Thursday, July 16, 2009

Social Security Disability - Broken Bones, Fractures

My husband had a slip & fall in Feb 09 and cannot return to work as a forklift driver. He will be losing his job as well as health benefits. Do you think he could get disability? He broke his femur and walks w/crutches and will not be 100% to return to work.

Unfortunately, Social Security disability is a total disability program, not a percentage disability program (for example, with veteran's disability claimants can be awarded on a percentage basis). Additionally, Social Security disability does not necessarily consider an individual to be disabled if they are not able to do their previous work. To receive social security disability or SSI disability, the condition must be severe enough to rule out the ability to engage in substantial gainful employment for 12 months. This includes jobs that are part of one's past relevant work history and also "other work" for which an individual might normally be considered to be qualified to engage in based on vocational considerations and medical limitations.

Social Security defines disability as any medically determinable mental or medical impairment that has prevented (or is expected to prevent) an individual from performing substantial gainful work activity for twelve months, or is expected to result in the death of the individual.

Frankly, most individuals with fractures are denied disability because Social Security does not anticipate that fractured bones will prevent work activity for twelve months and they expect individuals to be back to some sort of work activity within twelve months. In my experience as a former disability examiner, I did see a few cases where an individual's fracture never healed and in these cases the individual usually won disability benefits if they utilized the social security disability appeal process.

However, the appeal process could take months or even years to win disability benefits, so many individuals try to return to some type of work activity in order to support their households and maintain health benefits. This, of course, is not the way it should be and if more of our congressional representatives came from more varied walks of life (the great majority come from one single profession and this is hardly representative), we might see...well, its impossible to speculate what we "might see".

Regarding health benefits, Social Security disability recipients do not receive any kind of medical coverage for two full years after they become entitled to disability benefits. Therefore, filing for Social Security disability may not help your husband's situation unless he really is not expected to be able to perform any kind of substantial and gainful work activity in the future. I wish that I could give a more hopeful outlook as to your husband's chances of becoming eligible for Social Security disability.

That being said, it certainly would not hurt for your husband to file for disability with Social Security in the off chance that his fracture does not heal or there is severe permanent damage to the leg. Getting a disability application "in the pipeline" now could save valuable time later if it turns out that he won't recover the ability to engage in competitive employment in the future.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

If I get approved for SSD or SSI disability will I get back pay ?
What is SSI Disability Pay Based On?
Question about SSI Back Pay after being Approved
How much SS back pay do you get?
Qualifying for Disability - How difficult are the Qualifications ?
What is a Qualifying Disability for Social Security?



Blogger pumpkin said...

A licensed psychologist filled out the mental residual capacity form will it carry any weight before the ALJ? What if a treating doctor will not fill out the Physical residual portion of the form? (In my case they say its SS job to do this not theirs though they do agree to disability)
It takes at least a year to go before a ALJ so is it best to wait and have the treating doctors fill out the forms right before the hearing or is it ok for them to fill them out months in advance?

5:54 AM  
Blogger Disability Blogger said...

Actually, when the social security administration lists acceptable medical sources, they list licensed or certified psychologists right after physicians. And, in fact, with only a few exceptions, most DDS mental consultants are psychologists, not psychiatrists. Judges are used to seeing the forms completed by these professionals. Regarding timing of the RFC form, most claimant's representatives will try to get the form completed just right before the hearing. Getting it months in advance may cause it to "age out". Social Security likes medical evidence to be recent, i.e. not older than 90 days. As to your doctor, unfortunately there's nothing you can do. However, he is wrong. His opinion, since he is the treating opinion after all, could profoundly help...if he was willing to take the time to do it. Sorry to hear that.

10:36 AM  

Post a Comment

<< Home