Facts about Total Hip Replacement and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Hip replacement surgery, also known in the medical field as hip arthroplasty, is a procedure that involves implanting a prosthetic in place of the original hip joint.
2. The materials used for hip replacements are picked especially due to their easy acceptance by the body and their resilience against wear, although eventually they may need to be replaced if done early enough in life that they?wear out.??
3. The goal and purpose of the surgery is to relieve pain and stiffness and restore function in hip joints damaged from arthritis or severe injury.
4. Hip problems that may eventually lead to a doctor's recommendation of replacement surgery are arthritis, a break in the hip joint or bone, a tumor in the hip, and osteonecrosis, a condition that limits blood supply to the ball bone of the hip joint and results in death of the bone.??
5. Surgery is usually a last resort for treatment, since it is invasive and all surgery carries risk. First, treatment will include over-the-counter and prescription pain killers, physical therapy, and walking aids. If these treatments do not relieve symptoms, or the condition progresses to a point where these treatments are no longer effective, then surgery may be considered.??
6. To be considered a candidate for surgery, the patient must have severe pain that interferes with sleep and daily activities, and limited mobility in climbing stairs or standing up, all of which are not relieved by other treatment methods.??
7. After surgery, a period of rehabilitation with physical therapy will be necessary. Patients will need to allow time for the body to heal from surgery, as well as work up to increased joint movement.
8. Surgery and rehabilitation will result in less pain and more mobility in over 90 percent of cases. Specific improvement in activities will vary by individual, but many will eventually be able to do low impact exercises such as swimming.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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