Difference Between Marked And Moderate Pain Weakness And Limitation On Rom
There is no bright line separating marked and moderate hip disabilities. However, cases discussed below from the Board of Veterans Appeals look to a few factors.
The VAs regulations include two illustrations that show a normal hip flexion of 125 degrees and a normal hip abduction of 45 degrees. One case compared the veterans ROM to these illustrations and justified a disability rating decision by pointing out that the veteran had a 40% reduction in flexion and 66% reduction in abduction. Because the veteran did not require crutches, the BVA could not assign a 90% disability rating. However, it considered the loss of motion marked and assigned the 70% disability rating.
In another case, the BVA considered factors including:
- Using a cane for short distances and a walker for longer distances.
- Falling several times.
- Hip extension of 105 degrees and hip abduction of 25 degrees.
Based on these factors, a 50% disability rating was assigned to the veteran.
One of our experienced VA disability lawyers gives advice on what to do at your C& P Exam.
How Does The Va Rate Knee Pain
The VA will rate knee pain and conditions under many different diagnostic codes, depending on the specific problem, or problems, caused by a knee condition. For example, there are ratings available for instability of the knee, limitation of extension, knee replacements, etc. It is important to be aware of all the different ratings, and whether you are entitled to compensation for multiple ratings. This way, you can make sure the VA is giving you the proper percent rating and all of the compensation youre entitled to for your knee disability.
Below is a list of ratings that can potentially be assigned to the same underlying disability:
Rating decisions for one disability can be complicated. The general rule regarding multiple ratings for the same disability is, the evaluation of the same disability under various diagnoses is to be avoided. However, VA regulations specifically provide that the knee joint can be evaluated under multiple diagnostic codes where there are different manifestations of the same disability. So, as long as the knee disability affects you in separate and distinct ways, you can receive multiple ratings.
Remember that instability of the knee is a rating that is often overlooked. However, if you have problems with your knee dislocating or giving out because of a service-connected disability, instability of the knee can be rated in addition to other ratings for the same knee.
Getting Help From An Attorney
Knee replacement surgery has a high rate of success, so it is common for people who are applying for SSDI benefits after this procedure to run into problems. The process of applying for benefits and gathering the necessary proof of disability can be overwhelming and stressful.
Fortunately, there are legal professionals who are able to guide disabled individuals through the application process. These SSDI attorneys have the knowledge and skill needed when it comes to understanding the complex benefits application process. Legal representatives ensure that applicants are providing sufficient evidence and complete paperwork to boost their clientsâ chances of being approved for the benefits that are needed to pay for necessities like housing and food.
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How Long Does It Take To Recover From Hip Replacement
According to Thakkar, a hip replacement procedure can take two to four weeks to complete, but each patient is unique. A persons surgical procedure is influenced by several factors, including their level of activity prior to the procedure, their age, nutrition, previous health problems, and other factors outside of their control.
How Does The Social Security Administration Decide If I Qualify For Disability Benefits Due To Joint Problems
If you have joint pain or damage from any cause including arthritis, Social Security disability benefits may be available. To determine whether you are disabled by your joint condition, the Social Security Administration first considers whether your joint problems are severe enough to meet or equal a listing at of the . See . If you meet or equal a listing because of joint problems, you are considered disabled. If your arthritis or other joint condition is not severe enough to equal or meet a listing, Social Security Administration must assess your , to determine whether you qualify for benefits at and of the Sequential Evaluation Process. See Residual Functional Capacity Assessment for Joint Pain and Joint Damage.
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Does Hip Replacement Qualify For Blue Badge
There is no definitive answer to this question as it depends on the individuals circumstances. However, in general, hip replacement surgery would not automatically qualify an individual for a blue badge. To be eligible for a blue badge, an individual must have a disability that significantly impairs their ability to walk, meaning that they are unable to walk more than 50 meters without significant pain or discomfort, or require the use of a mobility aid.
Joint Replacements: Are They Covered
From the desk of Beth Loy, Ph.D., Principal Consultant/Technical Specialist
Joint replacement surgery may be a solution for someone who has dealt with osteoarthritis or rheumatoid arthritis for a long time, has an injury where replacement is the best option, or has other conditions where non-surgical management has not been successful. Although nearly every joint in the body can be replaced, most replacement surgeries involve the hip or knee . Candidates for joint replacement surgery often have severe joint pain, stiffness, limping, muscle weakness, limitation of motion, and swelling before and after surgery .
