OSTEOPOROSIS & SSD BENEFITS
WHAT IS OSTEOPOROSIS?
Osteoporosis is a medical condition that occurs because bone resorption exceeds the rate of bone formation. Bone is living tissue. In order for it to be healthy, it needs to undergo a renewal process. When a person has healthy bone tissue, there is a balance when old bone is broken down by cells and new bone is formed.
Osteoporosis occurs when the body loses too much bone or makes too little bone. This can also happen at the same time. Either way, the result is a decrease in bone density and quality. Because the bones become weak and fragile, it leads to a higher risk of fractures and bone deformity.
Approximately 10 million Americans have osteoporosis. Additionally, another 44 million Americans have low bone density, which places them at risk of getting osteoporosis. The reason it is such a serious condition is that if you have it, you are at risk of breaking a bone from a minor fall. Or, for example, something as simple as bumping into furniture.
WHO HAS OSTEOPOROSIS?
In fact, osteoporosis is so common that by 2025, experts predict it will be responsible for three million fractures. Which in turn will result in $25.3 billion in costs in America. Women get osteoporosis more often than men. For women, the chances of having osteoporosis is a greater risk than the combined risk of heart attack, stroke and breast cancer.
The World Health Organization defines osteoporosis as having a bone mineral density that is 2.5 or more standard deviations below peak bone mass. Osteopenia, however, is bone mass that is between 1.0 and 2.5 standard deviations below peak bone mass. Peak bone mass occurs for both men and women by their early thirties.
Genetic factors play the greatest role in your peak bone mass. But, other factors also impact the disease, such as diet, drug exposure, endocrine health, and weight bearing status. For example, most teens and young adults do not receive the correct daily amount of calcium, which is 1200 mg. Smoking and alcohol use also add to low bone mass. As does your gender.
Estrogen, a hormone in women, protects your bones. When you reach menopause, your estrogen level goes down and you become prone to bone loss. Additionally, bone loss in women continues into older age, as the Study of Osteoporotic Fractures showed significant bone loss occurs in women 65 years of age and older. Other factors that cause bone loss include a low intake of calcium and vitamin D and lack of weight bearing exercise.
HOW IS OSTEOPOROSIS DIAGNOSED?
Bone mineral density (BMD) tests, such as DXA scan, are able to test whether or not you have osteoporosis. The DXA scan measures bone density at various sites in the body. It then compares your bone density to that of a healthy young adult. Therefore, your T-score is compared to a young person with a normal bone density.
As stated earlier, the WHO defines osteoporosis as bone mineral density 2.5 or more SD below peak bone mass. However, the WHO criteria applies only to Caucasian, postmenopausal women, and not men. It also doesn’t apply to premenopausal women or women of ethnicity other than Caucasian. Doctors have yet to test low bone mass in other populations.
However, if you take the test and your T-score is -2.5 or lower, then you have osteoporosis. If you are at risk for breaking a bone, then talk to your doctor about starting a treatment plan, such as medication for osteoporosis. Your doctor will look at your particular health needs and give you medications that can treat all of your medical conditions.
RISK FACTORS FOR OSTEOPOROSIS
OSTEOPOROSIS UNDER SSA LISTING 1.19
1.19 Pathologic fractures due to any cause with both A and B:
A. Pathologic fractures that occur on three separate occasions within a 12 month period.
B. Impairment related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for at least 12 months in a row and medical records of at least one of the following:
1. A medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device that involves the use of both hands; or
2. An inability to use one upper extremity to independently initiate, sustain, and complete work related activities that involve fine and gross movements, and a documented medical need for a one handed, hand held assistive device that requires the use of the other upper extremity or a wheeled and seated mobility device that involves the use of one hand; or
3. An inability to use both arms to the extent that neither can be used to independently initiate, sustain, and complete work related activities that involve fine and gross movements.
Read here to learn more about what it takes to meet one of SSA’s listings.
HOW DOES THE SSA LOOK AT PATHOLOGIC FRACTURES?
When the SSA looks at pathologic fractures of the bones, they will look at every part of the skeletal system. Fractures result from disorders that weaken the bones and make them vulnerable to breakage, like osteoporosis.
Under Listing 1.19, the fractures must occur on separate, distinct occasions, rather than multiple fractures that occur at the same time. However, the fractures can occur on the same bone multiple times. There is no certain time period that must occur between the fractures for the listing to be met. But, all three fractures must occur within a 12 month period. For example, the fractures of a bone may occur within hours or days of each other.
Listing 1.19 does not consider other types of fractures. For example, the SSA does not use listing 1.19 to look at fractures that do not heal. They also do not use listing 1.19 to examine complex traumatic fractures that might occur, for example, in a car accident. Instead, the SSA uses listing 1.22 or 1.23 to deal with complex fractures or those that do not heal.
OSTEOPOROSIS CAN PREVENT YOU FROM WORKING
The Social Security Administration (SSA) recognizes that if your osteoporosis is severe, you may not be able to work a full time job. If you are unable to work full time for at least 12 months due to your medical condition, then it is possible for you to win SSDI and SSI benefits.
There are two types of Social Security benefits. The first type is Social Security Disability benefits (SSDI). This benefit requires you to have years of working a job and paying your taxes. The second type of benefit is Supplemental Security Income (SSI).This benefit is an addition to SSD benefits. Also, it is for people who have never worked or who have earned low wages.
