SHOULDER PAIN & SSDI BENEFITS
CAN SHOULDER PAIN QUALIFY FOR SOCIAL SECURITY DISABILITY BENEFITS?
Shoulders are complex joints and can be a source for pain and disability. The shoulder is made up of the arm bone (humerus) and the collarbone (clavicle). The scapula and the clavicle work together to form the glenohumeral joint, which forms a cage around the head of your humerus. Because it the way the shoulder is constructed, it can move and change its shape in multiple ways. Your shoulder joint is able to rotate and flex, as well as extend your arm. However, your shoulder joint is also subject to wear and tear due to the repetitive motions you perform on a regular basis. Repetitive motion or damage to a part of the joint can result in shoulder injury and chronic pain.
When you can’t use your shoulders to reach, lift, or carry objects, it may impact your ability to work. If your shoulder impairments are severe enough, you might qualify for Social Security disability benefits and Supplemental Security Income benefits.
In order to pay you benefits, the Social Security Administration (SSA) determines whether your shoulder condition prevents you from working for at least one year. The SSA defines work as earning over the substantial gainful activity (SGA) amount. The SSA will first look to see if your shoulder condition meets or equals a “blue book” listing, which is the SSA’s list of disabling medication conditions. If not, then the SSA will look at your age, education, and other factors to determine if you should be paid benefits using a vocational analysis.
SHOULDER PROBLEMS THAT CAUSE PAIN AND DISABILITY
Shoulder pain can occur due to the result of an injury, illness, or arthritis. Here are some examples of common shoulder problems that can cause chronic pain and may prevent you from working.
FROZEN SHOULDER (ADHESIVE CAPSULITIS)
Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain in the shoulder joint due to inflammation and thickening of the shoulder capsule. It can cause severe pain, stiffness, and limited range of motion in the shoulder.
Frozen shoulder is most common among people who are 40-60 years old. It is also more common among women than men. It usually occurs after an injury or illness that limits the use of your arm or shoulder for some time. This can cause the tissues around your shoulder joint to become tight and stiff, leading to frozen shoulder.
The symptoms of frozen shoulder include intense pain when moving your arm, stiffness in your shoulder joint, difficulty sleeping on the shoulder side due to pain, and a decrease in range of motion in the shoulder. Treatment for frozen shoulder includes physical therapy to help improve your range of motion and reduce pain. Also, your doctor can prescribe medications, such as anti-inflammatory drugs or steroids.
Calcific tendonitis occurs when calcium deposits form in the rotator cuff tendons. This results in inflammation and pain in your shoulder. The condition can be caused by a number of factors including aging, overuse, or injury. Symptoms may include issues moving the shoulder, pain when lifting objects or reaching overhead, and shoulder stiffness. Treatment options include physical therapy, rest, steroid injections, and sometimes surgery.
Shoulder impingement is a common condition that can cause pain and disability. It occurs when the tendons of the rotator cuff muscles become inflamed and irritated due to repetitive overhead activities. For example, you might work at an auto shop where you reach overhead to change oil in a car. This type of activity can lead to pain, stiffness, loss of range of motion, and decreased strength in the shoulder. It is important to recognize the symptoms of shoulder impingement so that it can be treated quickly. Treatment options may include rest, physical therapy, medications, injections, or surgery depending on the severity of the condition.
ROTATOR CUFF TEARS
One of the most common causes of shoulder pain is rotator cuff tears. Rotator cuff tears occur when the tendons and muscles that support the shoulder joint are damaged or torn. These are the muscles and tendons that stabilize your shoulder. If they are torn, this leads to pain, weakness, and limited range of motion in the shoulder joint. It is important to seek medical attention if you experience any symptoms associated with rotator cuff tears, as they can cause long term disability if left untreated.
