If you have been diagnosed with Avascular Necrosis and are unable to work you may be considering if filing for Social Security Disability is the right choice for you. If so, read on.
This article should not be construed as medical advice regarding necrosis. If you are having chronic pain or other symptoms, please seek medical attention.
Types of Disability Benefits
SSA generally offers two types of benefits for the disabled: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is based on the credits from the work that you have done in your life while SSI is a need based program. You must be found disabled under SSA’s Five Step Sequential Evaluation before you are entitled to either benefit.
What is Avascular Necrosis?
Avascular Necrosis, put simply, is when your bone tissue dies due to lack of blood flow. Another name for this is osteonecrosis, aseptic necrosis or just necrosis. Blood flow can be interrupted by a fracture or joint dislocation. Long term use of high dose steroids or excessive alcohol often precipitate Avascular Necrosis (Via the Mayo Clinic).
Certain medical conditions that affect blood flow are also associated with non-traumatic osteonecrosis: Pancreatitis, Diabetes, HIV, Gaucher Disease, Sickle Cell Anemia and Systemic Lupus Erythematosus.
In my clients with my Avascular Necrosis, men seem to be affected the most and usually it is the hip (femoral head) that contains the AV. But you can have Avascular Necrosis in other bones as well and women can also have it. Unfortunately, our firm has seen cases of AV in the wrist bones, fingers and even widespread bone death. Kienbock’s Disease is a specific form of osteonecrosis in which the bones of the wrist break down due to loss of blood supply (Via NIH).
Clients describe pain that begins mildly but progresses to excruciating over time. At first, you may only have pain when you try to walk or use your hands but eventually you may have pain even when you are at rest.
Eventually, after complete bone death occurs, you can have no pain or symptoms at all. But with complete both death, the bone can start to collapse on itself, fracture and affect the living tissue that surrounds it.
Treatment of AV depends on the stage of the disease you are in. An x-ray, MRI or bone scan can be used to determine what stage your affected bone is in. If you are in the earlier stages, non-surgical treatment may be used to reduce further damage to your bone (e.g. medication to help blood supply return to the bone, physical therapy or pain medicine). But eventually most people with Avascular Necrosis require hip replacement or joint replacement surgery by a orthopedic surgeon. Via WebMD .
Avascular Necrosis and Disability
As with all claims for Social Security Disability, the name of your impairment is not as important as the severity of your symptoms. In mild cases of AV, you will have difficulty proving your disability to SSA.
But, since Avascular Necrosis usually affects the hips or knees, as the disease progresses your ability to walk and bear weight can be affected. When AV affects other joints, you may be unable to use the joint at all as the bone disease progresses. If this is happening to you and you are unable to work, filing a claim for Social Security Disability benefits may be the only choice for you.
The Social Security Administration can evaluate Avascular Necrosis under 1.00 Musculoskeletal Disorders. Depending on the location of the osteonecrosis, different listings (1.17 or 1.18 are examples) can be used to evaluate your claim for disability benefits. As with most SSA listings, the above are difficult to meet. I have had clients that simply refuse to use a cane despite desperately needing one and other clients who can manage to take care of their personal hygiene even though it can take several hours just to bathe. The point is that you may be unable to work long before you meet this listing.
In addition to the above listing, the SSA can use the Medical Vocational Guidelines (The Grids) to find a claimant disabled based on necrosis. If you are 50 years of age (or older) and are unable to walk more than 2 hours in an 8 hour day, you may be found disabled this way.
The first step is to apply for benefits. If you can not work due to your Avascular Necrosis, apply as soon as possible. After you apply for Social Security Disability benefits (SSDI or SSI), your case will be sent to DDS in Raleigh, NC. The Disability Process can be long and difficult, even if you have been assessed with something as painful and life altering as Avascular Necrosis.
The Bishop Law Firm represents clients in claims for disability benefits in Raleigh, NC and surrounding areas. Our Social Security Disability Attorney does not get paid unless we win and we offer free case reviews by phone. Call us today, (919) 615-3095.