Getting Social Disability Benefits for Dupuytren's Contracture
When advanced Dupuytren’s contracture makes it impossible to use your hands, disability benefits are possible.
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Dupuytren’s contracture is a condition that causes deformities of the hand, most often in the middle finger, ring finger, and pinky. Dupuytren’s (also called palmar fibromatosis) causes the layer of tissue that lies under the skin of the palm to thicken and knot, which pulls the fingers inward and can prevent them from opening. The condition can occur in one or both hands.
Some symptoms can be treated using enzyme injections and a procedure called “needling” that can help break apart the tissue. In more severe cases, surgery may be necessary, but recovery is difficult and may require long periods of physical therapy. None of these treatments, however, can cure the condition.
Can I Get Disability for My Dupuytren’s Contracture?
To be eligible for disability, you must meet several basic requirements first: you cannot be working a substantial amount. Social Security has a threshold called the substantial gainful activity level (called SGA—for 2014, this amount is $1,070); you can't make above this amount and collect disability benefits. Equally as important, your condition must be expected to prevent you from working at the SGA level for at least 12 consecutive months.
If you meet these basic requirements, the Social Security Administration (SSA) must next determine whether your condition meets the requirements of one of the conditions in its Listing of Impairments. If it does, you will be approved for benefits automatically. Unfortunately, Dupuytren’s is not a listed condition. This means that you will have to prove your condition prevents you from not only doing your old job, but that it stops you from doing any other job in the U.S.
Getting Disability Without Meeting a Listing
To decide if you can work at any job, the SSA must first determine your residual functional capacity (RFC). Your RFC is the type of work you can do on a regular and sustained basis. The SSA will prepare a detailed RFC report that uses your medical records to assess how your condition affects your ability to do certain physical work-related activities such as walking, sitting, pushing, and pulling. Based on your functioning in these areas, the SSA will give you an RFC level for sedentary, light, medium, or heavy work.
Unfortunately, because Dupuytren’s contracture doesn’t affect a person’s strength, the SSA will probably conclude that you still have the RFC to do a sedentary job. This means that, on the basis of your RFC alone, you could be denied benefits and have to appeal. However, depending on the severity of your condition, there are techniques you may be able to use to help win your claim. These are discussed in more detail below.
A non-exertional impairment is one that affects your ability to perform certain non-strength related activities. Difficulty with manipulative (hand and finger) or postural (body positions) requirements such as reaching, handling, stooping, climbing, crawling, or crouching is one example of a non-exertional impairment.
If you cannot be treated effectively for Duyputren’s contracture, your ability to use your hands may be affected to the point that you can no longer use them to perform certain hand-related tasks. This could count as a severe non-exertional impairment.
While the SSA might agree this non-exertional limitation prevents you from doing your old job, you still have to prove you can’t do any other work either in order to win your claim. And the SSA will bring up many examples of jobs that don't require fine digital manipulation of both hands that it will say you can do.
Here are some examples.
- The claimant filed for disability due to Duyputren’s contracture in his dominant hand. Despite surgery, the claimant’s ring and pinky fingers remained curled to his palm. His past job had been as an auto mechanic, but the condition prevented him from doing his job because he could no longer move his hands into tight areas or grasp tools. Despite this, the SSA determined that there were other sedentary jobs he could do, such as working as a security guard. The claimant was denied benefits.
- The claimant filed for disability because of severe Duyputren’s contracture in both hands. His condition could not be treated and, as a result, the middle, ring, and pinky fingers of both hands curled tightly into his palm. His past work had been in construction, which the SSA determined he could no longer do. The SSA did decide, however, that he had the RFC to do at least light work. However, because he could no longer use his hands to effectively grasp, turn, or otherwise manipulate any large or small objects, his attorney was able to effectively argue that the extent of these non-exertional impairments prevented him from doing not only his old job, but any other work.
For more information, see our article article on how non-exertional limitations affect the disability decision.
It can be much easier for an older claimant to win disability, even if the SSA decides he or she can still do a sedentary job. This is because the SSA must use a series of tables called “the grids” that don't allow the SSA to take into account whether there are a few types of atypical jobs the claimant could still do.
The grids take into consideration a claimant’s age, education, RFC, and the skill level of his or her job to direct a finding of disabled or not disabled. Here is an example.
- The claimant, a 57-year-old man, filed for disability due to Duyputren’s contracture in both hands. He had a high school education. His condition was untreatable and caused the middle, ring, and pinky fingers to curl into the palm on both hands. The man's past work had been as a steel worker, which he clearly could no longer do because of his inability to grasp and hold his work materials. The SSA determined that he still had the RFC to do light work and that although his past job was skilled, he could not transfer any of these skills to another job. Under the grid rules for his age, high school education, RFC level, and the fact that his skills could not be transferred to another job, the man was given a finding of disabled.
For a detailed discussion of the grids, see our article on how the grids can be used to win your disability claim.
Combination of Impairments
Many people who suffer from Dupuytren’s contracture also suffer from other contracture disorders elsewhere in their body, particularly in the feet. If you suffer from contractures in multiple locations, the SSA will consider the combined effect of these conditions. Here is an example.
- The claimant suffered from severe Dupuytren’s in his dominant hand that could not be effectively treated. He also experienced symptoms to a lesser degree in his non-dominant hand. The claimant also developed contracture in his feet that affected his balance, which impacted his ability to bend and stoop. His past work had been as a carpenter, which the SSA concluded he could no longer do. Although the SSA determined he had the RFC to do a sit-down job, the claimant’s attorney was able to prove that because of the combined effect of his contractures, there were no jobs that he was able to do, and the claimant was approved.
For more information, see our article on how you can win your claim using a combination of impairments.
Contact an Attorney
Depending on the severity of your condition, your age, and whether you have other impairments, you may be able to win a claim for disability based on your Dupuytren’s. However, if Dupuytren’s is your only disabling condition and your case is denied, the techniques needed to win on appeal can be complicated. Consider contacting an experienced disability attorney to discuss your case. To find an attorney in your area, use our attorney locator to set up a consultation with a local disability attorney.