DISLOCATION OF THE SHOULDER
Dislocation of the shoulder is a common injury caused by forceful movement of the arm or a direct impact to the shoulder joint. It occurs when the upper arm bone (humerus) slips out of its joint with the shoulder blade (scapula). This usually happens during sports, falls, motor vehicle accidents, or other trauma. Dislocation of the shoulder causes intense pain and loss of motion in that joint. It is important to seek medical attention immediately if you think you have dislocated your shoulder in order to prevent further damage and promote a faster recovery.
Dislocation of the shoulder causes severe pain, swelling, and loss of motion in the affected arm. It can also lead to long-term instability in the joint. Treatment for this condition usually involves physical therapy and possibly surgery.
OSTEOARTHRITIS OF THE SHOULDER
Osteoarthritis is degenerative joint disease that affects the cartilage, bones, and tendons of the shoulder joint. Learn more about osteoarthritis and Social Security benefits here. As the condition progresses, it can lead to decreased range of motion, pain, stiffness and loss of function in the shoulder. Symptoms may include tenderness in the shoulder joint, difficulty moving or lifting objects with one arm, and feeling a grating sensation when moving your arm. Treatment options include physical therapy, medications, corticosteroid injections or surgery.
TREATMENT OF SHOULDER PAIN AND SHOULDER INJURIES
Shoulder pain and injury is a common problem that can cause significant issues in your ability to use your arms and to work. Treatment for shoulder pain depends on the underlying cause and may include physical therapy, medications, or even surgery. There are a variety of treatments available to address shoulder pain. Some can be done at a doctor’s office. For example, treatments for shoulder pain may include ultrasound therapy, electrical stimulation therapy, and thermal therapy. Should pain can also be due to neck pain. If you need more information about neck pain and benefits, read here.
Other treatments can be completed at home. For example, these treatments range from simple lifestyle changes like getting adequate sleep and limiting stress, to more specific remedies like natural supplements or herbal extracts. For instance, many people find that aromatherapy can be a helpful way to reduce stress and improve mood. However, while these home treatments may lower your pain level, they will not cure your shoulder condition if you need surgery.
MEETING SSA’S LISTING FOR SHOULDER PAIN
To qualify for SSDI and SSI benefits, you must provide medical proof that your shoulder problems meet the SSA’s criteria. Your doctor must also provide evidence that your shoulder pain is severe enough to limit your ability to work. If you are able to prove that your shoulder problems meet the SSA’s listing, then the SSA should pay you benefits.
There is not set SSA listing for the shoulder. However, there are a number of listings that you can meet which apply to you if you have severe shoulder dysfunction. For example, Listing 1.18 might apply to your case if you have the issues on the list below:
1.18 Abnormality of a major joints in any extremity (see 1.00I), documented by A, B, C, and D:
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:
2. An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving 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 involving the use of one hand; or
As you can see from the above listing, meeting the rule is hard to do. Not only must you have objective medical evidence, like an MRI, showing the damage to your shoulder. You must also have medical records that show your symptoms and you must be unable to use your arms to perform most tasks. The burden to prove you deserve benefits is on you.
LISTING 14.09 – ANOTHER OPTION FOR MEETING SSA’S LISTING FOR SHOULDER PAIN
Listing 14.09 is another option if you do not meet or equal listing 1.18. Using listing 14.09 you would need to show that you have inflammatory or rheumatoid arthritis in both of your shoulders. Under Part 2 of listing 14.09, which is highlighted, you would then need to show that you are unable to use both of your arms to perform fine and gross movements. While this listing is also very hard to meet, if you have severe impairments in your ability to use your arms due to rheumatoid arthritis, you would meet the listing.
14.09 Inflammatory arthritis. As described in 14.00D6. With:
- A documented medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device involving the use of both hands; or
- An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving 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 involving the use of one hand; or
2. One or more major peripheral joints in each upper extremity and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements.
1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45° or more of flexion from the vertical position (zero degrees); or
2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 30° or more of flexion (but less than 45°) measured from the vertical position (zero degrees), and involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity.
