Avascular Necrosis and Disability Benefits


The following is a guest post from Molly at Social Security Disability Help:

Avascular necrosis, or bone death, is a serious medical condition that worsens with time. Progressive pain and loss of mobility can make it impossible for an individual with Avascular Necrosis to maintain employment and earn a living. The resulting loss of income and lack of medical insurance can be financially devastating.

If you have Avascular Necrosis and can no longer work, you may be eligible to receive Social Security Disability benefits. Disability benefits can be used to help offset lost income, medical costs, and daily living expenses.

This article will provide you with a general understanding of Social Security Disability benefits and will prepare you to begin the application process.

SSD Programs and Basic Eligibility

Social Security Disability benefits are governed and distributed by the Social Security Administration (SSA). The SSA offers two different types of disability benefits. These are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program has separate eligibility requirements.

  • SSDI is designed to offer financial assistance to disabled workers and their eligible dependent family members. To qualify for SSDI, applicants must have paid a certain amount of Social Security taxes throughout their careers. For an in depth look into SSDI technical eligibility requirements, visit the following page: http://www.disability-benefits-help.org/glossary/social-security-disability-insurance-ssdi.

  • SSI, on the other hand, is designed to offer financial assistance to disabled individuals who earn very little income and have very few financial resources. Eligibility for SSI is based solely on the financial limitations set by the SSA. Learn more, here: http://www.socialsecurity.gov/ssi/text-eligibility-ussi.htm.

  • Individuals who qualify for SSDI but still fall within the SSI financial limits may be able to receive both SSDI and SSI benefits.

    Medical Eligibility

    If you meet SSDI or SSI technical eligibility criteria, you will then have to prove your medical eligibility. The SSA will perform an in depth review of your medical records to determine if your avascular necrosis is severe enough to cause complete disability. Your records will be compared with listings in the Blue Book, which is a manual of recognized disabilities and the medical requirements for each.

    Because there is no Blue Book listing for avascular necrosis, the SSA will attempt to match your symptoms with those of another Blue Book listing. The following listing requirements may closely match many of the symptoms caused by avascular necrosis:

  • Section 1.02 – Major dysfunction or deformity of one or more joints

  • Section 1.06 – Bone fractures

  • Section 7.05 – Sickle cell anemia

  • Section 14.02 – Lupus

  • Section 14.09 – Rheumatoid arthritis

  • If you require joint surgery as a result of avascular necrosis, you may also qualify for disability benefits under Blue Book listing 1.03. This listing requires that you are unable to effectively walk for a period of at least 12 months following surgery.

    To access all Blue Book listings, visit the following page: http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

    In is important to note that the SSA will consider the effects of all of an applicant’s conditions. For this reason, it is important to include information on any and all health conditions that impair your ability to work—even if they don’t occur as a result of your avascular necrosis.

    Medical Vocational Allowance

    If you do not meet or match a listing in the Blue Book, you may still be eligible to receive SSD benefits under a medical vocational allowance. Essentially, this means that the SSA will evaluate your physical capabilities, your job training, your age, and several other factors to see how your condition affects your ability to hold a job.

    To qualify under a medical vocational allowance, you will be required to complete a Residual Functional Capacity (RFC) form with a medical professional. You and your doctor must complete separate RFC report forms. Be proactive and have these done even before the SSA requires them. This may prevent any delays in your claim and possibly allow you to be approved faster.

    Social Security Disability Application Process

    Before beginning the application process, it is important that you collect all required medical and non-medical documents to support your disability claim. This may include the following:

  • Education and training documentation and employment records

  • Financial information regarding income, savings, and financial resources

  • Diagnostic test results, including imaging scans and bone biopsies

  • Notes from medical appointments that show physical findings, diagnosis, and observations about the limitations you experience and the outlook of your condition

  • Records of the treatments you’ve undergone and the manner in which they have affected you

  • RFC report forms from you and your treating physician

  • Once you have collected the necessary records you can begin the application process online or in person at your local Social Security field office. The application consists of several different forms. It is important that you take your time when filling these out. Any mistakes or incomplete information may result in the delay or denial of your claim.

    Receiving a Decision

    After submitting your disability claim, you may not receive a decision for several months. While you are waiting, it is important that you continue to follow any prescribed medical treatment and continue to collect updated medical records. This will help you in the event that your claim is denied.

    If your initial claim is in fact denied, you will have 60 days in which to appeal the SSA’s decision. It is important that you do not give up and that you continue on in your pursuit of disability benefits. It is understandable to be discouraged after receiving a denial but the appeals process is often a necessary step toward receiving disability benefits. In fact, many more applications are approved during the appeals processes than during the initial application.

    For more information visit Social Security Disability Help (http://www.disability-benefits-help.org/blog)or contact Molly Clarke at mac@ssd-help.org.


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