As most people are aware, Social Security Disability benefits are reserved for long-term disabilities that prevent people from working or severely limit their ability to work. It may come as little surprise that claims involving broken bones are often denied as the injuries are not considered severe enough.
That said, it may be possible to obtain benefits after suffering a broken bone injury if the fracture causes other issues that make the situation much more severe.
Below, learn more about applying for benefits for a broken bone injury. If you are severely disabled and have questions about applying for benefits, Schmidt Kramer may be able to help you. Our Harrisburg Social Security Disability lawyers have helped many applicants obtain benefits.
How Healing of Your Injury May Affect Approval for Benefits
While each situation is unique, it is generally the case that the healing of your fracture/broken bone injury will determine your eligibility for benefits.
Applicants who broke their tibia, femur or tarsal bones should be approved if it has been six months since the injury and:
- Medical records prove the bones did not rejoin; AND
- Your doctor says you will be unable to walk without a cane or crutches for one year, at minimum
However, the Social Security Administration (SSA) often does not believe victims will be unable to walk a year after the injury happened. If your situation fits these criteria and your application is denied, it may say you should have sufficient restoration of leg function within one year so there is no significant limitation of your ability to do work-related tasks.
Typically, applicants who are seeking benefits for a broken leg will only be approved if it has been more than one year from the date of their injury and they are unable to walk. Applicants with broken bones are often approved at an appeal hearing because the hearing often happens a year or more from the date of the injury.
Can I Secure Benefits Without Waiting for a Hearing?
This may be possible if you do one of two things:
- Ask for an on-the-record (OTR) review
- Request an attorney review of your application
An OTR review involves a judge reviewing your application without a hearing. You are essentially saying you should clearly be eligible for benefits because your medical records prove you are unable to walk one year after your injury.
You can also ask that a Social Security staff attorney review the case if you have new evidence that was unavailable when you originally applied for benefits. The evidence would likely need to show you have strong evidence your inability to walk will last a minimum of 12 months.
If you want to request either of these two options, you need to contact a Social Security hearing office or have your attorney advocate for you.
What About Claims for Upper Extremity Fractures
You may also be able to obtain benefits for a fracture of the humerus, radius or ulna in one of your arms. However, you need to establish/provide the following to be eligible:
- X-ray or other imaging test result proving the bones have not healed
- You are being treated by a surgeon whose goal is to restore the use of your arm
- The function you lost when the injury occurred has not come back and doctors do not expect it to come back within a year
It is important to note that once six months have passed since a surgical procedure and there has been no improvement, the SSA is likely to assume you will not get better. That means they may consider you no longer under active surgical management, which would likely make you ineligible for benefits.
If your broken bone has not healed in several months, but you do not qualify based on your disability, you may qualify based on the limitation of your ability to work.
If you broke your arm and you are unable to reach up high, push, pull or lift, you should make sure to note this on your application. If your muscles contracted because part of the bone died, you may not be able to use that arm. Fractures could potentially lead to arthritis, making it harder to use the joint the bone is connected to.
Another issue to consider is the psychological impact of persistent pain. For example, pain could make sleep difficult, make it harder to concentrate and lead to fatigue. These things could all affect your ability to get work done.
Applying for Disability Benefits? Schmidt Kramer Can Help
Many disability applicants are surprised when their applications for federal disability benefits are denied. The truth is, many initial applications are denied, even ones that seem like they are destined to be approved.
You have the option of filing an appeal, but this process can be complicated, which is why you should strongly consider seeking legal help.
Schmidt Kramer offers a free legal consultation to review your situation. If we take your case, there are no upfront fees.
Give us a call today to learn more. Phone: (717) 888-8888.