Avascular Necrosis and Social Security Disability

Avascular Necrosis

Avascular necrosis is often referred to by the medical shorthand—AVN. But it is also known by the descriptive term: bone death. When a bone does not get an adequate supply of blood, the bone dies, and as it dies, small fractures develop in the bone and can eventually lead to more significant and debilitating fractures. AVN most commonly affects the bones of the hips and pelvis, especially the head of the femur, which is ball-shaped and fits into a socket in the hip. Femur head AVN can make just even a slow, shuffling walk an excruciatingly painful process.

There are many root causes of AVN, including sickle cell anemia, serious trauma to the body in the affected area, and even alcohol abuse. Radiation therapy for cancer can also weaken a person’s bones leading to avascular necrosis. Long-term steroid use can also be a cause of AVN. Because steroids are often prescribed for treatment of other medical conditions like muscle disorders, respiratory illnesses, and autoimmune diseases, AVN can be an unfortunate side effect.

Regardless of the root cause of a particular case of avascular necrosis, its symptoms—joint pain, limited range of motion, and bone fractures—can be seriously incapacitating. Individuals battling these symptoms are often unable to maintain steady employment. If you are impaired by AVN and unable to work, you may be eligible for Social Security disability benefits.

There are two disability programs: Social Security Disability Insurance, which is known as SSDI, and Supplemental Security Income—commonly referred to as SSI. SSDI pays benefits to you and certain members of your family if you are disabled and you worked long enough and paid Social Security taxes. SSI is based on financial need. The Social Security Administration says, “It is designed to help aged, blind, and disabled people who have little or no income.”

There are two basic paths to qualifying for disability benefits. The first is to match the medical criteria in the “Blue Book,” the Social Security Administration’s (SSA) list of disabling conditions. If an individual’s symptoms match the requirements in the listings, they will likely qualify for disability benefits. While there is not a specific Blue Book listing for avascular necrosis you may still qualify for benefits if you can match the criteria in one of the two listings which align with symptoms associated with the disease.

Section 1.02 – Major dysfunction of a joint(s). Like nearly all the Blue Book listings, this listing is quite specific and requires in part: “Gross anatomical deformity . . . (and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s). With: A. Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively. OR B. Involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively…”

Section 1.06 – Fracture of the femur, tibia, pelvis, or one or more of the tarsal bones
“A. Solid union not evident on appropriate medically acceptable imaging and not clinically solid;
and
B. Inability to ambulate effectively…and return to effective ambulation did not occur or is not expected to occur within 12 months of onset.”

The Social Security Administration’s definition of “inability to ambulate effectively” (referred to in both listings) is strict. It means that you cannot walk without an assistive device that requires both hands—like a wheelchair or a walker – or are unable to travel outside of your home without assistance.

The hard, cold facts are that very few people who apply for Social Security disability benefits meet the precise, exacting requirements of the Blue Book listings, but there is a second way to qualify—by proving that you are unable to perform any work due to the symptoms of AVN given your age, education, and past work experience.

We advise you to always keep in mind that it is not the diagnosis of a disease or even the presence of a disease’s symptoms that qualifies you for disability benefits. It is far more important to conclusively demonstrate how much you are limited by your impairment rather than to emphasize the diagnosis itself. The Social Security Administration will evaluate your “residual functional capacity” (RFC)—an assessment of what you can still do despite your medical impairments. (For more on RFCs, click here.) To qualify for benefits, you must demonstrate that your symptoms prevent you from sustaining full-time, competitive employment on a consistent and reliable basis. Your medical condition(s) must be expected to last and keep you out of work for at least 12 consecutive months. In order to prove your case, you need to provide as much documentation as possible about your limitations.

This information ideally includes:

  • Thorough medical records, including notes from your physical exams detailing your symptoms and the frequency in which they occur.
  • Statements from your treating doctor(s) describing the severity of your symptoms and the prognosis in your case, and most importantly, your limitations.
  • Test results including scans from radiography, magnetic resonance imaging (MRI), or computed tomography (CT), or other imaging methods.
  • The length of any hospital stays or other required medical interventions, therapies, or treatments precipitated by your AVN.
  • A list of the medications you take, dosages for each, and the effect they’ve had on your symptoms.

In addition to thorough documentation of your medical condition, hiring an experienced Social Security attorney to fight for your rights can also improve your chances of being approved for disability benefits. Your attorney can help you compile the right information, prepare you for an appeal hearing if one is required, and can present the strongest arguments in your favor.

If you are unable to work because of AVN or any other medical conditions, call or email the Chicago Social Security Lawyers at Nash Disability Law today for a free consultation. (To learn the advantages of a local disability lawyer, click here.)

Testimonials

Thank you so very much for your help with my disability claim.  Please thank each and everyone who helped in getting this done. Every time I had questions and had to call you for advice, whomever I spoke with at the time was very helpful and polite and most of all caring. Once again, Mr. Nash, thank you so very much.

- Luisa

Thanks you for all your help with my disability case. I felt very confident after discussing my claim with your attorneys. The representation I had for my court date was wonderful. I know I couldn’t have done all that you did on my own . I am very appreciative for all the hard work, time, and care you gave to me!

- Renee