A Closer Look on Knee Replacements and Social Security

Knee replacements can sometimes be inevitable. However, these procedures could also mean medical expenses, which you could only hope that your Social Security could cover. This is also for this reason that one should learn more about knee replacements and Social Security.

What Is Social Security?

Social Security refers to a social insurance program that provides benefits or services in recognition of contributions to an insurance scheme. These services include retirement pensions, disability insurance, survivor benefits, and unemployment insurance.

Knee Pain Patients and Disability claims

Severe arthritis and other structural damage to the knees can highly support a successful Social Security disability claim. Most chronic knee pain patients who claim social security are in their forties and fifties. Knee pain is usually the result or wear and tear after a few years. Some are involved in a car accident years ago; some were injured when they were still high school athletes while others simply wore down their cartilage or bones in the knees after standing on hard concrete for many years.

Damage to one or both knees can result to exertional impairments like limitations on standing, walking, stooping, climbing and carrying. Non-exertional impairments are also present like pain, poor sleep, pain medication and side effects, and obesity.

Social Security judges usually encounter knee pain as the reason on claiming disability. However, you should bear in mind that when making a claim, you have to show that the pain is more than the mild to moderate discomfort that patients usually experience. Your pain must be very severe and debilitating to a point that you have difficulty in walking and sitting.

Moreover, most judges look for factors like long consistent work history of the patient, MRI and X-ray reports that are objective proofs of evidence of the knee problems, and recommendations from the attending doctor that knee replacement is needed. Bilateral knee replacements are usually favored. Other factors that the judges will consider include dysfunction of a major weight-bearing joint. They may also look into those who are over fifty years old with limited education as well as unskilled work background.

It should be proven as well that functional capacity for work has been affected and reduced by the knee pain itself.

A Case of Knee Replacement

Take, for example, a 59-year old female who worked as a registered nurse at a local hospital for thirty years. Educational background was high school graduate with two years in nursing school. In January 2005, she visited a relative in the hospital, but her right knee was unexpectedly buckled while exiting the elevator. During that time, she was 54 years old, a little overweight, and was suffering from non-insulin dependent diabetes and hypertension.

She was able to return to her job after the fall and underwent arthroscopic surgery on her right knee in March 2005. However, the surgery was not favorable, so she underwent right knee replacement surgery in October the same year. After a year, the left knee was also deteriorated as a result of the extra pressure of the surgery the other year. In November 2006, she had left knee replacement. However, she was not free of pain or was able to walk without assistance.

The judges agreed to have her on Social Security after hearing. According to them, the claimant cannot return to her job anymore. The claimant’s long and consistent work history, the objective nature of the medical problem presented, age, and helpful functional capacity form from the attending doctor were believed to be the main factors in the judges’ favorable decision.