Avascular necrosis, or osteonecrosis (bone death), is a condition that occurs when bones don’t receive adequate blood supply. As the bone dies, small fractures in the bone occur, eventually leading to more significant and obvious fractions. Among the most common bones affected by this condition are those in the hips and pelvis.
There are a number of different reasons avascular necrosis can occur, though the most frequent causes are sickle-cell anemia, serious trauma to the affected region, and alcohol abuse. Long term use of prescription steroid drugs can also lead to avascular necrosis, in some cases, and the condition can therefore be a complication of the treatments required for other medical conditions, including chronic respiratory illnesses, autoimmune disorders, and muscle disorders, to name just a few.
Applying for SSD with Avascular Necrosis
Regardless of what causes avascular necrosis to occur, the symptoms and the necessary treatments for the condition, can be quite debilitating. Symptoms include joint pain, range of motion issues and stiffness, in addition to bone fractures. Common treatments include medications and physical therapy, though in the most severe cases, surgery is typically required.
The Social Security Administration (SSA) will need to evaluate the extent of your symptoms and your overall condition in order to determine if you qualify for Social Security Disability (SSD) benefits. The first step in this process is for the SSA to evaluate your application for disability benefits under the criteria of a listed condition in its “Blue Book”, which is a manual of potentially disabling medical conditions utilized during the eligibility review for SSD.
While there is no dedicated listing for avascular necrosis in the Blue Book, and therefore no specific documentation criteria for meeting SSD eligibility requirements, the SSA will see if your application and your supporting documentation, including your medical records, “match” another condition that is listed in the Blue Book. If your avascular necrosis and symptoms you experience are as severe as those seen with another listed condition, you could qualify for SSD benefits based on that “match”.
Among the most common listings for avascular necrosis SSD applications to match are:
- Section 1.02 - Major dysfunction of a joint(s) – due to any cause
- Section 1.06 – Fracture of the femur, tibia, pelvis, or one or more of the tarsal bones
If your application doesn’t match closely enough to a listed condition, then the SSA will see if you meet the criteria for a “medical vocational allowance”, which basically means that while your disability doesn’t meet or match a listed condition, it may still be severe enough to prevent you from maintaining gainful employment, and therefore qualifies you to receive SSD benefits.
In order to make this determination, the SSA will need to evaluate your “residual functional capacity”. This is a measure of your capabilities, including your ability to care for yourself and perform essential job functions.
Medical Documentation to Prove Avascular Necrosis
No matter how your application for SSD benefits will be reviewed and potentially approved by the SSA, there are certain pieces of documentation which must be included in your supporting documentation in order for you to see a favorable outcome. These include:
- Thorough medical records, including notes from your physical exams detailing your symptoms and the frequency in which they occur
- the duration of hospitalization or other required medical interventions, therapies or treatments
- the types of medications you take, dosages for each and the effect they’ve had on your symptoms
- detailed statements from your treating physician(s) describing the severity of your symptoms and the prognosis in your case
- Imaging and other test results that formally document the diagnosis and the progression of the illness
Getting Help with Your Avascular Necrosis SSD Application
Whether you meet the SSA’s listing for dysfunction of a joint or a bone fracture, or need to prove you’re disability under a medical vocational allowance, you must work closely with your doctor to ensure your medical records are thorough and that your application and associated documentation meet the SSA’s evidence requirements for SSD eligibility.
Working with a Social Security attorney or advocate in putting together your application can also increase your chances of being approved for SSD benefits without delays. If necessary, your attorney or advocate can also assist you in compiling information and completing other required forms, and in preparing for and testifying at an appeal hearing, if one is required.
