
- all your medical records
- diagnostic evaluations and related notes
- tests performed and the results from those exams
- medications and other treatments or therapies you’ve tried
- detailed statements from your treating physician(s)
To qualify for SSD benefits, you’ll need to prove you’re unable to work in your previous field of employment. You must also show your shoulder replacement imposes such severe limitations that you can’t maintain gainful employment in any other field either. In other words, your condition must be proven to prevent you from working in any job for which you might otherwise be qualified.
Getting Help with Your Shoulder Replacement SSD Application
Proving a disability claim for a shoulder replacement can be difficult, especially as the majority of joint replacement surgeries go well, restoring joint function and range of motion for most patients. Extensive documentation of your medical condition and the limitations it imposes will be necessary for proving your disability. Working closely with your medical doctor is critical in your SSD application. Getting help from a Social Security advocate or attorney can also be very beneficial – helping you construct a thorough application and case file, thereby increasing the chances you’ll be approved for SSD benefits.