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KNEE REPLACEMENT SURGERY AND DISABILITY BENEFITS

Knee replacement surgery can result in winning SSD and SSI benefits if you can no longer work. Especially, if you have chronic pain and cannot work for longer than 12 months. Typically, over 600,000 knee replacement operations are performed every year in the United States. Sometimes people undergo double knee replacement surgeries. For example, many people have one knee operation and a few weeks later, have the second knee replaced.

Total knee replacement surgery involves replacing both sides of the knee joint. It is the most common operation. The surgery usually lasts between 1 and 3 hours. After surgery, you will have less pain and better mobility. But, you will have scar tissue. Knee scar tissue can make it difficult to move and bend your knees.

Knee replacement surgery is one of the most successful joint operations. According to research, more than 82 percent of total knee replacements are still functioning 25 years later. However, for certain people, knee surgery may not work. Research suggests almost 20% of those who have a total knee replacement experience chronic pain.

ELIGIBILITY FOR SSD & SSI BENEFITS AFTER KNEE REPLACEMENT SURGERY

If you have ever had surgery, you know pain doesn’t disappear after the operation. In fact, even with surgery, you may still have major problems with pain. For example, problems occur when the pain prevents you from working. It may also prevent normal activities, like standing or sitting. Chronic pain may result in the inability to walk. If you can’t walk or stand for prolonged periods, you may not be able to work. You may even have knee pain and knee swelling when sitting. Sedentary work requires sitting. If you cannot stand, you can’t perform light work. Similarly, if you cannot sit, you cannot perform sedentary work.

RESIDUAL FUNCTIONAL CAPACITY

When your ability to perform activities, such as sitting and standing is impaired, it is known as impairment in your “residual functional capacity.” If your residual functional capacity is limited, then the SSA may find you cannot sustain full-time work. If you cannot do your old job, you should apply for SSD and SSI benefits.

Knee surgery can also impact your ability to lift. Limitations in lifting also prevent certain kinds of work, just like back pain does. Knee pain may not go away, even after surgery, because the pain was originally brought on by arthritis. Arthritis is a life-long condition. If you have had an injury to a certain area of your body, it can become arthritic. Likewise, arthritis can also be genetic. If you have knee arthritis, there is a good chance you may have arthritis in other joints of your body. For example, knee replacement can also contribute hip impairments or even hip replacement surgery.

WINNING SSD UNDER LISTING 1.17 AFTER KNEE REPLACEMENT SURGERY

At Cannon Disability Law, we see clients who did not recover after knee surgery. Knee surgery results in being paid SSD benefits if you suffer from chronic pain and you need two canes or a walker to walk. The SSA applies Listing 1.17, to figure out if you should be paid SSD or SSI benefits. Listing 1.17 refers to reconstructive surgery of a major weight bearing joint. In other words, it applies to you if you have knee replacement surgery. Because, the knee is a major weight bearing joint.

Man with walker after knee replacement surgery, stitches close up. Painful scar after knee surgery

RECONSTRUCTIVE SURGERY  OF A WEIGHT-BEARING JOINT

In order to win SSD and SSI benefits, your physical condition must meet or equal an SSA listing. Meeting a listing means having all the symptoms on the list. Equalling a listing means having a combination of symptoms that are as severe as those in the listing.

If you did not recover from knee replacement surgery, your knee condition may qualify for benefits under SSA’s listings. The phrase “major weight-bearing joint” basically means a joint you need to stand and walk. Knees, hips, and ankles, all fall into the  category of a major weight-bearing joint.

Most joint surgeries do not keep your from returning to work. The reason for that is most people recover after surgery in under one year. To receive SSD and SSI benefits, you must have at least one year of disability to be paid benefits. This means that you cannot be working for over 12 months. If you do not have 12 months off work, then the SSA may not pay you.

SSA uses a certain rule to talk about reconstructive knee surgery. Listing 1.17 for reconstructive surgery or surgical arthrodesis of a major weight bearing joint is outlined below:

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)).

The definition of ambulating effectively is found in SSA’s regulations.

WHAT DOES THE SSA MEAN BY “AMBULATE EFFECTIVELY”?

SSA’s rules contemplate a very specific definition of effectively ambulating or walking.  The old SSA listing 1.02B states:

Inability to ambulate effectively means an extreme limitation of the ability to walk; i.e., an impairments that interferes very seriously with the individual’s ability to independently initiate, sustain, or complete activities. Ineffective ambulation is defined generally as having insufficient lower extremity functioning to permit independent ambulation without the use of a hand-held assistive devices that limits the functioning of both upper extremities.

The regulation goes on to say:

To ambulate effectively, individuals must be capable of sustaining a reasonable walking pace over a sufficient distance to be able to carry out activities of daily living. They must have the ability to travel without companion assistance to and from a place of employment or school. Therefore, examples of ineffective ambulation include, but are not limited to:

    • the inability to walk without the use of a walker,
    • two crutches or two canes,
    • inability to walk a block at a reasonable pace on rough or uneven surfaces,
    • the inability to use standard public transportation,
    • being unable to carry out common activities that require walking, like shopping and banking,
    • and the inability to climb a few steps at a reasonable pace with the use of a single hand rail.

