Hip Replacement Surgery Complications: Can I Get Disability Benefits?

Hip replacements are one of the most common surgeries in the United States. Every year, doctors perform more than 450,000 total hip replacements. The vast majority are safe and effective and can help relieve arthritic pain that limits your activities or prevent you from working.

But 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 have caused you to stop working during that time, you may qualify for disability benefits from the Social Security Administration.

Recovering After Hip Replacement Surgery

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.

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 in recovery is "postoperative" 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. Broadly speaking, in terms of an overall recovery, you can expect to feel mostly back to normal within three months, but a full recovery can take up to a year.

Symptoms of a Failed Hip Replacement

While the majority of hip replacements go smoothly, several issues can significantly delay your rehabilitation timeline. How long the pain lasts after surgery, and how long your recovery will be, depends on whether you get an infection or have a fall after the operation and whether there's a problem with your artificial hip or its placement.

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 adds more time to their recovery period.

Improper Placement of or Defect in the Artificial Hip

Some patients may need follow-up surgeries (called revision surgeries) because their artificial hip was improperly placed or the hip itself was defective. Revision surgeries can be more difficult than initial hip operations.

Sometimes a surgeon improperly places the artificial hip. In this instance, 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, either because of wear and tear, excessive weight, or overloading the joint.

If the prosthesis (the artificial hip) itself was defective, or it turns out to be the wrong size, the surgeon might need to replace it.

Similarly, if you are 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.

Often, a failed hip operation will require a surgical "revision" to repair the incorrect placement, the defective prosthesis, or damage to the prosthesis, which will lengthen the time you need for recovery.

When You Know If Your Hip Surgery Was a Failure

Ultimately, the goal of recovery after hip replacement surgery is to get you to what doctors refer to as "maximum medical improvement," or "MMI." Maximal medical improvement doesn't necessarily mean that you'll necessarily be 100% good-as-new; it just means that the medical professionals don't think any further physical therapy, procedures, or time will benefit you. If you're still experiencing pain when you reach the stage of maximum medical improvement, the focus of your treatment may switch to medication management alone.

If, after a year, any of the following is still true, you might be disabled under the Social Security Administration's guidelines:

• the pain continues to persist
• you're still limited in your daily activities, or
• you're unable to return to work despite reaching maximum medical improvement.

When Your Hip Replacement Complications Last Longer Than 12 Months

Unlike many private insurance providers, Social Security doesn't award benefits for short-term or temporary disability. In order to qualify for disability benefits, you must show that you've been unable to work due to the complications from your hip replacement for at least 12 months.

It's important to establish the 12-month period during which your hip pain prevented you from working. This period can include the time prior to your hip replacement surgery when you were unable to work due to hip pain.

Sometimes Social Security will approve you for benefits even if you haven't been off work for 12 months. For instance, if your doctor says you need revision surgery eight months after your initial surgery, it's likely you won't be fully recovered until after the one-year mark.

Note that recovery from hip arthroscopy, which is a much less invasive surgery used for hip labrum tears and femoroacetabular impingement (FAI), 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. If you do have symptoms of failed hip arthroscopy, however, such as reduced range of motion and pain or stiffness, Social Security would assess your condition similarly to hip replacement complications (below).

Qualifying for Disability Benefits for Hip Replacement Complications

In deciding your claim, Social Security can find you disabled "medically" or "vocationally." Social Security will find you are disabled "medically" when your medical records contain information, such as documented symptoms or test results, that the Administration has already determined is enough to find you disabled under its listings of disorders.

Qualifying Under the Medical Listing for Surgery of a Major Joint

Social Security provides a specific listing under which hip replacement complications can be evaluated. (If you haven't had surgery, you might be able to get benefits under the listing for degenerative hip joints.) The hip is defined as a "major joint" by Social Security, and so it can be evaluated under listing 1.17, for reconstructive surgery of a major weight-bearing joint. To be found disabled under this listing, you must provide Social Security with evidence of the following:

• documentation that you had surgery or surgeries on your hip
• evidence, such as doctor's 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.

You must be able to show how you meet each of these requirements in order to be found medically disabled. 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, Social Security probably won't find you disabled medically. You may still be found disabled "vocationally," however, if you can show that your symptoms are serious enough that they prevent you from working.

Qualifying Under the Medical-Vocational Guidelines for Hip Complications

Social Security doesn't expect that everybody who undergoes hip replacement surgery will be able to return to work, nor do they expect that everybody with a hip replacement will have complications so severe that they can no longer walk. The majority of disability applicants with hip replacement complications will fall somewhere in between. The process that Social Security uses to determine what you can and cannot do in a work setting is called "assessing your residual functional capacity."

Your residual functional capacity, or RFC, is what you can do physically 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. To see what jobs you can do, Social Security compares your RFC to job requirements.

Because most people who have hip replacement surgery are over the age of 50, Social Security will be particularly interested in whether your RFC prevents you from returning to any of the jobs that you've performed in the past. If you can't, you have a pretty good chance of being found disabled. Here's why. If you can't do your past job, Social Security will check to see whether you can switch to any other less demanding jobs. But for someone over 50, Social Security considers additional factors, such as your exact age, education, and whether you have job skills, when it determines whether you are capable of switching to another type of job. These factors are referred to as the Medical-Vocational Guidelines (or sometimes, "the Grid").

The Grid guidelines can make it easier for people over 50 to be found disabled; they don't need to show that they can't do less physically taxing jobs. For example, if you were working as a plumber before your hip replacement and you can't return to that job because the bending would be too difficult, Social Security 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. But, the Grid can be complicated. If your previous job was working at a desk, and you don't have difficulty sitting after your hip replacement, Social Security is unlikely to find you disabled since you could return to a similar job (regardless of your age). For more information, you can read about medical-vocational allowances.

How Do I Apply for Disability Benefits for Hip Replacement Complications?

An easy way to start your disability application is to file online with the SSA. You don't have to finish the application all at once; just make sure that you keep track of the application number given to you when you start the application, so you can access it again if you need to come back to it.

You can also apply for disability benefits by phone by calling 800-772-1213 from 8 a.m. to 7:00 p.m. Monday through Friday, local time. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.

Finally, you can apply for disability benefits in person at your local Social Security field office. You can locate your field office here. (Be aware that this option has been temporarily suspended in response to the ongoing COVID-19 pandemic.)

If you'd like help with your application, consider working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. If, with the help of an expert, your application is good enough to get approved at the initial application stage, you can save yourself up to a year of waiting for an appeal hearing.

_{Updated November 1, 2022}