Secondary Service Connection For Knee Pain
A secondary service-connected condition is one that resulted from a separate condition that is already service-connected.
For example, say a veterans service-connected spine injury caused them to later develop knee injuries. Secondary service connection can be established if the veteran has a nexus connecting the two conditions.
The Residual Functional Capacity Test
The Residual Functional Capacity test offers another way to get benefits if you do not meet the requirements for a Blue Book listing. This test, as its name indicates, measures your residual functional capacity, which is a fancy way of describing the amount of functionality you still have in spite of your condition.
Functionality refers to your ability to carry out work duties as well as daily living activities, such as:
- Eating
- Dressing
- Toileting
The RFC test, then, lets the SSA know what kinds of activities you can and cannot perform. The SSA uses these results to decide whether it believes you are capable of working or not.
To have an RFC test completed, you must visit either your own doctor or one appointed by the SSA. The doctor will perform a physical exam, run tests, ask you questions, and do whatever else they deem necessary to obtain an objective measurement of your functional capacity. Once the test is complete, we submit the results to the SSA, along with any supporting evidencefor example, lab test results, or a personal statement from your physician.
Can I Get Help At Home If I Have Arthritis
If you need help at home with tasks such as washing, getting dressed and going to the toilet, the first step to do is contact your local council. They will work out what sort of support you need and how much you can afford to pay. Find out more about arranging help at home.
Most local councils dont provide support if you just need a helping hand with your housework, gardening or shopping. Contact a local voluntary organisation such as your local Age UK or the Royal Voluntary Service to see whether they may be able to provide services for you.
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Is Arthritis Considered A Disability By The Canadian Government
Arthritis is a dynamic physical disability with over a hundred unique types of arthritis that have been discovered. The pain ranges in severity, and can be localized to specific spots on the body, such as the back, neck, hip, knees, or feet. At its worst, symptoms of arthritis can become chronic, resulting in constant discomfort.
Listing 102 Joint Dysfunction
If your arthritis has caused major dysfunction of any of your joints, you may be automatically eligible for disability under Listing 1.02. To qualify under Listing 1.02 you must prove that your arthritis has caused some type of deformity, such as excess boniness, misalignment, or permanent shortening of a joint, with chronic pain and stiffness that prevents you from using your joint fully. You must have x-rays or other images of the joint that show the joint space narrowing, bony destruction, or ankylosis of the joints. In addition, you have to have arthritis in either:
- the hip, knee, or ankle that causes significant difficulty walking, or
- the shoulder, elbow, or wrist/hand that prevents you from doing activities like holding a pen, typing or lifting.
If you suspect you would qualify under this listing, ask your doctor if your x-rays show a type of deformity mentioned above.
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How Joint Pain Can Qualify Under A Blue Book Listing
Social Security has recently updated its listing for joint dysfunction and given it a new number: listing 1.18. To meet the listing, a joint in one of your extremities must cause chronic joint pain or stiffness, known as arthraglia . Your pain or stiffness must be associated with an abnormality in a joint that causes problems with motion or stability.
Your medical records need to show evidence of an anatomical abnormality in one of the following ways:
- medical imaging must show either joint space narrowing, ankylosis, or the destruction of bone, OR
- your doctor must have found an abnormality on a physical exam, like subluxation , contracture , or bony or fibrous ankylosis .
In addition, you need medical documentation that you:
- need to use a walker, two canes or crutches, or a wheelchair or scooter that requires both hands, OR
- can’t use one hand, and you need the other to operate a one-handed wheelchair, cane, crutch, or other device, OR
- can’t use either arm or hand to begin, sustain, and finish work.
All of the above criteria must occur within a consecutive four-month period. For instance, you can’t have an MRI from last year showing an abnormal joint coupled with a need for a walker starting this month.
Social Security’s listing of impairments also includes others listings that are associated with chronic joint pain. To learn more about meeting the requirements under these listings, see our articles about these impairments:
Limitation Of Extension Of The Knee Diagnostic Code 5261
Limitation of extension of the knee refers to when the knee is not frozen but rather is limited in extension and cannot straighten all the way.
This knee pain condition is rated under diagnostic code 5261 and the disability ratings available are 0, 10, 20, 30, 40, and 50 percent. Typically, the greater limitation of extension , the higher the disability rating.
Similar to limitation of flexion of the knee, there are specific range of motion measurements that correspond with each disability rating. For example, if the leg can only straighten to within 45 degrees of being completely straight, then it is rated at 50 percent, whereas if it can only straighten to 10 degrees, it is rated at 10 percent.
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How To Use Lay Evidence For Knee Pain
Lay evidence includes statements from veterans, veterans friends and family members, and fellow service members.
