Burns and Social Security Disability

Social Security Disability Benefits for Burns

If you have suffered from burns or soft tissue injuries, you may be eligible to receive Social Security Disability benefits. Social Security Disability Insurance (SSDI) benefits are payable to those who become permanently disabled as long as the individual has worked enough to earn an adequate amount of credits and has paid in the required amount of taxes to the Social Security Administration (SSA).

Burns and soft tissues injuries requiring longer than a year to heal, or that result in serious or extensive skin lesions, may render you eligible to receive SSDI.

If you are found disabled and eligible for benefits, certain dependents may also be eligible to receive benefits as well. It depends upon the situation, your work credits, your disability and whether or not you have minor children.

Fortunately, many burns or other soft tissue injuries may heal quickly, but after they have healed there may be scar tissue left across joints and the skin that impacts your ability to function.

Burn scars can result in serious functional limitations, and can cause soft tissue injuries that impact the use of your legs, arms, or hands because of damage to muscles, tendons, ligaments or skin.

If serious burns have rendered you unable to participate in substantial gainful activity and earn a living, you should apply for Social Security Disability benefits through the SSA.

Although they do have strict guidelines to determine whether an individual is disabled, a case can be easier to prove with good documentation from a physician.

The Financial Costs Related to Burn Treatment

Soft Tissue Injuries Disabling Condition Social Security Benefits

According to the National Center for Biotechnology Information, calculating the cost of burn treatment can be challenging but is always expensive. The average burn hospitalization for the patient with 1% of the body affected is two days with that costing $15,250.

The average cost of burn treatment for a patient in the U.S. is $46,069, but of course those with worse burns may end up spending $300,000 to $500,000 or even more treatment.

There is often long-term treatment after experiencing a burn that involves surgical reconstruction and treatment of the scar tissue.

Extensive physical therapy may be required to ensure improved mobility, but even with therapy you may not be able to get back full functionality.

The therapy, however, can help improve the range of motion somewhat in most instances.

Burn treatment also involves prescription medication which may include antibiotics to fight off infection and pain medication because of the severity of the pain caused by burns.

Sometimes skin grafts may also be required to help with the recovery process.

The SSA Evaluation and Medical Qualifications

In order to qualify for SSDI, you have to show that you meet the requirements of the medical listing from the SSA Blue Book. The Blue Book is the SSA medical guide that is used to evaluate every disability claim during the application process.

Burns and soft tissue injuries have two listings in the SSA Blue Book. One listing covers injuries and burns that are requiring additional surgeries and treatment in attempt to restore functioning to the injured area while the other listing is for the impairments that are left from burns after all of the treatments have been completed.

Listing 1.08, injuries or burns that are being treated. To meet these requirements, you must have:

  • Burns or other soft tissue injuries to your legs, trunk, face, head or legs
  • Undergoing treatment from a surgeon in an effort to restore or save “functionality” of the burned or injured area
  • No longer have functional use of the burned or injured area restored and it is not expected to be restored within 12 months of the initial injuries or burns

To meet the listing for burns that are no longer undergoing surgical treatment under listing 8.08, you must have:
Burns with extensive skin lesions that are expected to last for at least 12 months.

Skin lesions are considered extensive if they are present in different parts of the body or in critical body areas that lead to major functional limitations.

Meeting Disability Criteria with an RFC

Even if you don’t meet the Blue Book guidelines, you may still be eligible for SSDI benefits if you can prove that your injuries render you unable to participate in substantial gainful activity and earn a living.

When evaluating burns and soft tissue injuries, the SSA understands that they can improve with the passage of time.

An ongoing treatment record and any changes in functioning need to be provided. With regards to functional limitations, physical examinations and medical imaging, all documentation should be provided when possible in order to support any limitations.

If you have burns and injuries requiring ongoing treatment, you should provide all medical records from each surgery and note any surgical side effects.

To prove the severity of any skin lesions, you should provide evidence of these lesions, how often they flare and how symptoms caused by the lesions, such as severe pain, limit your ability to function. List any treatments you have received as well as any side effects that those treatments cause.

If you don’t meet a listing, you can still qualify for benefits with a residual functional capacity form (RFC), which clearly states any physical, mental, or sensory limitations.

Limitations such as problems pulling, grasping, lifting, pulling, carrying items, standing or sitting can be very significant and impact the individual’s ability to work.

If your burn was severe enough to result in scarring that has caused tightening, it can limit your ability to make certain movements and decrease your range of motion.

That should be clearly indicated by your doctor when the RFC is completed. Decreased strength can also result if tendons and muscles underneath the burned skin were damaged.

Sensory limitations that impact your ability to adapt to your surroundings are also considered, such as injuries to the face and head that may impair your vision or hearing, or burns that may impact your sensory abilities such as touch.

Applying Specific Medical Tests to Your Case

The SSDI application process is very thorough, but the SSA may still request additional information. At the expense of the SSA, a medical evaluation may be ordered for informational purposes.

This is to confirm your disabilities and impairments as well as help determine if you are indeed unable to work. This evaluation can help prove your claim.

On occasion, a mental evaluation may also be ordered to determine if you have been impacted mentally and emotionally by the injury.

Sometimes depression, anxiety or post-traumatic stress disorder can impact your ability to work following severe injury

Even if you do not think you medically qualify for Social Security Disability benefits, you should consider speaking with a disability advocate or attorney about your options in regards to your condition.

They may be able to help you with the application process and make recommendations for you to get the financial help you need.