If you have club foot, you may be eligible for Social Security Disability benefits depending upon the severity of your condition. Club foot is a fairly common birth defect that results in the foot being twisted inward and down. Half of those with club foot have both feet affected by the condition.
Club foot can affect your ability to stand, walk, maintain balance, and perform other essential functions. You may even suffer from motion limitations and severe pain for years following successful treatments. If your club foot is not properly treated, it can worsen over time and cause significant disability. Regardless of whether your condition has been treated, it can still be disabling.
Your condition may require you to undergo a variety of treatments, including physical therapy, exercise, use of braces and/or casts, and surgery. There are no cures for the condition, but several treatment options to help lessen the severity of the impact of the genetic disorder.
The United States Social Security Administration (SSA) oversees the Social Security Disability Insurance (SSDI) program, which offers monthly benefits to workers who have become disabled because of an illness or an injury. In order to qualify for SSDI, you have had to work to earn enough credits and to pay into enough taxes to the SSA.
Further Reading: What Conditions Qualify For Disability?
If you are approved for SSDI, you may have dependents who are also eligible to receive benefits from your credits, such as minor children. In order to support your disability case, you need to provide as much documentation and as many medical records as possible.
The Costs Contributed to Treating Club Foot
According to Baby Center, a casting visit can cost as much as $600 and a tenotomy costs about $1,200. Other surgical procedures cost even more. There are regular doctor visits and prescriptions to treat the symptoms. The co-pays and coinsurance add up, so the average cost per year for treating the condition can be $1,500 to $5,000 per year.
Even if you undergo surgery you may still suffer from pain and swelling as well as limitations with your mobility. Regardless of the success of your treatment, odds are that you will require ongoing medical care for your condition and to lessen any symptoms, such as joint pain or arthritis that could develop from the condition.
The SSA Evaluation and Medical Qualifications
The SSA uses a medical guide, which is called the Blue Book, to determine whether an individual is considered disabled. The SSA Blue Book has a listing for major dysfunction of a joint, which is under Section 1.02. In order to meet the criteria, which is set forth in the book, you must have:
- Chronic stiffness and pain in the ankle joints
- Limited range of motion or abnormal range of motion in the ankle joints
- Difficulty walking
Medical documentation is essential in proving your case. In order to back up your disability claim, you need to provide as much documentation as possible. Examples of documentation that is necessary are:
- Imaging results that show joint deformities, severe arthritis in the ankle joint, or bone loss or damage
- Detailed notes from your physician that detail your physical exams along with functional assessments of your ability to walk, climb stairs, stand, and balance
- Records of the different treatments you have undergone and how they effected your condition
- A physician’s detailed statement that discusses the ongoing effects of your condition and your prognosis for club foot
Getting Disability with a Medical-Vocational Allowance and a RFC
If you don’t meet the criteria set forth in the Blue Book, you may still be eligible to receive SSDI benefits. You can pursue your benefits using a medical-vocational allowance, which considers your conditions, age, work experience, education, and skills. Using this combination, it is determined if you are able to perform any substantial gainful activity.
A residual functioning capacity (RFC) is a form that details your condition and how it limits you. As an example, if you are unable to stand for an hour because of your foot pain that is indicated. If your joint and foot deformities prevent you from being able to walk more than a couple hundred feet or if you require a cane or crutches, that is also indicated.
Once it has been determined that you are unable to do your past work, the team at Disability Determination Services will decide if you are able to perform some other kind of work, such as sedentary work which involves lifting a maximum of 10 pounds, sitting for at least 6 hours, and standing for 2 hours out of an 8-hour day.
Your doctor can complete the RFC and list the details and any limitations in detail. By having your physician, who knows your condition and limitations in detail, complete the form you can greatly increase your odds of being approved for disability benefits.
Applying Specific Medical Tests to Your Case
When you have club foot, you will undergo x-rays and imaging that will show the specifics of your condition. These test results should be included with your disability application. It is not uncommon for the SSA to order a medical evaluation at their expense. They will order an evaluation with a physician at their expense.
This evaluation is for informational purposes only and is to help determine the severity of your condition and the symptoms. Club foot can also cause you to suffer from stress, anxiety, and depression, so those must be considered as well. Sometimes a mental evaluation is also ordered to determine your mental limitations and how your condition has impacted your mental state.
The SSDI application can be a lengthy process. You may be denied benefits twice and have to file appeals in order to continue your case. The last step is a hearing before an administrative law judge who will rule on your case. Providing complete documentation is the key to proving your case so include as many medical records and documents initially as you can possibly provide to back up your claim and to show your condition’s severity.