Clubfoot is a fairly common birth defect in which the foot is twisted in and down. In about half of people with club foot, both feet are affected. Although club foot can be treated with stretching exercises, casts, braces, or surgery, there is no cure. Club foot sufferers may experience limited motion and pain years after "successful" treatment. If left untreated, the condition can worsen. In severe cases, a club foot sufferer may become significantly disabled.
If you find it difficult to work because of your club foot, you may be eligible for disability benefits under the Social Security program. This article explains how Social Security evaluates club foot, to help you determine whether you might qualify.
Qualifying for Benefits Under a Disability Listing
Severe club foot will qualify you to receive disability benefits if you meet the requirements in Social Security’s disability listing for major dysfunction of a joint. To qualify, you must have all of the following:
- Ongoing pain and stiffness in the ankle(s)
- Limited or abnormal motion in the ankle(s)
- X-rays of the ankle(s) showing joint space narrowing, bony destruction, or ankylosis, and
- Inability to walk effectively
When evaluating whether you are able to walk effectively, Social Security looks to see whether you are able to walk well enough to carry out the normal activities of daily life. Some examples of ways that you could show that you are unable to walk effectively include:
- You need a walker, two crutches, or two canes (one cane or crutch is generally not enough).
- You can't walk on rough or uneven surfaces at a reasonable pace.
- You can't use standard public transportation.
- You can't shop or run other errands without someone’s help.
- You can't climb a few steps at a reasonable pace with the use of a single hand rail.
Qualifying through an RFC Assessment
If you cannot meet the requirements of the joint dysfunction disability listing, do not give up. People with club foot have successfully apply for Social Security benefits without meeting the strict listed requirement of not being able to walk effectively. Instead, they are able to prove that their condition is so severe that it prevents them from working full-time.
What is Residual Functional Capacity?
Social Security will assess your physical and mental limitations to come up with your "residual functional capacity,” or “RFC.” The RFC assessment will indicate whether your disability limits you to sedentary work, light work, or medium work as well as what other limitations you have or accommodations you need.
The RFC of a person with severe club foot will be most affected by difficulties with standing and walking. If you are unable to stand or walk for more than two hours in an eight-hour day, you will be limited to sedentary work. But you should also consider how sitting affects your condition. In some cases, club foot suffers may be unable to sit without elevating their foot or feet, or may find that sitting for long periods causes numbness. If this is true in your case, your RFC should include a restriction to jobs in which you can stand or sit at will, and/or elevate your foot or feet. This rules out some types of jobs and means that you can't do the "full range" of sedentary work.
Pain from Clubfoot
Less obvious but no less importantly, your RFC should reflect any chronic pain that you experience. Social Security will first look to see whether your pain can be controlled by medications or other means. But if your chronic pain cannot be adequately controlled, it may cause significant limitations on your ability to work. For example, chronic, uncontrolled pain may make it difficult or impossible for you to concentrate, to learn and retain new information, or to get along with supervisors and coworkers.
Club foot may also cause related problems that should be considered in your RFC. For example, club foot sufferers may develop arthritis, secondary deformities in the foot or feet, sores or calluses on the foot or feet, or collapsed arches. If these conditions cause you pain or limit your mobility, they should be included in the RFC evaluation.
Social Security will also consider how your condition has affected your mental health (as long as you allege depression, anxiety, or the like in your disability application). Many people with limited mobility or chronic pain may become depressed. (Read more about how depression affects your eligibility for disability benefits.)
The Medical-Vocational Analysis
After completing your RFC, Social Security will determine if your RFC level and limitations allow you to do your past work. If not, Social Security will perform a "medical-vocational analysis," taking into account your age, education, and work experience (called vocational factors), to determine whether there are any less demanding jobs you can do, or can easily learn to do. Age is very important in this analysis. For instance, if you are over 50 and limited to sedentary work, you won't be expected to find other work unless you have job skills that could easily transfer to a sedentary job, or an education that trained you for a sedentary job. (In other words, Social Security will find that you can't be trained to do sedentary work because of your age and education, and will find you disabled).
In contrast, if you are under 50 and limited to sedentary work, you'll be expected to learn a new type of work, even if you have little education and no job skills. And Social Security will no doubt say there are plenty of sit-down jobs you can do, unless you can prove that your limitations rule out many types of sedentary work. To do this, you must try to prove that you don't have the mental capacity for sedentary work or that you have physical limitations, such as the inability to sit for six hours a day or the need to keep your leg elevated, that don't allow you to do most types of sedentary work.
For more information, see our article on proving you can't do sedentary work and how Social Security uses your RFC to determine disability.