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HIP REPLACEMENT & SSD BENEFITS

Hip replacement can result in winning SSD benefits if you are unable to work after surgery. However, you must be unable to work for at least 12 months following your hip operation. Additionally, your hip condition must interfere with your ability to perform your work. Likewise, it must also interfere with your ability to perform your other daily activities.

Most hip operations are successful. However, some total hip implant operations do not work. There are people who, after hip replacement, still experience severe pain. Also, due to pain and lack of mobility, they may not be able to walk without a cane or walker. Likewise, they may have trouble sitting and standing for periods of time.

If you are one of the people whose hip surgery was not successful, you should apply for Social Security benefits. You can apply for SSD and SSI benefits online at the Social Security website. We can also help you apply for benefits if for some reason you cannot do it on your own.

After hip replacement surgery,  you may be able to go back to work, but still be  off work for over one year. If that is the case, then you could be paid benefits for the time you were off work. This is called a “closed period” of benefits. A “closed period” of benefits has a beginning and an end. For example, the beginning might be the day you were told you needed a hip replacement. The end date of the period would be the date you went back to work.

TREATMENT FOR HIP DISORDERS

Doctors treat hip pain in a variety of ways. Treatment normally starts with medications, including inflammatory medication and pain medication. Other treatment can include physical therapy and steroid injections. These more conservative methods are done prior to hip replacement surgery. If you have severe hip pain, then you should discuss treatment options with your doctor.

hip replacement surgery with hip X-ray of skeleton

REASONS FOR HIP REPLACEMENT SURGERY

Common reasons for hip replacement surgery include damage to the hip joint from:

  • Osteoarthritis. This type of arthritis usually occurs to due “wear and tear” on the joint. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. Then, the bones then rub together and that causes hip pain.
  • Rheumatoid arthritis. This is an autoimmune disease that creates chronic inflammation which damages the hip cartilage.  Learn more about Rheumatoid arthritis.
  • Disease that causes the bone in joints to die.
  • Injuries or fractures in the hip bone.
  • Bone tumors that break down the hip joint.

In fact, according to the Agency for Healthcare Research and Quality, every year almost 450,000 people have total hip replacement surgery. In the past few years, the number of people having this hip operation has grown.  Part of the reason for the increase is the technology which makes hip surgery faster and less painful.

Unfortunately, there is no way to guarantee that hip surgery will work. Most patients, however, are willing to risk surgery because their hip pain is so intense. Usually it is pain after surgery which prevents people from working for over one year. However, to win SSD benefits after a hip replacement, you must meet the SSA’s medical rules.

AN OVERVIEW OF HIP REPLACEMENT SURGERY

Hip replacement surgery replaces your damaged hip joint with an artificial implant. Here’s an overview of the hip surgery process:

  1. Pre-surgery preparation: Before surgery, you will undergo an exam by your surgeon. This includes a physical exam, medical history review, and imaging tests such as X-rays or MRI scans to assess the extent of joint damage.
  2. Anesthesia: On the day of the surgery, you will be given general anesthesia which puts you to sleep to ensure your surgery is pain free.
  3. Surgery: Your doctor makes an incision along the side or back of the hip to access the hip joint. The damaged cartilage and bone are removed from the hip socket and the top of the femur. The femoral piece, which consists of a metal stem with a metal or ceramic ball on the end, is then inserted into the top of the femur. Then a metal cup lined with a special plastic or a ceramic liner is placed into the hip socket. This creates a new, smooth joint surface.
  4. Wound closure: After the hip implant is in place, your doctor closes the wound with stitches or staples.
  5. Recovery: Following surgery, you will be taken to the recovery room so they can monitor how you are doing. Next, you will be moved to a hospital room. Soon after surgery, you will start physical therapy.
  6. Rehabilitation: After leaving the hospital, you will continue with physical therapy and an exercise program to help in the healing process and improve the strength and use of your new hip.

RISKS OF HIP REPLACEMENT SURGERY

The risks of problems after hip replacement surgery are low. However, there can be problems following surgery. The most common problems that could occur include:

  • The ball comes out of the socket. This is the most common problem that can happen soon after hip surgery. It can happen if you are in certain positions, such as pulling the knees up to the chest.
  • Swelling that cause special cells to eat away some of the bone, causing the joint to loosen. This is the most common problem that can happen later after hip surgery.
  • Infection.
  • Blood clots.
  • Bone growth past the normal edges of the bone.
  • Leg length differences.
  • Difficulty standing and walking.
  • Need for a second surgery.

If you have one of the above problems, you may not be able to work for over 12 months. If that is the case, then the SSA applies their listing of medical conditions to see if you should be paid benefits.

