The Social Security Administration (SSA) doesn’t always make it easy for those who have had a hip replacement to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve.
Many hip replacement claims are denied because SSA says:
(1) Your hip replacement won’t prevent you from working at least 12 months,
(2) Your hip replacement problems aren’t severe,
(3) Your hip replacement or its complications don’t meet the requirements of, or is the equivalent of, a Medical Listing,
(4) You can return to the lightest job you held in the 15 years before you became disabled, or
(5) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
Not all hip replacement problems are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with hip replacements.
Most hip replacement surgery is successful and doesn’t result in disability that lasts at least 12 months. You have to prove that your hip replacement and your inability to walk properly interfere with your daily activities and ability to work.
Ms. Cavey works to overcome the claims denial by working closely with you and your physician by showing that you:
Meet the requirements for a disability listing, or
Proving that you rlimitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.
She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
What Are The Causes of Hip Replacement and Surgical Complications?
The most common reason for a hip replacement is pain caused by rheumatoid arthritis, osteoarthritis or as a result of vascular necrosis, a side effect of medication given for other conditions, including lupus, that causes destruction of the hip joint.
Treatment can include medication, physical therapy, injections and even surgery. Hip surgery involves removing part of the hip joint and putting in synthetic or metal parts. If you have surgery on both hips at the same time or have had surgery of both hips, you will have undergone bilateral hip replacement surgery.
Complications of hip surgery can include:
• Dislocation of the implant,
• Allergic reaction to the implant,
• Deep vein thrombosis,
• Change in leg length,
• Difficulty walking, and
• Increased pain.
What SSA Wants to See in Your Medical Records
SSA will review your medical records and look for the following:
A diagnosis of the underlying condition for which you underwent the hip replacement,
Detailed description of your pre- and post-operative symptoms,
Objective evidence of an inability to walk effectively to include an inability to walk without using a walker or two crutches or two canes; an inability to walk at a reasonable speed over a long enough distance to be able to complete the necessary activities of daily living like shopping; an inability to walk a block at a reasonable pace on rough or uneven surfaces; an inability to climb a few stairs at a reasonable speed with the use of one handrail, and an inability to travel to work or school without another person helping you,
Detailed treatment history, including medication, and your response,
Side effects of medication,
Evidence that you have complied with treatment, and
Any psychological problems, including depression or anxiety, that may interfere with your ability to function.
Hip Replacement and Its Complications and The Listing Of Impairments
There is a listing for bilateral hip replacement in the Listing of Impairments under the criteria for “Reconstructive Surgery or Surgical Arthrodesis of a Major Weight Bearing Joint.” Your medical records must establish that you meet every element of the Listing considered disabling.
To meet a Listing, you must have had hip replacement surgery and objective evidence of the inability to walk effectively.
However if your complications from hip replacement fall under or are equal to a listing, you might be approved for benefits at Step 3 of the Five-Step Sequential Evaluation.
If you have Hip replacement and another medical impairment like arthritis, SSA is required to consider the combined effects of your impairments when determining if your condition is equal to a listing or when doing your RFC analysis at Steps 4 and 5.
If you don’t meet or equal a listing, then SSA will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5. Because the listing requirements are difficult to meet, SSA finds that most disability applicants don’t meet a Listing.
When Your Hip Replacement Makes It Impossible to Work
If your hip replacement and its complication don’t meet a listing, you will have to prove that you:
Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your hip replacement.
Residual Functional Capacity For Hip Replacement
The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that explain:
How far you can walk,
Whether you can walk effectively,
How long you can stand and sit at one time and for an eight-hour work day,
How much and how often you can lift, stoop, squat, bend during an eight- hour work day,
Whether you have difficulty concentrating for long periods of time because of your pain,
Whether you have to take naps during the course of the day, how many and how long are the naps,
Whether you have good days and bad days and how many days per month you would miss from work, and
Whether you have psychological problems, including depression or anxiety, that would interfere with your ability to work.
This is not an exhaustive list of all of the questions on a hip replacement or other applicable RFC forms. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.
How Your Residual Functional Capacity Is Used At A Social Security Hearing
Many claims for hip replacement are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
Whether you can return to the lightest job you held in the last 15 years,
Whether there is other work you can do or could learn to do.
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
How Do I Get The Social Security Disability Benefits I Deserve For A Hip Replacement?
Hip replacement and its complications can interfere not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:
1. file your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits;
2. challenge a wrongful denial of your Social Security disability application or Request for Reconsideration;
3. file a Request for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.
The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by experienced Social Security Disability attorney Nancy Cavey.
Contact our Florida social security disability attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live in Florida
Hip replacement and its complications can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits. Call today for a free consultation at 727-894-3188.