Your thighbone or femur is the longest and strongest bone in your entire body. Because of the length and strength of this bone, it often takes a great amount of force to break this bone. One of the most common causes for a broken or fractured femur is when a person has been in a car crash. This bone is essential to your ability to walk and if you have fractured your femur it is very likely that you are about to undergo a lengthy and possibly life-changing healing process. Most femoral fractures require surgery to heal and will require possibly 4 to 6 months to heal, and some fractures can take longer to heal. However, even if the fracture does heal it is likely that you will not be able to return to the same level of activity that you once enjoyed. If this is your case then you might be considering whether or not to file for Social Security Disability payments and are wondering if you can qualify for Social Security disability payments for a fractured femur.
Can I Receive SSD Payments for a Femur Fracture?
The Social Security Administration has compiled a comprehensive list of the conditions that may qualify a person for Social Security Disability Insurance payments (SSDI). The Social Security Administration used the Blue Book and a five-step process to determine if a person has a medical condition known as an impairment that meets the requirements of a disability. The Blue Book can be found on the SSA’s website and is a good resource for you to use if you are considering whether or not to apply for SSD benefits. The Blue Book has a section that pertains to the Musculoskeletal System and specifically a section related to the femur. Section 1.06 sets forth what a claimant must prove if they are to be considered for SSD benefits. This includes:
Fracture of the femur, tibia, pelvis, or one or more of the tarsal bones. With:
Solid union not evident on appropriate medically acceptable imaging and not clinically solid;
Inability to ambulate effectively, as defined in 1.00B2b, and return to effective ambulation did not occur or is not expected to occur within 12 months of onset.
Under this section for a person to ambulate, or move, effectively means that a person is capable of sustaining a reasonable walking pace over a sufficient distance and is able to carry out the activities of daily living.
Who Can Receive Social Security Disability Benefits?
When you have been injured and are not able to work it can affect more than just you. In today’s time’s families often rely on one or both parents to make an income and if one is unable to work it may affect other members of the family.
Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability, and therefore the process for applying for SSDI benefits can be very complex and require thorough documentation.
Certain family members of disabled works can also receive money from Social Security this includes:
- Your spouse, if he or she is age 62 or older;
- Your spouse at any age, if he or she is caring for a child of yours who is younger than age 16 or disabled;
- Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 (or younger than 19 if still in high school);
- Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. The child’s disability must also meet the definition of disability for adults.
Note in some situations, a divorced spouse may qualify for benefits based on your earnings, if he or she was married to you for at least 10 years, and is not currently married to another person, and is at least age 62. Because the goal of SSD benefits is to ensure that people may meet their financial obligations if they have become disabled this may entail paying for the above groups of people.
Are There any Eligibility Requirements to get Social Security Disability Benefits?
If you have fractured your femur you are probably aware that you are looking at a lengthy healing time, and you often must face the reality that you will not be able to work the same way that you did, if at all, as you did before the accident. However, you may be wondering if there are any eligibility requirements for a person to receive Social Security Disability Insurance (SSDI) benefits.
In order for a person to qualify for SSDI benefits, they must have worked long enough to be covered by Social Security, which is usually 10 years. The next step is to determine if you have a medical condition that meets the Social Security’s definition of disability. As noted above a fractured femur may meet the definition. Under the Social Security’s definition a person is disabled if they are unable to:
- Do the work that they did before
- The Social Security Administration determines that they cannot adjust to other work because of their medical condition and
- The disability has lasted to or is expected to last for at least one year or to result in death.
If you meet these criteria then you may be entitled to SSD benefits. These benefits will be paid on a regular basis until you are able to work again.
What Happens if I am Denied Social Security Disability?
Often people think that when they are disabled or unable to work they are automatically entitled to receive benefits, however, this is not always the case. As noted above, you must qualify for benefits. Additionally, there are a host of reasons why a person may be denied including making too much money, the disability will not last long enough or is not severe enough, and failing to follow the prescribed therapy.
However, if you have been denied benefits you are entitled to an appeals process. If you applied for social security disability benefits and your claim was denied, the fastest and easiest way to file an appeal of your decision is by logging on to the social security disability website and visiting www.socialsecurity.gov/disability/appeal. On this site, you may upload documents online to support your appeal, which will function to decrease the time it would take to receive a decision from Social Security. If your SSI application was denied or if you wish to send a written appeal form, you must make your request within 60 days from the date you receive the Social Security Administration’s letter. The Social Security Administration assumes that you receive the letter five days after the date on the letter unless you can show them you received the letter later. Call your local Social Security office if you need help with your appeal.
However, if you want to appeal a Social Security Administration decision you should be aware that there are generally four levels of appeal which include:
- Reconsideration – A reconsideration is a complete review of your Social Security Disability claim by a person who did not take part in the first decision. This process allows you to have your original claim reconsidered and the evidence you submitted re-evaluated in addition to any new evidence that you may have collected.
- Hearing by an Administrative Law Judge – if after you have submitted your reconsideration and still are not pleased, you may request a hearing. This hearing will be conducted by an administrative law judge who did not have any part in the original decision or the reconsideration in your case. At the hearing, the administrative law judge will question you and any witnesses that you decide to bring.
- Review by the Appeals Council – if you disagree with the hearing decision you may ask for a review by the Social Security Appeals Council. The Appeals Council looks at all request for review, however, they may deny a request if they believe that hearing decision was correct. However, if the Appeal Council decides to review your case, they will either decide your case itself or return it to an administrative law judge for further review.
- Federal Court Review – Finally, if you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.
When a person receives a denial letter they often feel deflated and defeated, however it is important to understand that this is not the end of the road. Often claims are denied because there is not enough medical evidence of the disability. Often those who have been denied will seek additional medical evidence that they are disabled by going to the prescribed doctors and once they submit the additional evidence within the time frame to appeal find that they are granted SSDI benefits.
Contact a Fayetteville Social Security Disability Attorney For Trusted SSD Representation
For more than 20 years Ken Kieklak, Attorney at Law has fought for dedicated Arkansans who can no longer work due to an impairment or disability. To schedule a free and confidential consultation call (479) 316-0438 today or contact a Fayetteville AR disability lawyer our firm online.