Do Broken Bones Qualify for Social Security Disability?

Broken bones (or "fractures") can occur in any bone in your body. How the broken bone impairs your ability to function will depend on two things:

• the severity of the break, and
• which bone is broken.

While most fractures heal without permanent injury, complications can occur with broken bones that sometimes lead to disability. In particular, broken ankles and legs that don't heal well can affect your ability to walk and stand for long periods. But broken bones qualify for Social Security disability benefits only if the complications from the fractures affect your ability to work long-term—that is, for a year or more.

This article will examine the complications from bone fractures that might qualify you for disability benefits and when the Social Security Administration (SSA) will pay you disability benefits for broken bones.

Potentially Disabling Complications From Bone Fractures

Although most broken bones heal within a few months, sometimes the bones don't heal properly. Fractures can also cause other complications that can lead to long-term impairments. Some of these complications occur at the time of injury, while others show up days, or even months, later.

Immediate Complications From Bone Fractures

Breaking a bone is trauma to your body, and when a bone breaks, it can cause immediate complications that can be very serious, and sometimes disabling. Some possible immediate complications of bone fracture include the following:

• injuries to soft tissue like:
• muscles and joints
• tendons and ligaments, and
• major blood vessels, and
• trauma and damage to organs like your:
• heart
• kidneys
• liver, or
• brain.

If you suffer broken bones in a serious accident and lose a lot of blood, you could develop hypovolaemic shock (also called hemorrhagic shock), which can cause major organs to stop working. That can sometimes lead to long-term impairments.

Early Complications—a Few Days After a Bone Fracture

Some complications won't surface until a few days or weeks after you break a bone. Some of these complications can be dangerous and even life-threatening, such as:

• infection (most common in open fractures and those requiring surgery to repair)
• compartment syndrome (internal swelling that causes compression of nerves, blood vessels, and muscles)
• embolism (blood clot), including a pulmonary embolism which can result from leg, hip, and pelvic fractures, and
• adult respiratory distress syndrome (which causes fluid to build up in the lungs).

Delayed Bone Fracture Complications

Broken bones can sometimes lead to late or delayed complications. These are medical issues that don't occur until weeks or months after the fracture. Some of these complications can sometimes be debilitating, such as:

• improper healing, including the bone not rejoining, or healing in a deformed way
• shortening of the bone
• bone infection
• bone death due to lack of oxygen
• myositis ossificans (bone growth within the muscle, causing pain)
• Volkmann's contracture (permanent tightening of the hand at the wrist—making your hand look like a claw and severely restricting the use of your fingers), or
• complex regional pain syndrome (CRPS) (formerly called Sudeck's dystrophy), which can cause:
  • muscle wasting (atrophy)
  • stiffness, and
  • chronic pain.

Qualifying for Social Security Disability Benefits for Bone Fractures

Whether you're applying for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI), to get disability benefits, you must qualify medically and non-medically. There are two ways to qualify medically for Social Security disability benefits or SSI. You can either:

• prove that you meet (or "equal") the requirements of a disability listing in Social Security "Blue Book," which contains a list of impairments that are predetermined to be disabling, based on their severity, or
• show that your condition makes you unable to work (if you don't meet or equal a listing).

Whether your condition meets a listing or you plan to show your condition keeps you from working, you'll need to back up your claim with solid medical evidence. (Learn more about the medical evidence you'll need to win a Social Security disability claim.)

Meeting a Disability Listing for Bone Fractures

There are two listings in the Blue Book that cover broken bones. Specifically, there's one listing that covers certain bones in the pelvis, leg, and foot, and another listing that covers broken bones in your arms. (Social Security assesses back injuries and head injuries—including impairments caused by spine or skull fractures—under the listings for neurological disorders.)

To meet one of the listings for bone fractures of the legs, feet, or arms, your doctor's treatment notes should include an explanation of your limitations (lack of functional abilities), which should be supported by medical evidence, such as X-rays or MRIs. Physical therapy reports that show real functional limitations can also bolster your claim.

Listing for a Non-Healing Broken Leg, Ankle, or Foot

The bones in your lower extremities are all important for mobility and bone fractures that have a long-term impact on your ability to walk can sometimes meet the listing.

