Get Social Security Disability & SSI Benefits: Shoulder Pain

Winning Your Shoulder Case

Social Security's Reading Of Your Disabling Shoulder Medical Evidence Is Critical

A shoulder impairment is a common basis for Social Security and SSI disability benefits, and it may be caused by any number of traumatic events or medical impairments. No matter the bases of your shoulder impairment, you must give Social Security both medical evidence and non-medical evidence to prove you are disabled.

The first step is to provide Social Security your shoulder diagnosis. It is critical your diagnosis is supported by objective testing such as an MRI, CT, or x-ray. If you do not have this testing, it is nearly impossible to prove you have a severe shoulder impairment.

The second step is to provide Social Security your medical treatment records to determine what type of treatment you have received and whether your treatment has been helpful. If you have received little to no treatment, Social Security will presume your shoulder impairment is less severe than if you have had a significant amount of treatment. If your treatment has failed, Social Security will presume your shoulder impairment is more severe than if your treatment has dramatically improved your shoulder condition. If you have had a shoulder surgery, Social Security will presume your condition is worse than if you have not had a surgery. Ultimately, Social Security will be reading your treatment notes to determine the severity of your shoulder condition.

The third step is to demonstrate how your shoulder limitations disable you which involves both your medical records and non-medical records. When Social Security goes over your medical treatment records, it recognizes that shoulder limitations generally involve -

1. Reaching,
2. Gross manipulation,
3. Fine manipulation,
4. Lifting, and
5. Carrying.

Social Security will look for complaints you have made to your medical providers about these limitations, and it will look for clinical evaluations by your doctors to see if your doctor recognizes these problems. Social Security will also read non-medical records about your limitations such as forms you have filled out for Social Security, doctor statements, layperson statements from others you know, your hearing testimony if you have a hearing, pictures, or a submitted diary.

Common Shoulder Impairments & Surgeries

You have a better chance of winning your Social Security and SSI disability case if you have a shoulder surgery as it indicates to Social Security that your shoulder impairment is severe. The shoulder joint is a complex joint, and any serious shoulder impairment is difficult to treat. Therefore surgeries have varying levels of success. Some shoulder surgeries fail (they do not cure your shoulder problems). A failed shoulder surgery is even a stronger indication to Social Security that you are disabled.

Shoulder Fracture. A fractured bone (usually the humerus, glenoid bone, scapula (shoulder blade) or clavicle (collar bone) is reset. Hardware (plates, screws, and wires) placement is uncommon in a shoulder surgery. Usually, the shoulder is reset and immobilized until the bones heal.

Shoulder Labral Tear. The labrum is the lining of the shoulder socket. Labral tears are common. There are two types of labral repairs. First, if the labrum is separated from the shoulder socket, it is reattached to the socket with sutures, tacks, or clips. Second, if the labrum is damaged and frayed, the damaged sections are cut away (debrided), and this can be done arthroscopically with minimal invasion.

Rotator Cuff Tear. A rotator cuff (a shoulder tendon) tear is an unfortunate impairment because the success rates of rotator cuff repairs are poor. There are two types of rotator cuff repairs. First, the tendon tears away from the bone where it is attached. The success rate from this surgery is poor because it is difficult to reattach the tendon to the bone. Second, the tendon tears within the span of the tendon from one bone to another (the scapula to the humerus). The success rate is slightly better in this case, but if the tendon tore because of significant wear and tear, the tendon may not be able to be sewn together. Because of the low success rate of both surgeries, it is common that the rotator cuff is not repaired at all, and it is simply left torn.

Frozen shoulder. Frozen shoulder is also called adhesive capsulitis; it is not well understood, and doctors do not understand the cause. Frozen shoulder is generally understood to occur when either scar tissue or the connective tissue of your shoulder joint tightens and causes the shoulder to become immobile. It is more likely to occur after an injury or surgery. Pain and reduced range of motion are the most common symptoms. A frozen shoulder does resolve itself, and the average timeframe is about one to three years. There is a procedure that is sometimes performed called "manipulation under anesthesia" wherein a doctor puts you under anesthesia and then attempts to move your shoulder through ranges of motion in an attempt to loosen the shoulder and improve range of motion.

Shoulder Replacement. This is also called a total shoulder arthroplasty, and it is the surgery of last resort that is performed after years of damage from severe arthritis or degenerative joint disease. The damaged bone and cartilage are removed. Then an artificial ball and socket joint is placed. The ball is attached to the top of the humerus (upper arm bone), and the socket is attached to the glenoid bone or scapula of the shoulder.

Other Important Shoulder Conditions

Medical impairments that are not directly related to the shoulder but can cause shoulder symptoms and limitations include the following:

1. Burns,
2. Complex Regional Pain Syndrome/RSD,
3. Gout,
4. Neuropathy,
5. Osteoarthritis/Degenerative Joint Disease (frozen shoulder syndrome),
6. Psoriatic Arthritis,
7. Rheumatoid Arthritis, and
8. Skin Conditions.

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