D. Repeated manifestations of inflammatory arthritis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:
HOW TO EQUAL SSA’S LISTING TO WIN SSDI AND SSI BENEFITS
You can equal an SSA listing if your shoulder impairment is medically equivalent to a listed impairment in severity and duration. There are three ways that the SSA can find medical equivalence.
- If you have a shoulder condition in the Listing of Impairments but you do not have one or more of the findings in the particular listing, or you exhibit all of the findings, but one or more of the findings is not as severe as specified in the particular listing, then the SSA will find that your impairment is medically equivalent to that listing.
- If you have a shoulder problem that is not described in the Listing of Impairments, the SSA will compare your findings with those for a closely related impairment. If the findings related to your shoulder condition are at least of equal medical significance to those of a listing, then the SSA will find that you equal a listing.
- If you have a combination of medical conditions, no one of which meets a listing, then the SSA will compare your findings with those for closely related listed condition. For example, you could have shoulder problems and a back condition under listing 1.15. If the findings related to your medical conditions are at least of equal medical significance to those of a listing, then they will we will find that your combination of medical conditions is equal to that listing.
HOW DOES THE SSA FIGURE OUT YOUR RESIDUAL FUNCTIONAL CAPACITY?
If you do not meet or equal one of SSA’s listings, you can still win benefits. You can win benefits if you can show that you are not able to work at any job in the national economy due to an impaired residual functional capacity (RFC).
In order to determine your RFC, the SSA first looks to the medical evidence in your case. The medical evidence will show what limitations you have due to the pain in your shoulders. It will also show if you have been in physical therapy or what type of treatments you have tried. Likewise, it will show if you have had surgery and if the surgery was successful or not. That is why it is so important for the SSA to have all of your medical evidence.
Typically, hiring a lawyer to help you get all of your medical records is a wise choice. Learn more here about how to obtain your medical evidence for free. If you do not have enough medical evidence for the SSA to make a decision, then they will arrange for your to have a consultative exam to look at your shoulder problems.
The SSA can order a consultative exam for both mental and physical conditions. Find out more about consultative examinations here.
RESIDUAL FUNCTIONAL CAPACITY FINDINGS COME FROM YOUR MEDICAL RECORDS
In order to figure out your physical RFC, the SSA will examine your medical records. They will take into account what your doctor states in your medical records. Also, the SSA will review any statements from your doctors about your ability to work.
Additionally, they have their own doctors that review your medical records, but never meet or examine you. These doctors are paid by the government and work for Disability Determination Services (DDS), the state agency that reviews all SSDI and SSI cases. The SSA will take the medical opinion of these doctors into account too. Likewise, if they need more information, they may send you to a consultative exam. Learn more here about what to expect at SSA’s consultative exam.
The SSA will also consider descriptions about your limits from your family, neighbors and friends. Find out more information about what types of evidence the SSA must consider here. For example, your family or friends could write a statement about the effects of your shoulder pain and talk about how you cannot lift, type, or wash your own hair. Find out more here about RFC and how it combines with age to eliminate work. Also, find out more about SSA’s Medical Vocational Guidelines here.
YOUR RESIDUAL FUNCTIONAL CAPACITY IS BASED UPON YOUR OWN STATEMENTS
Another type of evidence the SSA considers when figuring out your RFC is your own statements on the forms you fill out for the SSA. For example, when you apply for SSDI and SSI benefits, you fill out forms about your past work. You also fill out forms during the appeals process about what you do during the day.
Your answers on these forms are often some of the most important statements you make. If you state on your Work History form that you lifted nothing on the job, then that is what the SSA assumes is correct. Frankly, there are no jobs where you lift “nothing.” But for some reason, many people write that down as an answer. Even desk jobs require some lifting. You might, for example, lift files, boxes of paper, books, or supplies. The SSA wants to know the heaviest weight you lifted on the job.
If you state that you are still able to do your hobbies, such as golfing, bowling, or painting. Then, the SSA is going to assume that your shoulder problems are not severe enough to keep you from working. Those may have been your hobbies in the past, but you are filling out a form about how you can no longer work. So, if you cannot do your hobbies because of your shoulder pain, then don’t write down your past hobbies as your hobbies.
