Burns and other soft tissue injuries often heal in a relatively short amount of time, but after healing, scar tissue across joints and skin can cause lasting functional limitations in the use of one's hands, arms, or legs. Soft tissue injuries include accidents that damage the skin, muscles, tendons, and/or ligaments; muscle strains and sprains are the most common soft tissue injuries (see our article on whiplash for neck strain issues).
Complications From Burns
There are three degrees of burns depending upon the extent of the burn. Below is an overview of the degree of burns, their symptoms, and possible complications.
- First Degree. These burns are red, swollen, and painful when they are touched. However, they do not blister. Generally do not cause any complications.
- Second Degree. These burns are red, swollen, and painful with blisters present. They can ooze clear fluid. Complications can include the formation of scar tissue that can shrink as it heals, which can restrict movement.
- Third Degree.These
burns are not painful because the nerves underneath the burns are
destroyed. The skin becomes leathery and discolored. Complications can
be extensive with these burns and can include:
- destruction of muscle tissue, which can harm the kidneys as the muscle tissue goes into the blood stream and is filtered by the kidneys
- infection that can spread into the blood stream, and
- thick, crusty skin (eschars) that can become tight and cut off blood supplies to other areas of the body.
Qualifying for Social Security Disability Benefits
To qualify for Social Security disability benefits (both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)), you must show that you meet the requirements of a medical listing from the Social Security “Blue Book” or prove that you are unable to do any work because of the functional limitations caused by your injuries.
Meeting a Listing
Soft tissues injuries and burns have two listings in the Social Security Blue Book. One listing covers injuries and burns that are still undergoing surgeries and other treatment in an attempt to restore function to the injured area, and the other listing is for impairments left from burns after all treatments have be completed.
Injuries or burns that are being treated. To meet the listing for injuries and burns still being treated (Listing 1.08), you must:
- have burns or other soft tissue injuries to your arms, legs, trunk, or face and head
- be undergoing treatment by a surgeon in an effort to restore or save "functional use" of the burned or injured area (including recovering from complications from the treatment, such as surgical complications, infections and illness related to the treatment, and the effects of those treatments on an individual’s ability to achieve the best results possible), and
- not have functional use of the burned or injured area restored, and functional use is not expected to be restored within 12 months of the initial burns or injuries.
"Functional use" of your arms and legs include the ability to walk and use your arms to complete tasks. Functional use of your trunk includes the ability to bend and twist to complete everyday tasks. Functional use of the face and head can include vision, hearing, speech, chewing, and swallowing.
Burns that are no longer being treated. For burns that are no longer being surgically treated, Social Security will generally evaluate the impairment under the body system that is affected. For example, if your vision has been affected by burns, you will be evaluated under the vision loss listing. If your lung function has been affected, you will be evaluated under the listings for respiratory disorders.
However, if it is only your skin that is affected, and you have multiple skin lesions that seriously impact your ability to function, you can be evaluated under the burn listing.
To meet the listing for burns no longer under ongoing surgical treatment (Listing 8.08), you must:
- have burns
- with extensive skin lesions
- that have lasted or are expected to last for at least 12 months.
Skin lesions are considered extensive when they are present in different parts of the body or in critical body areas that has led to very serious functional limitations. An example of such skin lesions includes burns on the soles of both of your feet or palms of your hands that seriously limit walking or completing tasks using your hands, or burns on both arms near the joints that seriously limit the use of your arms.
Medical Evidence Required to Meet a Listing
In evaluating burns and soft tissue injuries, Social Security understands that they often improve over time. Therefore, an ongoing record of treatment and changes in functioning should be provided. With regards to functional limitations, physical examinations and medical imaging should be provided when possible to support self-reported limitations.
For burns and injuries that are receiving ongoing surgical treatments, you should provide all medical records from each surgery and note any side effects of surgery.
To prove severity of skin lesions, you should provide evidence that shows the extent of your skin lesions, how often they flare up, how symptoms caused by the lesions (such as pain) limit your functioning, and the treatments you've received, including any side effects from those treatments.
Functional Limitations That Restrict Work
If you don't meet or equal a listing, you may qualify for benefits if your functional limitations prevent you from doing any work. Social Security will assess your functional abilities using a Residual Functional Capacity (RFC) form, which looks at physical, mental, and sensory limitations.
For those with burns and severe soft tissue injuries, physical limitations, such as problems with lifting, pulling, pushing, or carrying items, and with walking, standing, and sitting can be significant. If the injury is severe enough to cause scarring that tightens, it could limit individual’s ability to make certain movements; individuals with extensive burns often have decreased ranges of joint motion. In addition, burn victims whose muscles and tendons were damaged under burned skin may have decreased strength in those areas.
Social Security also assesses sensory limitations that affect the ability to adapt to one's surroundings. For those with burns or injuries to the face and head, injuries to hearing, seeing, or sense of touch could impair their ability to adapt to different living situations. The risk of infection can also limit the type of work place in which an individual can be employed.
More severe complications could force an individual to be hospitalized and not be able to even attempt to do other work. Frequent hospitalizations will be considered in assessing whether or not you can work. For more information, see our article on not being able to have regular attendance at a full-time job.
To learn more about the RFC assessment and how your functional limitations affect Social Security's disability determination, see our series of articles on how Social Security decides if you can do any work.