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Musculoskeletal Disorders And Social Security Disability

Your musculoskeletal system comprises all of your body’s bones and the muscles 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 prevent you from working.

Social Security’s rules recognize a wide variety of musculoskeletal conditions that, if severe enough, may qualify for disability benefits from the Social Security Administration. Below, we discuss how the Social Security Administration evaluates the most common bone, muscle, and connective tissue impairments in Social Security Disability Insurance (SSDI or SSD) and Supplemental Security Income (SSI) benefit claims:

Joint Problems

Osteoarthritis

Although osteoarthritis can affect any joint, the most commonly 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 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 limit their mobility or use of their hands severely, they may qualify for disability benefits.

Shoulder Pain & Shoulder Dysfunctions

Social Security does not have a specific listing 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.

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 often occur in the neck or lower back and can 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.

Neck Pain

Yes. You may be approved for disability benefits based on neck pain 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 difficult.

Bilateral Hip Replacement

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.

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 a condition that 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. Typical 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 weaken. 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

Carpal Tunnel Syndrome

Many disability examiners do not approve carpal tunnel syndrome (CTS) upon initial application or reconsideration. However, many applicants with carpal tunnel syndrome have been successful in winning disability benefits on appeal, especially when combined with other impairments.

Torn ACL

If you are over 50 years old, have a history of manual labor, and can no longer stoop, squat, kneel, crawl, or lift heavy items, a torn ACL may qualify you for disability benefits under the SSA GRID rules.

Sciatica

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.

Soft Tissue Injuries

Soft tissue injuries that leave extensive skin lesions or take over one year to heal may qualify you for Social Security disability benefits.

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”).

Torn Meniscus

A torn meniscus is not the type of injury that 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 justify an award of benefits.

Problems Affecting the Bones

Herniated Discs

How much pain one experiences with a herniated disc entirely depends on its position. Constant neck, back, arms, or leg pain can appear if it presses on a nerve. It could cause only occasional pain in affected areas or worsen 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.

Avascular Necrosis

Also known as osteonecrosis, avascular necrosis 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. Suppose you can show that your avascular necrosis is so severe as to prevent you from working on a full-time continuous basis. In that case, Social Security may approve your disability claim and pay cash benefits.

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

Listing 1.00 Musculoskeletal Disorders – Adult is listed on the SSA’s website. The following Musculoskeletal System conditions are listed in Social Security’s Listings of Impairment:

  • 1.01 Category of Impairments, Musculoskeletal Disorders
  • 1.15 Disorders of the skeletal spine resulting in compromise of a nerve root(s) 
  • 1.16 Lumbar spinal stenosis resulting in compromise of the cauda
  • 1.17 Reconstructive surgery or surgical arthrodesis of a major weight-bearing
  • 1.18 Abnormality of a major joint(s) in any extremity 
  • 1.19 Pathologic fractures due to any cause 
  • 1.20 Amputation due to any cause
  • 1.21 Soft tissue injury or abnormality under continuing surgical management 
  • 1.22 Non-healing or complex fracture of the femur, tibia, pelvis, or one or more of the talocrural bones
  • 1.23 Non-healing or complex fracture of an upper extremity 

Categories of Impairments

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 on 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 must show that prosthetic devices could not be used to help them work again.
  • Fractures. Fractures can qualify for disability benefits in some instances. Still, the claimant must be able to show that the fracture is expected to make it impossible for them to work for a year or longer.

You must 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 must demonstrate that your disability has lasted or is expected to last twelve months or longer. Those who are claiming disability benefits due to musculoskeletal conditions must continue treatment with their doctors. As part of its decision, the SSA will consider whether you have been following your doctor’s treatment plan and whether it has impacted 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

Get Help with Your Social Security Disability Claim

If you have a disabling musculoskeletal disorder and need help with your Social Security disability claim, we can help. Nick Ortiz is a national Social Security disability attorney who can represent claimants anywhere in the United States. Call the Ortiz Law Firm at (888) 321-8131 to schedule your free case evaluation.

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