How To Get Social Security Disability & SSI Benefits: Hip Pain

Want to know how to win your hip case? You will win if you satisfy both the Social Security and SSI Non-Medical Criteria and Disability Criteria.

On this page, we discuss how Social Security evaluates your hip medical evidence. On the next page, we discuss how Social Security evaluates your hip-related Functional Limitations to determine if you are disabled. Then on the last page, we discuss how to Submit Winning Evidence to establish your hip condition, your limitations, and other necessary points of your hip disability case.

What Social Security Finds Important About Your Hip Medical Records

Social Security evaluates a significant number of hip disability cases. If you suffer hip symptoms, you may have a medical condition that is directly located at the hip, or you have a medical condition that is not directly located at the hip but affects the hip. Either way, Social Security will award benefits if your hip condition and resulting limitations are severe enough. Typical limitations of a hip condition usually involve 1) standing, 2) walking, and 3) the need to lie down throughout the day. There are several common hip conditions that are directly located at and related to the hip.

Most Common Hip Conditions In A Social Security & SSI Disability Case

Hip Impingement. There are two reasons one suffers a hip impingement. First, either the cartilage or labrum of the hip and socket are damaged. Second, either the ball of the femur or the socket of the hip have become misshapen (usually due to a congenital deformity, osteoarthritis, or bone spurs). In either case, the hip and socket do not move smoothly.

Labral Tear. There are two types of labral tears. First, your labrum is torn and detached from the hip socket. In this situation, a surgeon will perform a labral tear repair – the labrum is reattached with screws, tacks, or clips. Second, your labrum is torn and attached to the hip socket. In this situation, a surgeon will perform a labral debridement – the torn parts of the labrum are trimmed away.

Bone Spurs. A bone spur (osteophyte) is a small abnormal growth on the bone – the bone being the femoral head or hip socket (pelvis) in this case – that is typically caused by inflammation resulting from osteoarthritis or tendonitis. Bone spurs cause friction and pain with movement and may damage the hip cartilage or labrum. If the bone spurs are severe, a femoral osteoplasty surgery is performed wherein the bone of your femoral head is smoothed and possibly reshaped. A periacetabular osteotomy surgery may also be performed wherein your hip socket (pelvis) is smoothed or repositioned. In some cases, your femoral head is capped with a metal cover, and your hip socket is also lined with metal.

Hip Dysplasia. This is a medical condition where the hip socket does not correctly and completely surround the femoral ball so that the hip joint dislocates. It is nearly always a congenital condition. A periacetabular osteotomy is performed to correctly reposition the hip socket over the femoral head.

Hip Deformity. A hip deformity or misalignment is usually a congenital deformity. A hip osteotomy may be done wherein the bones of the hip (most commonly the femur and pelvis) are cut and placed into a correct position. It is very significant surgery.

Hip Replacement. There are two aspects to this surgery. First, your femur is cut and an artificial ball is attached to the femur with screws and/or pins. Second, an artificial socket is attached to your pelvis with screws and/or pins.

The Impact Of A Hip Surgery On Your Disabilty Case

Any time a doctor refers you to a surgeon, and the surgeon recommends a surgery, Social Security will acknowledge that your hip condition is severe and that your functioning is limited. Your hip joint is a major joint of the body, and it carries a significant portion of your body weight. Surgeries and rehabilitation do not always fix the problem. Any time you have a failed hip surgery (it is unsuccessful), your odds of winning your case grow dramatically as Social Security acknowledges your functioning will be even worse.

Other Disabling Hip Conditions

Review our other pages for additional medical conditions that affect the hip:

1. Amputations
2. Burns,
3. Complex Regional Pain Syndrome/RSD,
4. Diabetes-Related Conditions,
5. Gout,
6. Neuropathy,
7. Peripheral Artery Disease,
8. Psoriatic Arthritis,
9. Rheumatoid Arthritis,
10. Skin Conditions,
11. Vasculitis, and
12. Venous Insufficiency.

A Hip Case – Grid Rule And Hearing Allowance

Ms. Mitchell lived in San Jose, CA. She suffered from a hip impairment (her most significant medical impairment), a small hernia, a mild lumbar impairment, hypertension (high blood pressure), mild diabetes, obesity with a body mass index (BMI) that ranged from 38 to 42, and mild to moderate depression. She was over age 50 at all times since her alleged onset date of disability (AOD). Her past work was as a housekeeper; this was her only past job. She had not performed much work in the previous ten years prior to her application date, and therefore, she did not have enough work credits to qualify for a Social Security Disability benefits; she did qualify for SSI disability benefits. Her case was denied at the initial and reconsideration Social Security levels, and we requested a hearing with an administrative law judge (ALJ).

At the time of her application and AOD, Ms. Mitchell had been suffering primarily from left hip and left leg pain. She had a left hip MRI that showed severe arthritic (degenerative) changes with extensive joint space narrowing. She regularly used a wheelchair (this was not prescribed by a doctor). About four months prior to her hearing, she underwent a hip replacement. After her surgery, she had only a minimal reduction in her hip and leg pain, and she began to suffer occasional urinary leakage. Also after her surgery, she did not use her wheelchair, but she did use a walker for about a month. Thereafter, she used a cane which she used up to the time of her hearing. She underwent physical therapy (PT) after her surgery for about six weeks.

We had four big challenges in her case. First, her clinical findings from her primary care doctor and her orthopedist were relatively normal – the doctors did not indicate she had muscle weakness or atrophy, reduced sensation, or reduced range of motion. Second, after her hip replacement, her orthopedic surgeon indicated that she was cured of her previous hip condition. Third, we did not have a post-surgery x-ray or MRI demonstrating an abnormality of the hip. Fourth, we did not have an indication from any medical source she needed a wheelchair, walker, or a cane. Unfortunately, we did not have a medical source statement (RFC form) from her treating doctors to address any of the three above problems.

We argued at hearing that because she was over age 50 with no past sedentary work or work skills, she could win her case and be found disabled if she was limited to sedentary work – she met Social Security Grid Rule 201.10. The main issue in this argument was that she was limited to sedentary work. We had to argue that she did not have the ability to walk and stand throughout an eight-hour workday. We took her testimony on the following issues with specific emphasis on standing and walking:

1. Continued pain and numbness in her left hip and leg;
2. How long she could stand and walk;
3. When she used the wheelchair, walker, and cane and why;
4. Difficulties she had grocery shopping;
5. Her need for a shower chair;
6. Her need for a chair in the kitchen for cooking and doing dishes;
7. Housework help she received from others;
8. Problems driving and running errands like grocery shopping;
9. Poor sleep due to pain;
10. Difficulties she had in post-surgery PT; and
11. Pain medication changes.

Her physical therapy records were very important as they demonstrated she had profound difficulty standing and walking. She did not meet her goals when she was released from PT (her insurance kicked her off early). These records were sufficient to convince the ALJ that her cane was necessary and that she could not stand and walk to perform her past work or other light work. Hence, she was limited to sedentary work. Because she had no sedentary work skills (past work as a housekeeper), she met Grid Rule 201.12.

Ms. Mitchell brought a witness, but the ALJ did not call the witness. The ALJ agreed with our argument about the grid rule and awarded both Social Security disability and SSI benefits at the hearing which happens at only about 10% of hearings. It was a fair allowance for a client who was clearly disabled under Social Security’s rules.