The ADA does not indicate whether temporary impairments are covered or excluded. However, it has been indicated that the duration of an impairment is not a key factor in determining whether someone meets the definition of disability under the ADA. In other words, the question is, Is the person substantially limited in a major life activity? Most individuals who have joint replacements will likely be substantially limited, at least temporarily, in walking, lifting, standing, and performing manual tasks. These are major life activities specifically mentioned in the ADA, the ADA Amendments Act, and their corresponding regulations. So, to be on the safe side, employers might not want to rule out the possibility that short-term impairments resulting in joint replacements might now be covered by the ADA.
Determining If You Can Work
When the SSA receives your application, they first determine whether you’re currently working and how much youre earning from your work. If you are earning $1,220 per month or more as stated in the 2019 COLA, you cant qualify for benefits because the SSA will determine that youre able to perform substantial gainful activity.
What Information Will I Need To Provide
When applying for Social Security, you may be asked to provide the following:
- Confirmation of your diagnosis from an Orthopedist, including several physician notes over the course of your illness
- Physical examination reports from a doctor giving a detailed description of the findings, including your ability to perform daily activities of living, a list of assistive devices needed, and general measurements of joint motion
- X-rays, CT scans, MRIs, or other imaging results over time. Imaging results before your hip replacement and after your hip replacement are vital.
- Orthopedic surgical notes
- Documentation of your rehabilitation course
- Notes from any other health care provider involved in your care, such as physical therapist, occupational therapist, or other health care provider
If you are missing any of the above medical records, you should speak to your doctors office or hospital immediately. The more medical evidence that you have on your side, the better your chances of receiving financial assistance benefits related to your hip replacement.
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What Symptoms Do I Need To Qualify
As a general rule, the Social Security Administration considers a hip replacement surgery to be a success. While recovery and rehabilitation may take some time, the overwhelming majority of patients can regain mobility and bear weight well within one year from their surgery.
Typically, social security benefits are reserved for those patients who experience long-term difficulty with their hip replacement. The Blue Book is a manual used by the Social Security Administration to determine benefit eligibility.
The two primary listings that may apply to hip replacements fall under the musculoskeletal section of the book. Here are some signs that your Hip Replacement might qualify you for disability benefits:
If You Dont Meet Social Securitys Requirements Under Reconstructive Surgery Of A Major Weight Bearing Joint But You Have Had Both Hips Replaced Social Security Will Consider Your Residual Functioning Capacity What You Are Capable Of Doing Despite Your Disabilities
Any limitations you experience from your hip replacement and medical treatments will be evaluated. For example, Social Security may find that you can only work in a sedentary job, work that is done mostly while a person is seated and limits lifting of any objects to 10 pounds. However, even a sedentary job can require walking or standing at least two hours each day, so an applicant may not be able to perform even sedentary work. If Social Security determines that the symptoms associated with your hip replacement and treatments prevent you from doing any job, you may be awarded a medical-vocational allowance.
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Abnormality Of A Major Joint
You might meet the listing for having an abnormality of a major joint if you have degenerative joint disease in your hips, knees, ankles, feet, shoulders, elbows, wrists, or hands. To meet the requirements of this listing, you need medical documentation that you can’t:
- walk without a walker, two canes or crutches, or a wheelchair or scooter that requires both hands, or
- use one hand due to arthritis, and you need the other to operate a one-handed wheelchair, cane, crutch, or other device, or
- use either arm or hand to begin, sustain, and finish work.
In addition, you need to have a history of joint pain or stiffness and a loss of motion or instability in the affected joint. Finally, you must have an obvious deformity in a joint that shows up during a doctor’s physical examination or in medical imaging . Social Security is looking for an abnormality like narrowing of a joint space, destruction of bone, joint contracture, or ankylosis .
What Makes Knee Replacement Surgeries Necessary
For Veterans experiencing certain knee conditions or severe pain, surgery may be the best treatment. If the knee injury or condition hasnt responded to medication, physical therapy, or other treatment options, a total or partial knee replacement may be necessary.
Some common conditions that may require a knee replacement include:
- Unusual bone growth
Total knee replacements can be very successful, but partial knee replacements may be a better option for some Veterans. If the knee pain or injury is affecting only one of the knees three major components the medial compartment, lateral compartment, and patellofemoral compartment then a partial or unicondylar knee replacement will be less invasive.
Either way, Veterans who require knee replacement surgery due to an injury or condition sustained in the line of service will be eligible for VA disability benefits. Below, well break down the ratings you may receive for knee pain and knee replacements.
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Disability Rating For Hip Replacement
The disability rating for hip replacement can vary depending on the severity of the condition and the age of the patient. Generally, patients who are older and have more severe hip problems will have a higher disability rating.
