A fracture of the femur, tibia, pelvis, or one or more of the tarsal bones can qualify as one of the disabling conditions for SSDI under SSA rules when the fracture is severe, you have chronic fractures, or the fracture significantly limits your ability to function or work full-time.
A fracture of the femur, tibia, pelvis, or one or more of the tarsal bones is a serious orthopedic injury involving major weight-bearing bones. These fractures can result from trauma, accidents, or falls and may require surgery, immobilization, or long-term rehabilitation. Symptoms can range from moderate pain to severe mobility limitations and complications.
Approval for Social Security disability depends on:
• Diagnosis confirmation
• Severity and complications
• Duration (must last or be expected to last at least 12 months)
• Treatment response
• Functional limitations affecting the ability to sustain full-time work
Even if your fracture or fractures do not exactly meet a Blue Book listing, you may still qualify if the loss of function caused by the fracture is medically equivalent or prevent you from maintaining full-time work.
Applicants may qualify for SSDI for fractures of the femur, tibia, pelvis, or tarsal bones or SSI for physical disability depending on their work history and financial situation. These types of fractures are often evaluated under SSA musculoskeletal listings (Section 1.00).
Common Symptoms the SSA Looks For
The SSA evaluates the severity of fractures based on how well the bones heal, whether there are complications, and how the injury affects your ability to move and function.
For example, if you have a fracture that has not healed properly or requires you to avoid putting weight on the affected area, especially if you have a bone-weakening condition like osteoporosis, you may not be able to work a job where you need to stand, walk, or move throughout the day.
Common symptoms of these fractures include:
• Severe pain at the fracture site
• Inability to bear weight on the affected limb
• Swelling and bruising
• Limited range of motion
• Difficulty walking or standing
• Joint stiffness or instability
• Complications such as nonunion or improper healing
When evaluating your claim, the SSA will look over your medical history and records to see how severe your condition is. If your fracture or its complications affect your mobility to the point where you cannot perform basic work activities, you may be able to qualify for SSDI.
Symptoms associated with your fracture may be disabling if they:
• Fluctuate during the healing and rehabilitation process
• Worsen with activity or weight-bearing
• Persist despite treatment such as surgery, physical therapy, or immobilization
The SSA will look at your medical records and other evidence to determine if your symptoms are severe enough to keep you from working.
How A Fracture Of The Femur, Tibia, Pelvis, Or One Or More Of The Tarsal Bones Can Affect Your Ability to Work
Fractures of the femur, tibia, pelvis, or tarsal bones that are severe can make it impossible for you to work if you cannot perform basic physical activities required in most jobs. Even moderate symptoms can cause limitations that make it difficult to work like:
• Difficulty standing or walking for long periods, which would make it impossible for you to perform jobs that require being on your feet
• Pain that isn’t fully controlled by medication interfering with concentration
• Limited ability to lift, carry, or move
• Reduced mobility affecting coordination and balance
• Need for assistive devices such as crutches or a walker
• Need for frequent rest or elevation of the affected limb
• Frequent absences due to medical appointments or complications
Frequent doctor’s visits, surgeries, or hospitalizations can also be considered impairments that make it impossible for you to work.
The SSA’s Medical Criteria for Physical Disabilities
The Social Security Administration requires that you submit detailed medical records and documentation of your symptoms and your condition during the SSDI application process. You must show proof that your condition and symptoms make it impossible for you to work.
Evidence that can support your claim that you can’t work may include:
• X-rays, CT scans, or MRIs confirming the fracture
• Surgical reports if operative treatment was required
• Treatment records including casting, bracing, or physical therapy
• Documentation of healing progress or complications such as nonunion
• Reports describing daily functioning
Even if you don’t meet the SSA’s strict Blue Book requirements, you can still qualify for SSDI or SSI if you can prove that your symptoms directly impact your ability to work.
If You Don’t Meet the SSA Criteria With A Fracture Of The Femur, Tibia, Pelvis, Or One Or More Of The Tarsal Bones
If you don’t meet the Blue Book requirements, you may still be able to qualify for SSDI or appeal a disability denial.
The SSA evaluates your Residual Functional Capacity (RFC), or ability to work based on your symptoms.
You may qualify based on:
• Inability to stand or walk for extended periods
• Need to use assistive devices
• Limited ability to lift or carry weight
• Pain affecting focus and pace
• Reduced mobility or balance issues
• Ongoing treatment or rehabilitation needs
• Frequent medical visits or complications
Long-term mobility limitations and healing complications can strengthen your claim.
Qualifying for SSI With A Fracture Of The Femur, Tibia, Pelvis, Or One Or More Of The Tarsal Bones
SSDI is a disability program based on work credits. If you have never worked, or you haven’t earned enough work credits to qualify for SSDI, you can apply for SSI.
SSI is a disability benefit program similar to SSDI, but it’s financial need based, not work based. However, there are income and asset limits you must meet to be eligible for SSI.
You must have assets no greater than around $2000 for a single person, or $3000 for a couple. And when you apply, you still have to show that your medical condition makes it impossible for you to work.
A strong disability claim includes:
• Consistent medical treatment
• Specialist care (orthopedist or surgeon)
• Diagnostic imaging results
• Documentation of pain and mobility limitations
• Records of treatment or surgical interventions
• Work history showing reduced capacity
Initial denials are common, and the disability claim process often involves appeals.
How Much Does Disability Pay With A Fracture Of The Femur, Tibia, Pelvis, Or One Or More Of The Tarsal Bones
Disability benefits are not based on your diagnosis. The amount of benefits that you qualify for are based on your earning history for SSDI. In some cases, you may qualify for as much as $3-4,000 more per month if you have a history of high earnings.
SSI benefit amounts are income-based and capped, so there’s no way to qualify for higher payments.
Typical SSDI and SSI amounts nationally are:
• The average SSDI payment is about $1,500 per month
• The federal maximum payment for SSI is about $943 per month (may vary by state)
How to Apply For SSDI With A Fracture Of The Femur, Tibia, Pelvis, Or One Or More Of The Tarsal Bones
You can apply for SSDI or SSI over the phone, online, or by making an appointment to apply in person at your local SSA office. But no matter what way you apply, your application needs to include your work history, your medical records, a list of your medical providers, and any other documents that can show how your condition makes it impossible for you to work.
A smart way to show the SSA how your symptoms affect your ability to work is to track:
• Frequency and severity of pain
• Activities that worsen symptoms
• Medication use
• Impact on daily functioning
Supporting statements from medical professionals and others can help your claim. If you can, get supporting statements from:
• Doctors or specialists
• Medical providers
• Family members
• Employers or HR
Strong evidence for disability can improve your chances of approval.
How a Disability Lawyer Can Help
A disability lawyer may be able to help you with your claim. A lawyer can help you by explaining exactly what medical evidence you should include with your claim, helping you meet all filing deadlines, handling your appeal if your application is denied, and helping you understand the SSA's requirements. Disability attorneys charge no upfront fees and are only paid if you win.
Get Help With Your Fracture Disability Claim Today
If a fracture of the femur, tibia, pelvis, or one or more of the tarsal bones is preventing you from working, you may qualify for benefits. Request a free case evaluation today to get connected with a disability attorney who may be able to answer your questions and help you apply for SSDI.