Veterans can use lay statements to outline the onset and progression of their knee condition. They can also describe its severity and how it affects daily life. Lay evidence can be very helpful when a veteran lacks certain medical evidence.
Surgery Of The Ankle Foot Knee Or Hip
Alternatively, you can qualify under the listings for degenerative joint disease if you’ve had reconstructive surgery or surgical arthrodesis of a major weight-bearing joint. Your major weight-bearing joints include your hips, knees, ankles, and feet.
To meet the requirements of this listing, you must need a walker or two canes or crutches to walk or, if you can’t walk, you must need a wheelchair or scooter that requires the use of both hands.
Your physical limitations must last or be expected to last for at least 12 months following your surgery.
If you have degenerative joint disease in your hips, you may find it helpful to read our article on getting disability for degenerative hip joints or, if you’ve had a hip replacement, getting disability after hip surgery.
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Is Your Condition A Listed Impairment
Step 3 asks if the impairment meets or equals a medical listing. Social Security Administration breaks the body down into 14 major systems or listings. Included in these 13 systems are more than 150 categories of medical conditions that, according to Social Security Administration, are severe enough to prevent an individual from performing any work.
Arthritis is considered under the Musculoskeletal Body System and has several specific medical listings or categories.
Inflammatory Arthritis
To satisfy the listing criteria, a person with inflammatory arthritis must have persistent swelling, pain, and limitation of joints such as the:
- Wrists and hands
Degenerative Arthritis
People who have degenerative arthritis satisfy the requirements if they have significant limitations using their arms/hands or have a significant problem standing and walking. Those who have significant back or neck problems due to degenerative processes must have persistent sensory, reflex and motor loss to satisfy the listed criteria.
Conditions Not Listed
However, if a person’s arthritis does not satisfy a medical listing, the Social Security Administration continues to the next two steps to see whether the person might still qualify for disability benefits. At the next two steps:
Types Of Knee Problems
Knee pain can arise from knee injury, overuse, osteonecrosis or arthritis. Common knee injuries are sprains, bursitis, meniscus tears, dislocations and fractures. Most minor knee injuries heal on their own while others require surgery . If you injured your knee while working, you may also have an injured worker claim .
Osteonecrosis has similar symptoms to arthritis but it causes bone disease and eventual collapse. In my clients with Avascular Necrosis there symptoms progress from no pain to excruciating pain and back to no pain when the bone itself has died.
Knee osteoarthritis occurs when the cushioning between joints wears away. With the loss of cartilage eventually bones will rub resulting in pain, swelling, stiffness and decreased range of motion. Osteoarthritis can be caused by age, heredity or gender. Via WebMed . I frequently meet clients who have sustained injuries to their knees in their youth who have now developed osteoarthritis with age.
Knee pain can also be caused by Rheumatoid arthritis . RA is an autoimmune disorder that can cause joint pain in the knees and chronic pain in all joints of your body. RA is usually treated with immunosuppressants that have their own side affects.
Knee issues are diagnosed by x-ray or MRI. Treatment for knee issues includes weight loss, medications, physical therapy, injections , braces and finally surgery. Surgery can range from arthroscopic, partial knee replacement to total knee replacement.
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Canada Pension Plan Disability Benefits
The Canada Pension Plan provides monthly payments to people who contribute to the plan during their working years.
You may be eligible for CPP disability benefits if:
- you contributed to the CPP for a certain number of years
- you’re under 65 years old
- you have a severe and prolonged mental or physical disability
- your disability prevents you from working on a regular basis
The benefits include payments to children of a person with a disability.
Apply as early as possible if you think you’re eligible for CPP disability benefits. Quebec residents may be eligible for a similar program called the Quebec Pension Plan . It may take several months to process your application.
If you applied for CPP or QPP disability benefits and were told that you’re not eligible, you can ask to have your application reviewed or considered again.
Once you reach age 65, your CPP disability benefit will automatically change to regular CPP payments. Your regular CPP payments may be less than the CPP disability payments you got before.
If so, consider:
Getting Your Information In Order
To make sure the process is streamlined, its helpful to compile your medical paperwork in advance.
This includes your date of original diagnosis, descriptions of impairments, work history, and treatments related to your RA, says Michael Parker, specialist in long-term disability for Pond Lehocky Giordano, a Philadelphia law firm that often consults on Social Security disability issues.
In every disability case, whether its with the Social Security Administration or an insurance carrier in the long-term disability realm, the adjudicator will determine the applicants ability to function, he says.
Rheumatoid arthritis is a systemic condition, attacking multiple systems of the body, he adds. Thats why its important when describing your condition to indicate how all parts of your body are affected.