SSDI benefits are for those who have worked and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history. To qualify for SSDI, you must have earned enough “work credits” to qualify. A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, you will only qualify for Supplemental Security Income benefits.
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income and assets. If you have a spouse who earns more than $4000 a month, for example, then that income will prevent you from getting SSI benefits. You cannot qualify for SSI benefits, no matter how severe your medical condition, if you do not meet the income and asset rules for SSI.
Osteoporosis is one of the main reasons that people file for SSDI and SSI benefits. The SSA awards benefits to those whose osteoporosis prevents them from working and doing activities of daily living.
MEDICAL EVIDENCE PROVES YOU DESERVE SSD BENEFITS
When you apply for SSDI and SSI benefits, the SSA will first look to your medical records to determine if they can pay you benefits. Medical records are crucial to winning benefits. Find out more about the importance of medical records in your SSD case.
The SSA obtains your medical records. Next, an SSA worker reviews your medical records. The worker will be looking for evidence about osteoporosis. For example, the SSA will want to see the following items:
- medical imaging, such as MRI, CT scan, X-ray, or DXA scan
- physical exam notes or progress notes from your doctor
- a record of your medications for pain and any side effects you may be experiencing from your medications
- the medical opinion of an expert in bone density
- physical therapy records that help show your attempts to treat your pain
- records which show you use an assistive device, like a back brace, cane, walker, or wheelchair
- reports of any other bone damage or spinal condition
Remember, it is your responsibility to supply your medical records to the SSA. You should ask your treating doctor to write a letter to the SSA that states you cannot work due to your severe back pain. The burden to prove that you deserve benefits is on you.
OBTAIN MEDICAL EVIDENCE FOR FREE OR LOW COST
If you need medical records that prove your osteoporosis, then make an appointment with your doctor. Your doctor can order tests, like an MRI or CT scan. This evidence helps you win your case. However, if you can’t afford to see a doctor, then you still have options.
On this website, we provide a list of free and low cost health resources in the Intermountain West. Click below to learn more about free and low cost options in your state:
- Utah Free Health Clinics
- Nevada Free Health Resources
- Colorado Free Medical Resources
- California Free Healthcare Resources
- Idaho Free Health Services
Additionally, if you cannot afford treatment, you can request that SSA send you to one of their doctors. You can visit one of SSA’s doctors for free. They will write a report about your medical conditions. Further information about your free SSA doctor exam can be found on this website. Also, more information is written below on this blog.
If the SSA sends you to a free exam with one of their doctors, make sure that you bring the things that you use to help you walk or sit. For example, bring your cane or walker to the exam. Also, if you use a brace for your back or other part of your body, then wear it. Finally, remember that at the exam you could be under investigation.
OUR EXPERT ATTORNEYS & LEGAL STAFF
If you need help winning benefits for osteoporosis, then you have found the right law firm. You can learn more about the attorneys at our law firm on our About Us page. You want to know about the person who will be helping you, because you want to get along with them. Make sure they understand your medical conditions.
For example, you may want to know that Dianna Cannon has been helping her clients win Social Security cases for over thirty years. Additionally, Brett Bunkall and Andria Summers have also won thousands of SSDI and SSI cases.
In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our legal experts can help you file for SSI benefits using the SSA’s website. However, we will need your help to apply for SSI benefits. Why? Because only you know your personal financial information. SSI benefits require you to have minimal assets and monthly income. You will need to report that to us and the SSA.
Likewise, if you need an appeal, we can help you do that too. There are also many forms that will need to be filled out. Don’t worry. If you have questions about these forms, we will answer them. You can learn more about SSA’s appeal forms here. Call us today for help winning your SSD benefits.
WHAT OUR LAW FIRM DOES FOR YOU
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 during the Social Security process.
When you leave that up to us, you can focus on your health. Our attorneys and staff can:
- Help you file your application for SSD and SSI benefits
- File an appeal if you receive an initial denial from DDS
- Collect your medical records
- Help you confirm your SSA Doctor Exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing
- Question the expert witnesses
- Read more about job experts here.
- Learn more about medical expert testimony here.
- Request review of an decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your SSD application online at Social Security’s website, then you have 6 months to complete the application. It is best to complete the application quickly. You don’t want to run out the 6 month time limit.
HIRE US TO HELP YOU WIN OSTEOPOROSIS BENEFITS
If you have a spinal condition that keeps you from working, then we can help you win benefits. Remember, there are two types of benefits: SSDI benefits and SSI benefits. When you file an application, you are filing for both types of Social Security benefits.
Here are some tips. When you file your online application for benefits, the SSA may send you a written summary of your online application. If you receive the written summary in the mail, then you need to sign it and send it back to the SSA. The SSA gives you an envelope to send it back. Do it quickly.
Additionally, once you receive a denial from the SSA, you only have 60 days to file an appeal. You should appeal every negative decision the SSA makes. However, you must not fail to meet the time limits set by the SSA. Our advice is simple. Appeal early. Appeal often. Never give up.
As Social Security experts, our attorneys will properly present your case to the SSA. Contact us today. Take advantage of our free review of your case. We can often give you information that will help you win benefits. If you call, then we can answer your questions. Remember, we are experts in SSI and SSD benefits. We will do our best to win your SSDI and SSI benefits for osteoporosis. Call today. Put our legal experience to work for you.