YOUR RFC IS USED TO DETERMINE IF THERE ARE ANY JOBS YOU CAN PERFORM
At your SSA hearing, the Judge will ask questions to the vocational expert (VE) about whether or not a person with your RFC can work. Typically, the Judge will use three to four types of questions. These questions can include many different symptoms from your shoulder condition.
For example, the Judge may ask if a person with shoulder pain cannot concentrate on the job, could they work. Or, the Judge may ask what kind of work would be available to a person who cannot lift their arms above their head due to shoulder injury. The Judge’s questions will include your residual functional capacity. Learn more here about your residual functional capacity here.
Once the Judge is done asking questions, your attorney has the right to question the VE. For those who do not hire an attorney, they are left to try to ask the VE questions on their own. Obviously, most people do not know what questions to ask because they have never been to a hearing. Nor do they have the training they need in order to understand what questions to ask.
Vocational experts testify about what kinds of jobs are available to you. However, they also testify as to the number of jobs that exist in the national economy. For example, a VE may testify as to whether your work skills from you past work can be used in other jobs. A VE may also testify as to the effects of solely nonexertional impairments on the range of work a person can do. Learn more about the role of the vocational expert at your hearing here.
APPLYING FOR BENEFITS IS EASY WITH THE HELP OF CANNON DISABILITY LAW
In order to qualify for SSDI benefits, workers over the age of 30 must have worked at least 20 work credits within the ten year period just prior to the start of their disability. Find out more about the definition of work and substantial gainful activity here. If you do not have enough work credits to qualify for SSD benefits, then you can apply for SSI benefits. SSI benefits do not require a work history, but you must meet SSA’s income and asset rules.
Applying for benefits with the help of Cannon Disability Law is simple. We will help you file your application for benefits online at the Social Security website. If you receive SSD benefits, then within 24 months of your onset date of disability, you will also receive Medicare benefits. Medicare benefits are a form of health insurance that pays for your medical bills. Find out more about Medicare benefits here. With SSDI benefits, you can receive past due benefits one year prior to the date of your application.
SSI benefits, however, only pay out from the date of your application. They begin the day you apply and do not go back prior to the application date. Also, SSI comes with Medicaid benefits, not Medicare. If you do not apply quickly, you are losing benefits. You should apply for benefits as soon as you know you will not be going back to work. Learn more about past due disability benefits here.
CANNON DISABILITY LAW WILL HELP YOU WIN SSDI & SSI BENEFITS
If you or a loved one is suffering from a severe shoulder pain or injury, you may be wondering whether the Social Security Administration (SSA) will approve your claim for SSD and SSI benefits. If so, call Cannon Disability. We are the only law firm helping SSD and SSI clients in Utah and Nevada with over 30 years of experience. For example, we are rated in the top three SSD lawyers in the state of Utah.
We also help clients in many other states. For example, we have clients in Las Vegas, Nevada. We are also rated in the top three SSD lawyers in the state of Nevada. Find out more about our Nevada legal experience here. We also have clients in Idaho, Colorado, and California. Learm more information about Idaho SSDI benefits here. We have Colorado benefit information here and California SSD and SSI benefit information here.
We’ll help you get your SSDI benefit and fight for the benefits the SSA owes you under the law. We offer a free review of your case and you do not pay an attorney fee until we win your benefits. If you have questions about attorney fees, read here.
If you want to learn more about our lawyers, then read our About Us page. For instance, Andria Summers is an amazing advocate. She can also help you with your Medicare plan. Additionally, she has won thousands of SSD cases. Dianna Cannon has been helping SSD and SSI clients for thirty years. Brett Bunkall also has years of experience helping people obtain their benefits. We are experts and we have won over 20,000 SSDI and SSI cases. You can trust us to help you win your benefits. Contact us today. Put our legal experience to work for you.