In particular, he says, document how RA is affecting your hands which are commonly, and significantly, impacted by the condition. Most occupations require frequent use of the hands, says Parker, so this will be crucial information to convey to the adjudicator.
Its also helpful to specify how your legs are affected, including your knees and ankles, which can greatly affect the type of work youre able to do.
You may want to take pictures of your joints to show flares, to give a better idea of what you go through as a result of the disease, he says.
Also, let your doctors, colleagues, and family know youll be going through the application process.
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Understanding Social Security Disability For Rheumatoid Arthritis
Simply being diagnosed with rheumatoid arthritis does not qualify you for disability. However, if your ability to work is greatly affected or impaired by your condition, then with the proper documentation, you may be entitled to SSA disability benefits.
The exact requirements that a person must meet to qualify for disability with rheumatoid arthritis are defined by the SSA blue book under Section 14.09. In general, a person must be able to provide documentation that rheumatoid arthritis has greatly affected their joints or constitution, and this has limited their ability to perform their job.
For example, you can qualify for disability with rheumatoid arthritis if you have experienced one of the following:
- Inflammation or deformity of the major joints in your arms and legs, and it has led to an inability to walk without a walker and perform fine motor movements with your hands
- Inflammation or deformity of the major joints in your arms and legs along with two organs or body systems being moderately to severely affected, and youve experienced weight loss, fatigue, fever, and/or malaise
- Repeated flare ups with weight loss, fatigue, fever, and/or malaise, along with a limitation of daily activities, social functioning, or the ability to turn in tasks on time
Can You Get Disability For Arthritis In The Spine
If you have a spinal condition, such as arthritis of the spine, it can cause severe pain and limit your mobility. If arthritis in the spine has left you unable to work, you may qualify for disability benefits administered by the Social Security Administration .
If you have arthritis of the spine and you think you will be out of work for at least 12 months, get a free case evaluation today.
To qualify for Social Security Disability benefits, you must meet the criteria established for a listing in the Blue Book, which is a medical guide used to determine if an individual is legally disabled and meets the criteria for monthly benefits.
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How To Qualify For Disability With A Knee Problem
As mentioned above, the SSA wants to make sure youre severely impaired and cannot work before you can approved for disability benefits. To that end, the SSA uses something called the Listing of Impairments, which contains severity standards for numerous medical issues. The Listing is broken down by body system, so first, lets look at Section 1.00: the musculoskeletal system.
Under Section 1.00, either of the following conditions might be relevant to your knee issue:
- Section 1.02 Major dysfunction of a joint. This can be due to any cause, and should present with all of the following:
- Anatomical deformity.
What Does The Ssa Mean By Assistive Device
Now, the SSAs new regulations focus on whether you need an assistive device to help you walk. An assistive device, for the purposes of these listings, is any device that you use to improve your stability, dexterity, or mobility. An assistive device can be worn orhand-held . It can also be used in a seated position .
When the SSA uses the phrase documented medical need, they mean that there is evidence from a medical source that supports your medical need for an assistive device for a continuous period of at least 12 months . This evidence must describe any limitations you have in your upper or lower extremity functioning.
Your records must also explain the symptoms that show you need to use a cane or walker. However, the SSA does not require that you have a specific prescription for the assistive device. By focusing on the need for an assistive device, the SSA has shown they are concerned about the inability to work while, at the same time, using a device like a cane to stand and walk. It is common sense to note that if you are using your hands to support yourself, because you cannot use your legs to do so, then you cannot use your hands to work.
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Type Of Social Security Disability Benefits
There are two main types of SSA disability benefits that you may be eligible for: Social Security Disability Insurance and Supplemental Security Income . SSDI is based on the credits from the work you have done in your life, while SSI is a need based program. You must be found disabled under SSAs Five Step Sequential Evaluation before you are entitled to either benefit.
In order to be found disabled, you need medical evidence demonstrating the cause of your knee problem and how your symptoms affect your ability to work.
Vas Bilateral Factor Rule: When Both Knees Have Disabilities
VA recognizes that if veterans have a disability that affects both knees, the ability to function on daily basis is going to be even more limited. In this case, VA will combine the ratings of the left and right knees and add anadditional 10 percent.
For example, if a veteran had a 20 percent rating in their right knee for limitation of flexion and a 10 percent rating in their left knee for instability, VA will first take those two ratings and combine them to get a total of 28 percent. From there, VA will take 10 percent from that 28 percent and add it to the 28 percent. The new combined rating would be 31 percent .
In this specific example, the veterans combined disability rating does not change, but in other cases, this bilateral factor can be the difference between a 20 and 30 percent combined rating, a 90 and 100 percent combined rating, etc.
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