Every year, around 600,000 Americans receive partial or total knee re-placements, requiring thousands of dollars per person to cover surgery, outpatient costs, and recovery time. For many, paying for these expenses is just not an option. However, it may be possible with assistance from Social Security.
Knee Replacement Tips
Knee replacements are notoriously difficult to receive benefits for, as they are expensive as they are common. To increase your chances of receiving benefits, be sure to follow the steps below:
1. Check the SSA’s Blue Book ahead of time to see if your knee replacement automatically qualifies for insurance.
The Social Security Administration (SSA) keeps a list of all pre-approved disabilities in what’s known as the “Blue Book”. Most of the disabilities included in the Blue Book are either terminal, permanent, or incredibly severe. However, knee replacements can also qualify if you meet the following criteria:
- You have a major joint dysfunction that includes anatomical deformity and chronic joint pain, stiffness, and limitation of motion that affects your knee and severely interferes with your ability to walk, or
- You have had reconstructive surgery or surgical on your knee be-cause of your severe inability to walk and you are not expected to return to normal movement for at least 12 months after surgery.
One of the most important phrases here is “12 months” — regardless of your disability, it is incredibly difficult to qualify for insurance if your impairment will be fixed in less than a year.
If you meet either of these qualifications and have the medical paperwork to prove it, you have a good chance of qualifying for Social Security Disability Insurance (SSDI). If you do not meet these qualifications, though, there are other steps you can take.
2. Speak with your doctor to receive your medical forms and ask them to fill out an RFC.
Disabilities that are not listed in the Blue Book can still qualify for insurance as a “medical vocational allowance”. This is Social Security’s way of saying, “Your disability doesn’t quite meet our requirements, but it is still severe enough to require help.” To help support your case, gather as much documentation as possible from your doctor to show the history and severity of your knee problems.
You can also ask your doctor to fill out a Residual Functional Capacity (RFC) form. These forms assess the severity of your disability and can help demonstrate the severity of your impairment. These forms can be downloaded from the SSA’s website.
3. Highlight your past work history to demonstrate the impact this surgery will have on your ability to function.
The more you can prove that knee surgery will prevent you from living your life, the better chance you have at receiving benefits. For example, a construction worker that requires knee surgery has expertise in a field that requires him to be mobile. Not only will knee surgery recovery pre-vent him from returning to work, but it will prevent him from getting any other work in a similar field. Evidence like this can also help build you a stronger case.
Consulting with a Social Security Attorney
For questions regarding the application process or your eligibility for disability insurance, consider speaking with a Social Security attorney. Their legal experience with cases like yours can vastly increase your chances of receiving the benefits you deserve.