If you recently received a hip replacement, you are far from alone. Those who have recently had a hip replacement may qualify for Social Security disability benefits. To qualify for disability benefits after a hip replacement, you must meet the SSA's Blue Book listing outlining the specific medical qualifications.
As stated, if you have received a hip replacement, you are not alone. According to data from the HealthDay Reporter, hip replacements are more common now than they’ve ever been.
In fact, in people aged 45 to 54, hip replacements have increased by 205% over the past few years. Part of the reason for this increase is ever-improving technology, making hip replacements faster and less painful than before.
Unfortunately, even modern medicine cannot make hip replacements painless. While many recipients see recovery within 4-6 months, others can still face complications from their surgery for up to a year after, or even longer.
If you are struggling to live your daily life due to continued pain and complications after your hip replacement, then you may qualify for financial assistance through the Social Security disability benefits program.
Using the Social Security's “Blue Book”
Social Security disability benefits are for those whose conditions leave them unable to work or care for themselves independently for 12 months or longer. This is how the Social Security Administration (SSA) defines “total and permanent disability.” You can review how the SSA evaluates each condition in their compiled guidelines, known as the Blue Book.
Of course, depending on your condition, there are different requirements to determine whether or not your symptoms can help you qualify. These requirements are organized and listed in the Social Security Administration’s Blue Book.
Hip replacements are listed in the Blue Book under Section 1.03: “Reconstructive Surgery or Surgical Arthrodesis of a Major Weight-Bearing Joint.” Here, it states that hip replacements can help you qualify for disability benefits if you are unable to ambulate effectively (and are not expected to do so) within 12 months of your surgery.
An “inability to ambulate” is defined by the SSA as an extreme limitation of a person’s ability to walk, use their legs, or get around without the use of both arms.
If it has been longer than a year since your surgery and you are still unable to walk reliably without assistance, then you may be able to qualify for benefits.
Potentially Qualifying Before Surgery
The SSA Evaluation and Medical Qualifications
One thing that some applicants are unaware of is that they may qualify for benefits prior to the surgery. By providing evidence of your medical condition before the surgery, you may qualify for retroactive disability benefits to also cover a period before your hip replacement.
Under Section 1.02 of the Blue Book, “Major Dysfunction of a Joint Due to Any Cause,” it states that an applicant with hip problems can qualify for benefits if they have:
- a gross anatomical deformity (subluxation, contracture, bony or fibrous anklyosis, etc.) and chronic joint pain and stiffness,
- signs of limitation of motion or other abnormal motion of the affected joint(s),
- medical imaging to demonstrate the narrowed joint space, bony destruction, or anklyosis of the hip, and
- an inability to ambulate effectively (as explained previously)
This listing is far more complex than Section 1.03, so it is understandable to be unsure of your qualifications here. The best way to know if your hip condition has qualified since before the surgery is to speak with your physician and receive/redo tests to further understand your diagnosis.
Preparing for the Application
The majority of work required on the disability application comes in the preparation beforehand. Once you have the required paperwork ready, all that’s left is to get started on the SSA’s website. Below are the most important pieces of medical information you should prepare before starting your application:
- MRI/CT scans: Imaging is arguably the most important test you can provide to demonstrate the severity of your hip issue, before and after surgery. Include all imaging scans taken since the beginning of your hip problems.
- Residual Functional Capacity test: This test measures your current ability to do many of the physical functions necessary for daily life, such as walking, sitting, standing still, or standing up from sitting, pushing, lifting, or bending.
- Current and past treatment attempts: The SSA will want to know everything you tried before and after surgery to fix your hip complications. Those with a treatment-resistant condition are more likely to qualify for benefits before surgery.
- Physical therapy logs: This will also help the SSA to see how, despite treatment attempts, you have been unable to see positive results.
- General medical history: This includes even regular physician check-up notes that go back as far as you can get them. The better the SSA understands your medical history, the more likely you are to receive benefits
Working With a Disability Attorney
Even if you feel certain you’ll receive benefits, you never know what will happen until you see results. Regardless of your situation, it may be wise to play it safe and consider consulting with an attorney before you apply.
Not only do most offer free consultations, but the majority are legally required to not take payment unless they help you win your case. For help with filing paperwork, updating the SSA, and potentially building your case in court, there is no better resource than a disability attorney.