In order to win benefits you can meet or equal a listing. However, keep in mind that it is very difficult to meet a listing. Each listing has several elements that you must prove in order to meet that listing and win benefits.

Also, keep in mind that the date your benefits begin is tied to your application for SSD benefits and SSI benefits. With SSD benefits, you can obtain benefits one year prior to the date of application, as long as you were not working due to your medical condition. As for SSI benefits, they begin the day you apply and not before that date.

HIP REPLACEMENT AND SSD BENEFITS UNDER LISTING 1.17

Listing 1.17 is the most common listing the SSA uses when you have had hip replacement surgery and are seeking benefits. You can read the elements of the listing below. As you can see, one of the main elements in the listing is a physical condition that will last 12 months or longer. This is particularly important, in that many people will have hip surgery, but few will fail to recover in one year.

Listing 1.17 – Reconstructive surgery or surgical arthrodesis of a major weight bearing joint (see 1.00H), documented by A, B, and C:

A. History of reconstructive surgery or surgical arthrodesis of a major weight bearing joint.

AND

B. Impairment related physical limits of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months.

AND

C. A documented medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device for which you use of both hands.

As you can see from listing 1.17, the SSA focuses on the ability to walk without assistance after a hip replacement operation. The SSA is looking at whether you need a walker or bilateral canes or crutches.

If you need these assistive devices, then you must use both hands on the device in order to walk. If you cannot keep your balance without the use of a walker or the use of two crutches, then it is likely you meet the listing. Therefore, you would win SSD benefits by meeting listing 1.17.

MEETING LISTING 1.18 FOR HIP ABNORMALITY

Another listing that the SSA can use to determine if you should be paid SSD benefits is Listing 1.18.  Listing 1.18 focuses on abnormal motion or instability of a major joint, like the hip. However, you need more than pain, stiffness, and abnormal motion in the hip joint.

You must also meet the durational rule. In other words, the symptoms must last longer than 12 months. Additionally, you must also have trouble walking, as in the last listing. You will need to use, for example, two canes or a walker in order to assist you in walking. Other examples of limits brought on by a hip abnormality are below:

1.18 Abnormality of a major joint(s) in any extremity (see 1.00I), documented by A, B, C, and D:

A. Chronic joint pain or stiffness.

AND

B. Abnormal motion, instability, or immobility of the affected joints.

AND

C. Anatomical abnormality of the affected joints noted on:

1. Physical examination (for example, subluxation, contracture, or bony or fibrous ankylosis); or

2. Imaging (for example, joint space narrowing, bony destruction, or ankylosis or arthrodesis of the affected joint).

AND

D. Impairment related physical limits of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following:

The listing also requires impairment related physical limitation of musculoskeletal functioning lasting or expected to last for a continuous 12 month period with medical evidence of at least one of the following:

  • Need for a walker, bilateral canes, bilateral crutches, or a wheeled and seated mobility device (wheelchair) involving use of both hands; or
  • An inability to use one upper extremity to begin or continue work activities involving fine or gross movements and a documented medical need for a cane requiring the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand; or
  • An inability to use both upper extremities to the extent that neither can be used to independently initiate and complete work activities involving fine and gross movements.

In all of the above examples, the SSA is once again looking at whether your hands are free while you are mobile. If your hands are using two canes, then they are busy supporting your body in an upright position. Therefore, they cannot be used to perform work activities.

A MEDICAL EXPERT MAY TESTIFY ABOUT YOUR HIP REPLACEMENT

At your hearing, the ALJ has the option to call a medical expert. A medical expert is there to testify about your hip symptoms following surgery. Specifically, the doctor will testify whether your hip condition meets or equals a listing.

The medical expert can also testify if your hip surgery creates other issues, such as back pain or knee pain. Back and knee pain can occur due to problems walking after hip surgery. If you back pain impacts your ability to sit, stand, walk and lift, then it impacts your ability to work. Find out more here about knee surgery and benefits here.

The medical experts who testify at the hearing are usually retired doctors. Some of the doctors, however, still practice medicine. If the judge calls a medical expert to the hearing, you need to make sure the doctor is an expert.  If they are not an expert, they should not testify about your hip condition.

Your attorney can object to the medical expert. Also, the medical expert may not understand the SSA’s rules. If that is the case, then your attorney can request the judge find a witness does. Find out more here about the medical expert at the hearing.

WIN BENEFITS AFTER HIP REPLACEMENT WITH YOUR RESIDUAL FUNCTIONAL CAPACITY (RFC)

What happens if you don’t meet or equal one of SSA’s rules? Can you still win benefits? The answer is yes. But only if your hip pain effects your RFC.