Patients who have hip replacement are eligible for disability benefits at 100% for the first six months, then gradually increase to 200%. You can get a total disability rating from the VA if you have hip replacement and another condition as well. Those who receive hip replacement from the VA will be familiar with their rating system by the time they receive it. A total hip replacement disability rating of 100% is always the starting point for determining whether or not a VA patient should receive a disability rating. An examination one year after surgery determines the condition of the hip, and a new rating is assigned. Patients who have hip replacement surgery at a VA hospital are not required to be disabled by the VA. A service connection must be included in every VA disability claim.
The Ada And Hip Replacements: What You Need To Know
A hip replacement is a type of surgery where a damaged hip joint is replaced with a new artificial joint. The surgery is usually performed to relieve pain and improve mobility. The ADA, or Americans with Disabilities Act, is a federal law that prohibits discrimination against people with disabilities. This law applies to employment, public accommodations, transportation, and telecommunications. A hip replacement may be considered a disability under the ADA if it limits a persons ability to perform essential job functions or participate in everyday activities.
A 100 percent rating for a one-year period after the prosthesis is installed is required in accordance with Code 5054. If there are any painful motions or weakness, such as crutches required following the implantation, a 90 percent rating is required.
According to the SSA, arthritis may qualify as a disability. If you have arthritis that is so severe you will be unable to work for at least 12 months, and you meet the SSAs work requirements as well, the SSA will declare you disabled and will allow you to receive disability benefits.
Furthermore, you must be expected to be unable to work for at least 12 months due to your illness. The typical time frame for healing from a hip arthroplasty is one year after the surgery.
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Evidence For Knee Pain Claims And Appealing Under The Ama System
In general, pain claims are among the most difficult to prove without an underlying condition. Fortunately, knee pain is often connected to another diagnosis that can be established with diagnostic testing. Be sure your knee pain claim includes:
- Documentation of injuries, surgeries, or other conditions with knee pain as a secondary symptom
If your claim is initially denied for any reason, hope is not lost. The Appeals Modernization Act System gives you three options to have your claim reviewed if you disagree with the decision. It also allows you to submit additional documentation that will support your claim without having to wade through a lengthy, step-by-step appeals process.
You can read more about these three review options here.
Hip Pain That Limits Your Ability To Work May Qualify You For A Disability Award
If your hip pain is severe, lasts more than 12 weeks, and limits your ability to work or perform regular activities, you may be eligible for a disability benefit. Furthermore, arthritis, rheumatoid arthritis, and other autoimmune diseases may be candidates for a disability award. A doctor must be present to demonstrate that the primary reason for your inability to work is hip pain.
How To Apply For Disability For Joint Pain
If you’re applying for Social Security disability insurance , you can file your entire claim online on Social Security’s website. If you’re not comfortable filling out forms online, you can call Social Security at 800-772-1213 to start your claim.
If you don’t have enough work credits, and you have low income, you can apply for SSI. Most individuals filing for SSI only cannot file the whole application online, but they can get started on Social Security’s website. For more information, see our article on applying for Social Security disability benefits.
If you’d like help with your application, consider working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Click for a free case evaluation with a legal professional to determine whether your knee replacement complications are severe enough to qualify for benefits.
Does Arthritis Qualify For Disability
Many people may mistakenly believe that arthritis is a disability. Arthritis and a variety of other conditions can make you incapacity. If you are limited by your arthritis to a limited range of movements or activities, you may be eligible for disability benefits.
Arthritis And Your Benefits: How Much You Can Receive Per Month
In terms of arthritis, it is estimated that you will receive a monthly benefit of $1,301.59. You can calculate the amount by taking into account your previous earnings. If you are employed but have little or no earnings, you may be eligible for a higher benefit. If your earnings history is high, your benefits may be less.
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Definition Of The Study Group
The hip or knee arthroplasty group was identified by the following procedure. Firstly, all subjects reporting prosthesis as a cause of difficulty were selected. For these subjects the interview data were re-examined by one of us to exclude subjects with another prosthesis , subjects with severe neurological conditions interfering with mobility , and subjects for whom the investigator could not be sure whether or not they had knee or hip arthroplasty . During this first stage, subjects whose difficulties were caused by lower limb arthroplasty were identified. Secondly, subjects not reporting prosthesis as a cause of their difficulty in daily living but responding yes to both questions: Do you have a prosthesis replacing a part of your body? Is it a lower limb prosthesis?, were selected. For these subjects the interview data were also re-examined to exclude subjects with another prosthesis , subjects with severe neurological conditions interfering with mobility , and subjects for whom the investigator could not be sure whether or not they had knee or hip arthroplasty . This second stage allows the identification of subjects with lower limb arthroplasty that was not a cause of their difficulty.