The ability to walk independently about one’s home without the use of a cane or walker does not, in and of itself, constitute effective ambulation. However, the SSA is focusing their rules on walking. Needing a cane or walker to walk is very important in SSA’s rules. If you require a two canes or a walker in order to walk, you probably meet SSA’s rules and you should receive benefits.

WHAT DOES THE SSA MEAN BY “ASSISTIVE DEVICE”?

Now, the SSA’s new rules focus on whether you need an assistive device to help you walk. An assistive device, for the purposes of these listings, is any device that you use to improve your stability, dexterity, or mobility. An assistive device can be worn (see 1.00C6b and 1.00C6c) or hand-held (see 1.00C6d). It can also be used in a seated position (see 1.00C6e). Normally, SSA means you are using a cane or a walker to help you walk.

When the SSA uses the phrase “documented medical need,” they mean that there is evidence from a medical source that supports your medical need for an assistive device (see 1.00C2b) for a continuous period of at least 12 months (see 1.00C6a). This evidence must describe any limitations you have in your upper or lower extremity functioning.

Your records must also explain the symptoms that show you need to use a cane or walker. However, the SSA does not require that you have a prescription for the assistive device. By focusing on the need for an assistive device, the SSA has shown they are concerned about your ability to work while using a device like a cane to stand and walk. It is common sense to note that if you are using your hands to support yourself, because you cannot use your legs to do so, then you cannot use your hands to work.

APPLY FOR SSD BENEFITS AFTER KNEE REPLACEMENT SURGERY 

If you have not returned to work after you knee surgery, the SSA may pay you SSD benefits. In order to prove you cannot return to work, you should hire a law firm who are experts in SSD cases. Cannon Disability is that firm. We have over 30 years of legal experience helping those seeking SSD and SSI benefits. In that time we have won over 20,000 SSD and SSI cases for our clients. Therefore, we know what it takes to prove your case to the SSA.  We want to help you win. Also, we have won over $100 million in ongoing disability benefits for our clients.

You do not want to go to court alone. Those who go without an attorney rarely win benefits.

It is our job to help you obtain the medical evidence you need to win benefits. At Cannon Disability Law, for example, we help you apply for SSD benefits. We also help you appeal an SSA denial. You only have 60 days to appeal a denial from the SSA. So, don’t delay.  You do not want to miss an appeal deadline. Call our office. We will help you appeal. In fact, we can answer your questions over the phone at no cost to you.

CONTACT CANNON DISABILITY LAW AFTER KNEE REPLACEMENT SURGERY

It is always our goal to win benefits for our clients. Your ability to care financially for yourself and your family relies upon the results of your SSD case. Additionally, your ability to receive Medicaid and also Medicare depends upon whether you are successful with your disability claim. Even the amount of your future retirement benefits can be at risk if you do not win SSD benefits.

You need to hire an SSD attorney with experience. We bring 60 years of combined experience to your disability case. For example, Dianna Cannon has been representing people with disabilities for over thirty years. Brett Bunkall and Andria Summers also have many years of litigation experience representing clients in disability hearings. Additionally, our legal staff also has years of experience helping clients with their disability cases.

One thing you may not know is that we are able to help you with your case no matter where you live. For example, we represent clients in Utah and Nevada. If you need to know more about winning Utah disability benefits, then read here. Likewise, if you need to know more about Nevada disability benefits, then read here. We also have clients in Idaho, Colorado, and California. You can trust that our representatives will do the job to win your SSD and SSI benefits. We want to be your disability legal team. Contact us today.

patient on walker after knee replacement surgery

THE TOP SSD ATTORNEYS WANT TO HELP YOU AFTER YOUR KNEE REPLACEMENT SURGERY

We will use our legal skills to help you through the Social Security benefits process. It is our goal to win your case. But, it also our goal to make it easier for you. We offer a free consultation. And, there is no obligation to become a client if you call. You can simply ask questions. That is what we are here for. We will try to help you, even if you don’t become our client.

It also doesn’t cost you money upfront to hire us. Why? Because we work on 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. But, how much is the fee? The fee is 25% of your back benefit. However, the fee is currently capped at $6000. You never pay more than the cap. And, the 25% fee is the more likely fee. You pay whatever is less. 25% of your back benefit is usually less than the $6000 cap on fees. Again, you pay the lesser of the two amounts.

If there are costs in your case, then you pay for those costs. Costs are minimal. They are usually less than $100. Typically, the only cost you will pay for is a copy of your medical records. And, we only charge you what the doctor charges us. You will owe costs whether we win or lose. In order to hire most lawyers, you have to pay an upfront fee. We don’t work like that. You don’t have a job. So how can we expect you to pay? We can’t. That is why we work on a contingency fee basis. Contact us today if you need help with your benefits after knee replacement surgery.

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