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HIP REPLACEMENT & SSD BENEFITS

Hip replacement can result in disability benefits, if you are unable to work after surgery. However, you must be unable to work for at least 12 consecutive 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 daily activities.

Most hip replacement operations are successful. However, some total hip implant surgeries do not work. There are people who, after hip replacement, still experience severe pain. Also, due to pain and functional limitations, 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 Disability benefits. You can apply for SSD and SSI benefits online at the Social Security website. We can also help you apply if 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 might be eligible for disability benefits during the time you were off work. This is called a “closed period” of disability benefits. A “closed period” of disability 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 typically 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, 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. The inflammation damages the hip cartilage.  Learn more about Rheumatoid arthritis here.
  • Disease that causes the bone in joints to die (e.g., osteonecrosis).
  • Injuries or fractures.
  • Bone tumors that break down the hip joint.

In fact, according to the Agency for Healthcare Research and Quality, every year approximately 450,000 people have total hip replacement surgery. In the past few years, the number of people having this hip operation has increased.  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 replacement surgery will be painless. Most patients, however, are willing to risk surgical complications because their hip pain is so intense. Typically it is pain after surgery which prevent people from working for over one year. However, to qualify for disability benefits after a hip replacement, you must meet the SSA’s medical qualifications.

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 replacement 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 replacement surgery.
  • Infection.
  • Blood clots.
  • Bone growth past the normal edges of the bone.
  • Leg length discrepancy.
  • Difficulty standing and walking.
  • Need for revision surgery.

If you have one of the above complications, you may not be able to work for over 12 months. If that is the case, the Social Security Administration applies their listing of disabilities to determine if you are eligible for 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 obtain 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 disability. As for SSI benefits, they begin the day you apply and not before that date.

HIP REPLACEMENT AND DISABILITY UNDER LISTING 1.17

Listing 1.17 is the most common listing the SSA uses when the claimant has undergone hip replacement surgery and is claiming disability. You can read the requirements of the listing below. As you can see, one of the main elements in the listing is a physical limitation 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 limitation 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 (see 1.00C6a) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i)).

As you can see from listing 1.17, the SSA is focusing 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 be eligible for disability benefits by meeting listing 1.17.

MEETING LISTING 1.18 FOR HIP ABNORMALITY

Another listing that the SSA can use to determine if you are eligible for disability 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 criteria. In other words, the symptoms must last longer than 12 months. Additionally, you must also have difficulty 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 limitations 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 joint(s).

AND

C. Anatomical abnormality of the affected joint(s) 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 limitation 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 documentation 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 one-handed assistive device 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 scenarios, the SSA is once again looking at whether your hands are free while you are mobile. If your hands are using an assistive device, such as 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 disability hearing, the ALJ has the option to call a medical expert. A medical expert is there to testify about your hip impairment following surgery. Specifically, the doctor will testify whether your hip impairment meets or equals a listing. The physician can also testify if your hip replacement creates other issues, such as back pain or knee pain. Back and knee pain can occur due to difficulty walking after hip surgery. Find out more here about knee replacement surgery and disability benefits here.

Medical experts 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 in orthopedics.  If they are not an expert, they may not be qualified to testify about your hip impairment. Your representative 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 who has the right qualifications.

WIN BENEFITS AFTER HIP REPLACEMENT WITH YOUR RESIDUAL FUNCTIONAL CAPACITY

What happens if you don’t meet or equal one of SSA’s listings? Can you still win disability benefits? The answer is yes, but only if your hip impairment effects your residual functional capacity (RFC).

Your RFC is what you can physically do after taking into account all of your impairments. Your RFC determines your work capability. The categories of work are sedentary, light, medium, heavy, and very heavy. Each level of work has a specific definition. Sedentary exertional demands are less than light work demands, which are, in turn, less than medium. The SSA typically uses three definitions of work:  sedentary, light, and medium. These categories will be the most likely be the work categories that the SSA will use to determine if you can work at your old job or adjust to other work.

At the lower levels of you disability claim, a Disability Determination Services (DDS) physician will identify how your current limitations prevent you from working. In other words, the DDS physician will outline your residual functional capacity by looking at your medical records. Find out more here about the importance of medical records in your disability case.

Additionally, you also have the option to have a Residual Functional Capacity 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 therapist after surgery. Your treating doctor knows more than anyone about your disability and the impact it is having on your ability to work. The SSA will consider your doctor’s opinion when determining whether you are eligible to receive benefits. Overall, having your doctor’s help may increase the chances of your SSD claim being approved.

THE VOCATIONAL EXPERT AT THE HEARING

The other time that your residual functional capacity is important is at the disability hearing. If you appear at a disability hearing before a judge, a vocational expert may give testimony at your hearing. Vocational experts testify about the kinds of jobs you could perform. Also, they testify about the number of jobs that are available to someone with your impairments. Learn more here about vocational experts.

At the hearing, the ALJ presents a hypothetical to the VE. Then, the VE testifies if you can work with the physical or mental issues found by the ALJ. Likewise, your attorney presents a hypothetical question to the VE. That question is also based upon your testimony and your medical impairments. At Cannon Disability, we have the experience you need to cross-examine the vocational expert at your hearing. Your testimony and your medical records are crucial to proving your disability after hip replacement surgery. The burden to prove disability is on you. Find out more here.

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

We will use our skills to help you through the disability process. It is our goal to win your case. But, it also our goal to make applying for disability benefits easier for you. We offer a free consultation. If you call, then there is no obligation to become a client. You can simply ask questions. We will answer. Even if we don’t accept representation in 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. This is a contingency fee. It means if we win, 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 $6000 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 $6000 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. We also have a small office fee that covers expenses we incur for your case. However, that fee is also less than $100. You will owe the costs in your case whether we win or lose your case. However, 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.

CANNON DISABILITY LAW’S REPRESENTATIVES

If you cannot work after hip replacement surgery, then Cannon Disability Law 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 disability 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 a disability 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 or not you win your disability claim. In order to fight the SSA’s denials, you need a representative with experience. Hire us. Dianna Cannon has been representing people with disabilities for over thirty years. Brett Bunkall and Andria Summers have many years of litigation experience. Together, we have won over 20,000 disability hearings. You can trust us. We will do everything we can to win your SSD and SSI benefits.

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