Does Hip Replacement Qualify for Disability?

Hip replacements are some of the most common surgeries in the United States, with doctors performing more than 450,000 each year. Many hip replacements are scheduled to correct a defect called hip dysplasia, which happens when the bones in your hip joint don’t fit together properly. The vast majority of hip replacements are safe, effective, and can help relieve pain that interferes with your daily routine.

As with any operation, hip replacement surgery has risks as well as benefits. You can expect some limitations while you recover from your surgery. But if these limitations last for more than 12 months and keep you from working full-time, you may qualify for Social Security disability benefits. Knowing what evidence you need in order to be considered disabled can help make the application process go smoothly and increase the chances that your claim will be approved.

When Does a Hip Replacement Count as a Disability?

The Social Security Administration (SSA) awards disability benefits to people who have a medically determinable impairment that prevents them from earning income at the level of substantial gainful activity for at least one year. So if you’re able to return to work full-time within one year of your hip replacement surgery, you won’t qualify for benefits—although you may be eligible for private short-term or long-term disability insurance payments during that time period.

Because many people who undergo hip replacements are able to go back to work relatively soon after the operation, it’s very important that you establish a 12-month period during which you were being treated for hip pain or undergoing postoperative rehabilitation. Here’s how you can make sure your medical records reflect the full duration of your impairment.

Pre-Operative Records

Before you undergo hip surgery, you’re expected to have seen your doctor for tests, imaging, and medication in order to diagnose and treat your pain. The SSA will consider clinical notes from your doctor’s visits, X-rays and MRIs that show evidence of hip dysfunction, and prescribed pain relievers (such as steroid injections) when determining whether symptoms from your impairment have lasted for 12 months or more.

Operative Records

Many people who've undergone hip replacement surgery are able to walk out of the hospital on the same day. If you have another medical condition that needs monitoring, you might need to stay in the hospital overnight. Some people with more complex surgeries, such as bilateral hip replacement (both hips), benefit from starting their recovery in an inpatient unit, which requires a longer stay at the hospital.

In addition to your original hip replacement, the SSA can consider scheduled future surgery as evidence that you won’t be fully recovered until after 12 months have passed (for example, if your doctor says you need revision surgery eight months after your initial operation). The agency will want to see admission and discharge documents from the hospital where you had your surgeries.

Post-Operative Records

After the operation, the first step in recovery is getting the surgical wound to heal properly. The small incisions made for hip surgery typically heal in about six weeks. But even if you've closely complied with your doctor’s instructions, there is a chance the wound could become infected. Depending on the severity of the infection, this could add weeks or months to your recovery.

The second step is usually physical therapy. This stage of rehabilitation involves getting used to regular movements and practicing basic daily activities such as getting out of bed or a chair. Then, you will gradually progress to more difficult tasks, such as climbing stairs or walking longer distances. Generally, you can expect to feel mostly back to normal within three months, but a full recovery can take up to a year. The SSA will take time spent on wound care and physical therapy into consideration for the 12 month requirement.

What If I Still Have Hip Replacement Symptoms After a Year?

This one year “durational requirement” is only one step in Social Security’s sequential evaluation process, however. In order to qualify for benefits, you’ll need to show that any residual limitations from the hip replacement surgery either meet the requirements of a listed impairment or eliminate your ability to do any kind of job on a regular basis.

Qualifying Under the Medical Listing for Surgery of a Major Joint

Listed impairments are conditions that can automatically qualify you for disability benefits provided certain evidentiary requirements are met. Social Security can evaluate hip replacements under listing 1.17, Reconstructive surgery of a major weight-bearing joint. In order to be found disabled under this listing, you must have evidence of the following:

• documentation that you had surgery or surgeries on your hip
• evidence, such as doctors’ notes and tests, that you have difficulty moving as a result of your hip surgery, and
• proof that you need to use help to walk, such as a walker, crutches, two canes, or a wheelchair.

The criteria listed above must be present at the same time or within a "close proximity of time," typically meaning 4 months (12 months during the “pandemic period” beginning April 2, 2021 and ending on May 11, 2025, or the "post-pandemic period" beginning May 12, 2025 and ending on May 11, 2029). The last requirement is perhaps the most difficult. If you've experienced complications from your hip replacement but don't require the use of a walker or two canes, or another assistive device, the SSA probably won't find that you meet listing 1.17. But you can still get benefits if you can show that your residual limitations are serious enough that they prevent you from working.

Qualifying With a Reduced Residual Functional Capacity

Social Security doesn’t expect that everybody who has hip replacement surgery will either be able to return to work or have complications so severe that they can no longer walk. The majority of disability applicants who’ve had hip replacement complications fall somewhere in between. In these cases, the agency must determine what they’re still able to do in a work environment, a process called “assessing your residual functional capacity (RFC).

Your RFC is a description of what physical and mental activities you can still perform despite your limitations. For example, your RFC might say that you can lift 20 pounds frequently but that you can't stand for more than two hours a day. Social Security compares the restrictions in your current RFC with the duties of your past jobs to see whether you could do them today. If not, the agency will need to see whether other work exists that you could perform. If you’re younger than 50, that typically means that you’ll need to show that you can’t do any sedentary (sit-down) jobs.

