Get Social Security Disability Benefits & SSI With Knee Pain

Winning Your Knee Disability Case

Your Knee And Social Security's Review Of Your Medical Records

Social Security will thoroughly evaluate your case to determine whether your knee condition is severe enough to warrant a finding of disability. Your knee condition may be the result of a variety of injuries or medical conditions. You will be asked to submit to Social Security your medical records and other supporting evidence.

Like with any impairment, Social Security will need a diagnosis of your knee condition to determine if you are disabled. This is done by an x-ray or MRI. Which is done first, or at all, depends on what your doctor's suspects to be your medical problem and how much money or insurance you have (MRI's are more expensive). Sadly, x-rays are usually done first, and they are not a good diagnostic knee tool. It is difficult to determine with an x-ray whether you have a variety of knee conditions such as a damaged ligament, tendon, or meniscus; osteoarthritis or rheumatoid arthritis; cartilage damage; patellofemoral pain syndrome; or gout. X-rays are great in identifying a bone fracture. If your doctor determines your knee x-ray shows significant findings, an MRI may be done (money and insurance is again considered).

Social Security will also need your medical records to determine if you are disabled (e.g., doctor's visits, physical therapy, medications, injections, ablations, surgeries, canes, walkers, scooters, and wheelchairs). Medical records will document your knee symptoms and limitations. The primary disabling physical limitations of a knee impairment is difficulty standing and walking, and the need to elevate the knee to relieve pain, swelling, and numbness. There are several common and severe knee conditions and related surgeries specific to the knee.

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

ACL/PCL/MCL Tear. There are three major ligaments of the knee: 1) anterior cruciate ligament (ACL), 2) posterior cruciate ligament (PCL), and the 3) medial cruciate ligament (MCL). The most vulnerable ligament is the ACL; it is therefore the most commonly torn knee ligament. Surgery is nearly always recommended for a significantly torn ligament - an ACL, PCL, or MCL ligament repair. For each type of surgery, the knee tendon is either reattached or, a cadaver tendon is used (but with about a 25% failure rate), or more commonly, the tendon is replaced with a harvested graft tendon from the hamstring.

Osteoarthritis and Torn Meniscus. The meniscus is the cartilage that rests between the femur and the tibia and pads the knee joint. If the meniscus is damaged (torn or frayed) such that a surgery is necessary, the solution is either a meniscectomy (removal of the torn meniscus section) or debridement (removal of the frayed meniscus section). If the meniscus cannot be repaired with a meniscectomy, the solution is either a meniscal transplant (the damaged meniscus is replaced with donor cartilage) or a knee replacement. Osteoarthritis is the most common cause of meniscus damage.

Rheumatoid Arthritis and Inflammed Synovium. The synovium is a membrane that lines your knee joint (along with cartilage). If the synovium becomes damaged, inflamed, or excessive synovium growth occurs, a synovectomy is performed to remove the synovium. Synovial damage is most commonly caused by rheumatoid arthritis.

Baker's Cyst. This is a fluid-filled sac (cyst) that occurs on the backside of your knee. The cyst usually develops when the body produces excess fluid in response to damaged knee cartilage. Surgery is an out-patient procedure wherein an incision is made in the knee, and the cyst is removed.

Gout. This is a type of arthritis wherein monosodium urate crystals build up in the knee - Gout.

Misaligned Knee Cap. This usually results from a congenital deformity (since birth) or a traumatic injury. Whether you have a surgery depends on the severity of the misalignment. The appropriate surgery is a tibial tubercle osteotomy wherein your retinaculum is cut and resewn to allow the kneecap to move into proper alignment.

Knee Fracture. A fracture is due to an acute injury. A surgeon will perform a open-reduction-internal fixation (ORIF) wherein the fracture is reconstructed with wires, pins, or screws. Social Security will rarely award disability based on a simple knee fracture. To obtain benefits, you will need to show the fracture has not healed despite surgery, and you will likely need to show multiple surgeries to repair the fracture. Ccommonly, a knee fracture will not heal if the injured person smokes. If you are a smoker, your doctor will undoubtedly recommend you stop smoking. One of Social Security's many rules is that you follow prescribed treatment. If Social Security determines your fracture is not healing because you continue to smoke against doctor's orders, it will not award disability benefits.

Knee Replacement. This surgery is the most severe knee surgery of all. A knee replacement is generally prescribed if your knee impairment cannot be repaired. The most common condition resulting in a knee replacement is severe osteoarthritis that has destroyed your knee cartilage. With this surgery, a surgeon removes the knee and part of the femur and tibia. A two-part artificial hinge (usually made of metal, ceramic, and plastic) is attached to the femur and tibia with screws. If the kneecap is in good condition, it is put back in place. If it is in poor condition, the underside of the kneecap is removed and replaced with artificial materials, or the entire kneecap is replaced.

Knee Surgeries & Disability

Social Security will generally find your knee condition more disabling if you undergo a surgery. Obviously, if you require a knee surgery, your condition is worse than if you do not need a knee surgery. Sadly, the knee is a poorly designed joint, and sometimes doctors can only do so much to surgically repair a knee. Occasionally, knee surgeries do not work, and your knee symptoms continue - or worsen. In this case, Social Security will generally find your knee impairment even more disabling.

Other Significant Disabling Knee Conditions

Several medical conditions are not specific to the knee. Instead, they are general to the body, but they can affect the knee:

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