You might think that an amputation would guarantee you disability benefits, but it's not so. Only certain types of amputations qualify for disability benefits.
Qualifying for Disability for Amputation
You can be found disabled automatically if your amputation meets specific criteria set forth in Social Security's official listing for amputations. Social Security does not take into account how you lost a limb -- whether through an accident or diabetes -- as long as you meet one of the criteria below:
- Amputation of both hands
- Amputation of one or both legs at or above the ankle. You also must not be able to walk effectively. “Ineffective walking” generally means that you have stump complications that don't allow you to use prosthetic a device effectively and/or you need to use both your hands to handle a walker, two canes or crutches, or a wheelchair.
- Amputation of one hand and one leg at or above the ankle. You also must not be able to walk effectively.
- Amputation of one leg up to the hip (hip disarticulation), or
- Pelvic amputation (hemipelvectomy).
Other Amputations That Cause Problems Working
There are obviously many amputations that do not fit the criteria listed above. If you have an amputation that prevents you from working, such as an amputation of your dominant hand, you may still be eligible for disability benefits, even if your amputation does not exactly fit the criteria above.
If your work-related activities are limited because of your amputation, Social Security will assess your “residual functional capacity,” or “RFC.” Social Security will look at whether or not you can walk effectively on an artificial leg and whether you are capable of sedentary activities. If you have lower limb amputation, you may also be restricted in what kinds of surfaces you can safely walk on, as well as have restrictions around crawling, kneeling, climbing, bending at the knees, and activities that require good balance. For upper limb amputations, Social Security will look at your ability to grasp things, fine motor movements, typing and writing abilities, and your ability to lift objects.
Your RFC assessment is then used by Social Security to determine what kind of work you are still capable of doing despite the limitations from your amputation. If Social Security finds that you are capable of performing any job you used to have, or any other job, the SSA can deny your claim. But if Social Security determines that the symptoms associated with your amputation are so limiting that there is no job you can perform, you will be awarded benefits under what is called a “medical-vocational allowance.” Learn more about the RFC and medical-vocational allowances.
Presumptive Disability with Certain Amputations (SSI only)
The Social Security Administration (SSA) administers two different programs that provide payments to disabled individuals: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Through SSI, people who are disabled and have very little or no income and resources receive monthly disability payments so they are able to obtain necessities.
If you are applying for SSI and you have two limbs amputated or one leg amputated at the hip, you will be granted presumptive disability right when you apply at the Social Security office. The SSA field representative can approve you for six months worth of presumptive disability checks based on his or her observation that you are either missing two limbs or a leg from the hip down.
However, even if you qualify for presumptive disability, you still will have to be found eligible to continue receiving SSI according to the eligibility rules above. Fortunately, if you are granted presumptive disability but then are found ineligible for SSI, you will not have to repay the presumptive disability payments. Learn more about presumptive disability benefits.