Your RFC is what you can physically do after taking into account all of your medical conditions. Your RFC determines your ability to work. The types of work are sedentary, light, medium, heavy, and very heavy.

Sedentary work demands are less than light work demands, which are, in turn, less than medium. The SSA usually uses three types of work at your hearing:  sedentary, light, and medium. The type of work you did in the past will be what the SSA uses to determine if you can go back to your old job or adjust to other work.

At the lower levels of your claim, a doctor hired by the SSA will identify how your current symptoms prevent you from working. In other words, the doctor will outline your RFC by looking at your medical records. Find out more here about the importance of medical records in your SSD case.

Additionally, you also have the option to have a RFC form filled out by your treating doctor. You should take such a form to your hip surgeon. Also, you can take an RFC form to your physical therapy appointment after your surgery.

Your treating doctor knows more than anyone about your medical condition and the impact it is having on your ability to work. The SSA will consider the opinion of your doctor. Overall, having the help of your doctor will increase the chances of winning your SSD benefits.

THE VOCATIONAL EXPERT AT THE HEARING

The other time that your RFC is important is at the Social Security hearing. If you appear at a hearing before a judge, a vocational expert (VE) may give testimony. VEs testify about the kinds of jobs you could perform. Also, they testify about the number of jobs that are available to someone with your symptoms. Learn more here about the job expert at your hearing here.

At the hearing, the ALJ presents a question to the VE. Then, the VE will testify if you can work with the physical or mental issues found by the ALJ. Likewise, your attorney presents questions to the VE. Those questions are also based upon your testimony and your medical symptoms.

At our law firm, we have the experience you need to question the VE at your hearing. Your testimony and your medical records are crucial to proving your case after hip replacement surgery. The burden to prove you deserve benefits is on you. Find out more about proving the SSA should pay you benefits here.

WHAT OUR LAW FIRM DOES TO WIN YOUR BENEFITS

After hip surgery, you do not have to obtain SSD benefits on your own. We can help file your SSD application. Also, we can help you through each of the appeal stages of the Social Security process. When you leave SSD process up to us, you can focus on your health. Our attorneys and staff can:

If you file your SSD application online at Social Security’s website, then you have 6 months to complete the application. However, it is best to complete the application quickly. You don’t want to run out the 6 month time limit or delay your case.

HOW WILL YOU AFFORD THE ATTORNEY FEE IN YOUR SSD CASE?

We will use our skills to help you through the SSD appeal process. It is our goal to win your case. But, it also our goal to make filing for SSDI benefits easier for you. We offer a free review of your benefits. If you call, then there is no pressure to become a client. You can simply ask questions. We will answer. Even if we don’t accept your case, we will still try to help you.

It also doesn’t cost you any money to hire us. Why? Because you only pay us an attorney fee if we win your case. If we win, then you pay us out of your back benefits. If you do not win, you do not pay an attorney fee.

How much is the fee? It is 25% of your back benefit. Also, there is a fee cap set at $7200 by the SSA. You never pay more than the fee cap at the hearing stage of your case. And, 25% of your back benefit is usually less than the $7200 cap. You will pay the lesser amount.

If there are costs in your case, then you pay for those costs. But the costs are usually less than $100. Typically, if a doctor charges for copies of your medical records, then that is your bill to pay. However, most costs are less than $100. You will owe the costs in your case whether we win or lose your case. Your attorney fees come from your back benefit. You only pay an attorney fee if we win your case. You owe no attorney fee if we do not win benefits for you.

HIRE OUR EXPERT LAWYERS AND STAFF TO HELP

If you cannot work after hip replacement surgery, then Cannon Disability Law can help. We can help you apply for SSD and SSI benefits. Also, we can help you appeal an SSA denial. Additionally, we will represent you in court at your Social Security hearing. We will help you be a witness in your case.

If necessary, we can appeal your case to the Appeals Council. And out more about the Appeals Council here. Likewise, we can file an appeal in Federal Court. Also, we can represent you where you live. For example, we can represent you if need an attorney in Utah or Nevada. Additionally, we can help you if you live in Idaho, Colorado, or California.

Your ability to receive Medicaid and Medicare depends upon whether you win your SSD and SSI claim. Find out about Medicaid benefits here. Also, learn more about Medicare benefits here. In order to fight the SSA’s denials, you need an attorney with experience.

Hire us. Dianna Cannon has been helping people with win benefits for over thirty years. Brett Bunkall and Andria Summers have many years of legal experience. Together, we have won over 20,000 SSDI and SSI hearings. You can trust us. We will do everything we can to win your benefits for your failed hip replacement.

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