But because most people who have hip replacement surgery are over the age of 50, they may have an easier time qualifying under the medical-vocational grid rules. The grid rules use factors such as your age, education, and training to determine whether you could make the switch to a less physically demanding job before you hit retirement age. So if you were working as, say, a plumber before your hip replacement and you can’t return to that job because the bending would be too difficult, the SSA can find you disabled even if they think that you would be capable of working a desk job. The same isn't true for a 30- or 40-year-old.

What Kinds of Hip Surgery Complications Are Disabling?

While the majority of hip replacements go smoothly, several issues can significantly delay your rehabilitation timeline. Complications may involve infections at the surgical site, improper placement of the artificial hip, or defects in the prosthetic device. Each complication can lengthen your recovery period, keeping you from working.

Infections

Infections occur infrequently, but they can develop after your hospital stay has ended, or sometimes even many months after surgery. Signs and symptoms of an infected joint replacement include:

• increased pain or stiffness
• swelling or warmth and redness around the wound
• wound drainage
• fevers, chills, and night sweats, and
• fatigue.

Our immune systems usually take care of the bacteria that make it into our bloodstream, but, because joint replacements are made of metal and plastic, it's difficult for the immune system (or antibiotics) to get rid of bacteria that may have settled there. Some patients with infected joint replacements need additional surgery to cure the infection, which further prolongs their recovery.

Improper Placement or Defect in the Artificial Hip

Some patients may need follow-up operations called “revision surgeries” because their prosthesis (artificial hip) was improperly placed or defective. When improperly placed, pain can result from the hardware used in the implant or from bone loss around the implant. Other times the implant loosens on its own due to normal wear and tear, obesity, or excessive strain on the joint.

If the prosthesis itself was defective or turns out to be the wrong size, the surgeon might need to replace it. Likewise, if you’re injured from a fall or accident soon after the hip replacement, the prosthesis may need to be replaced with a new one. Signs that you might need the artificial hip replaced include:

• pain in the hip, groin, or thigh
• limited mobility
• trouble walking, or
• a feeling of looseness or “give” in the hip.

Revision surgeries to correct a “failed” hip replacement can be more difficult than the initial operation, which will lengthen your recovery time.

Keep in mind that the ultimate goal of recovery after surgery is to get you to what doctors refer to as “maximum medical improvement,” or "MMI." MMI doesn't necessarily mean that you'll be 100% good-as-new—it just means that your doctors don't think any further physical therapy, procedures, or time will benefit you. At this stage, any limitations you have are likely to be permanent (and more likely to be found disabling). Here are some examples:

Note that recovery from hip arthroscopy, which is a much less invasive surgery used for hip labrum tears and femoroacetabular impingement, is less likely to drag on. Initial recovery usually takes two to three months, but the chances of complications are much lower than for hip replacement surgery.

Getting a VA Disability Rating for Hip Pain

Veterans who have service-connected hip pain may qualify for a VA disability rating. Using the VA Schedule for Rating Disabilities (38 C.F.R. §4), hip replacement is evaluated under diagnostic code 5054 for a certain time period, generally four months, after surgery, with residual limitations being evaluated according to the degree to which your hip and thigh movement is restricted. These ratings can range from 10% for relatively minor restrictions to 90% if you have a severe malformation where your foot doesn’t reach the ground. For more information, see our article on how VA disability ratings work.

Applying for Disability Benefits

Applying for Social Security benefits is a fairly straightforward process. You have several methods to choose from:

• File online using the agency’s SSDI application portal (or SSI portal, for certain eligible claimants).
• Call the Social Security national hotline at 800-772-1213 (TTY 800-325-0778 for the hearing impaired) between 8 a.m. and 7 p.m., Monday through Friday.
• Go to your local Social Security office and speak with a representative in person.

The VA application process works much in the same way. You can read our article on filing for veterans disability benefits for more information on how to submit your claim for VA compensation.

What If I Don’t Qualify for Benefits?

It’s not uncommon for people with hip replacements to have their disability applications denied on their first try. Because the surgery has such a high success rate, the SSA can be skeptical that you won’t be able to make a full recovery and return to work, at least on initial review. Fortunately, if your application is denied, you have 60 days to appeal the decision.

Not everybody who gets a denial wants to appeal, however. If you’re thinking about trying to return to work, the Americans with Disabilities Act (ADA) requires employers to provide reasonable accommodations to help you perform your job. (42 U.S.C. §12112(a)(5))(2026). These accommodations may include adjustments to your work setting or schedule, such as ergonomic desks and chairs, mobility aids, accessible parking, or additional time off.

Keep in mind that you aren’t obligated to have a lawyer to appeal a denial or ask for accommodations. But you may want to seek legal counsel if your employer denied your request for reasonable accommodations or you need to schedule a hearing with an administrative law judge. An employment discrimination attorney can make sure that your ADA rights are respected, while an experienced disability lawyer can represent you at your disability hearing. Many attorneys offer free consultations, so there’s little risk in seeking help.