The lower extremity fractures covered in listing 1.22 include breaks in any of the following bones:

• femur (thigh bone)
• tibia (the large shin bone)
• pelvis, or
• one or more talocrural (ankle) or tarsal (foot) bones, including the calcaneus bone in the heel.

To meet the requirements of the listing, you'll need:

• an X-ray or other imaging showing there isn't a solid union of the bone
• a physical exam in which the doctor can feel or tell by movement that the bones haven't reunited, and
• a documented need for a walker, two canes, or two crutches to walk.

To approve you for disability, Social Security generally requires that your broken leg or foot hasn't healed for at least six months and that you have a doctor's opinion (backed up by evidence) that says it's unlikely to heal for a total of at least 12 months. But Social Security typically only grants disability to applicants with fractures when it's been over a year and the disability applicant still has trouble walking.

Listing for a Non-Healing Broken Arm

Bone fractures in your upper extremities (arms) are covered in listing 1.23. The listing requires that:

• You're still under a surgeon's care for a break in your upper arm bone (humerus) or a bone in your forearm (radius or ulna), and
• You're unable to begin, sustain, and complete work-related activities that require "fine or gross" movements of your arms or hands.

You also must have one of the following:

• an X-ray or other imaging that shows the fracture hasn't healed properly (there isn't a solid union of the bone), or
• a complex fracture with one or more of the following:
• bone fragments
• more than one break in a single bone
• bone loss due to severe trauma
• damage to the surrounding soft tissue, or
• severe cartilage damage to or dislocation of the associated joint.

Note that you can only meet the requirements of the listing for a non-healing broken arm bone if you're awaiting additional surgery or medical treatment that's expected to improve function in your arms. If your doctors are done treating your fractures and you still have problems using your arms and hands, you won't meet the listing, but you can try to prove you can no longer work any job (see below).

Proving You Can No Longer Work After a Bone Fracture

If your bone fractures don't meet or equal a listing, you could still be eligible for disability benefits if you're unable to do any job. Here's what will happen next.

Social Security Assesses Your Limitations

If you had a complex or non-healing bone fracture, you might have any of the following:

• limited ability to use the injured limb due to nerve or muscle damage
• bone death or contracture of the muscles due to the break that caused you to lose the use of that limb, or
• a fracture inside or around a joint space (called an "articular or periarticular fracture") that's caused arthritis, making it difficult to use the joint.

In evaluating whether your lasting complications make you unable to do any work, Social Security will use a Residual Functional Capacity (RFC) form, which assesses your physical and mental limitations.

For example, if you broke bones in your arm, your RFC will detail how your condition has affected your ability to do things like:

• lift
• push
• pull, and
• reach overhead.

Similarly, if you fractured leg bones, your RFC will include the difficulty you now have with things like:

• standing
• sitting and standing up from a seated position, or
• walking for certain periods of time.

Social Security Considers Any Mental Impairments

If you're filing a Social Security disability claim after bone fractures, you'll likely apply based on your physical difficulties. But your mental abilities might be affected as well—especially if you're experiencing significant, ongoing pain.

Living with constant pain can affect your ability to work. It can be distracting and make it difficult to stay focused on tasks. And if the pain interrupts your sleep, your concentration might be further limited due to fatigue. Additionally, round-the-clock pain can make it hard for you to deal with stressful situations or conflicts with co-workers.

If you claim that pain or fatigue affects your ability to work, or this is mentioned in your medical records, Social Security will use a mental RFC form to assess your ability to function in the following areas:

• completing work tasks
• handling work stress, and
• interacting with coworkers and supervisors.

For Social Security to properly weigh the effects of the pain on your overall impairments, you must provide medical documentation that proves the possible sources of the pain. (For more information, read our article on how Social Security evaluates chronic pain.)

Social Security Asks if Your Bone Fracture Keeps You From Working

After Social Security assesses all the above limitations, the agency will consider whether your limitations keep you from doing your prior work. If they do, the agency must then decide whether there's other, less demanding work that you could adjust to, considering your:

• physical and mental limitations
• age
• education and training, and
• work experience (job skills).

Social Security follows specific guidelines in deciding whether your RFC allows you to do your prior jobs or any other jobs. Learn more about how Social Security decides whether or not you can work.

_{Updated July 13, 2023}