If you are filing a claim for reconstructive surgery or arthrodesis of a major weight-bearing joint, you need to know what the SSA wants to see in order to approve the claim and get the benefits you deserve.
How can you qualify? The most straightforward way is to meet the definition the SSA has laid out in their Listings of Impairments for this specific issue. These listings are the medical standards or set of criteria that the organization has laid out for individual conditions. If someone can prove they meet these criteria, they automatically qualify to receive disability benefits.
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Alternatively, someone who doesn’t completely meet the requirements in the Listings of Impairments can still qualify for disability benefits if they can show that their health issue keeps them from being able to work in any position in the nation that meets their education and experience. This is accomplished by going through the SSA’s Five Step Sequential Evaluation Process or proving that medical issue in question is the equivalent of one of the disabilities in the Listings of Impairments.
Ideally, you want to meet a disability listing, but it’s not easy. Precise objective medical documentation is needed, and the SSA won’t even consider a disability based on a listing unless you’ve already been out of work for 12 months – or it is believed that you will be out of work for at least that long – due to your medical condition.
Standards and Medical Criteria for Listing 1.03
To meet listing 1.03 – Reconstructive Surgery or Arthrodesis of a Major Weight-Bearing Joint, you need to show a couple of things to the SSA:
- That reconstructive surgery or arthrodesis occurred
- That there is an inability to ambulate effectively in knee, hip, or ankle joints after surgery
- That this inability has gone on (or will continue) for 12 months or longer
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Of course, it is not enough for your doctor to simply write a letter to the SSA stating that your inability to ambulate will last for longer than a year. Objective proof is required, and some of the tests that can help in this regard include x-rays, the Apley grinding test, Arthrocentesis, Arthrography, Drawer sign (anterior and posterior), Magnetic Resonance Imaging (MRI) of bone, McMurray’s Test, Patrick’s Test (Fabere Test), and Range of Motion (ROM) tests. If you can show positive results on one or several of these tests, it will go a long way towards helping your cause.
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Don’t lose heart if you aren’t able to match something on their Listings of Impairments. You can still use the Five Step Sequential Evaluation Process we mentioned above to show that your condition keeps you from working. If you want the best chance at getting the benefits you deserve, talk with an experienced Social Security disability lawyer today. Learn more about the claims process by reading our Social Security Disability eBook for free! If you need help today, call us at 800-562-9830 for a free case evaluation.
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