Osteoporosis is a medical condition where your bone tissue does not replenish itself as it should, causing your bones to become weak and brittle and placing you at greater risk for fractures. Osteopenia means that you have lost bone mass, but your bones are usually strong enough to resist fractures; it can be the early stages of osteoporosis.
Osteoporosis is sometimes referred to as the "silent disease" because there are no early symptoms. Often, the first sign that bones are getting weak is a bone fracture, or multiple fractures. Severe osteoporosis may cause the bones to break spontaneously or as the result of minor falls, such as from standing height. Breaks may also occur from normal daily activity, such as coughing, bending, and lifting. Generally, the bones most susceptible to fracture from osteoporosis are the hip, spine, and wrists.
In addition to being susceptible to easy fractures, you may also notice a loss of height (getting shorter by an inch or more) or postural changes (like frequent stooping or feeling bent forward), both of which are caused by compression fractures to the spine. As more fractures occur, the back becomes curved or hunched. This abnormal curve of the spine places extra strain on the back muscles, tendons, and ligaments, and can also cause nerve impingement.
People who have low calcium intake are at higher risk of developing osteoporosis, as are those with a history of eating disorders or gastrointestinal surgery—because these conditions lead to a lack of calcium, which weakens the bones.
Additionally, people with certain medical conditions are at higher risk of osteoporosis; in particular, chronic kidney disease and certain types of cancer. In chronic kidney disease, a limited supply of vitamin D causes calcium to move from your bones to your blood, causing osteoporosis and weak and brittle bones. Additionally, many cancer treatment therapies lead to bone loss and increased fracture risk. Whatever the cause, osteoporosis can be a debilitating condition that limits your daily activity tolerance and prevents you from being able to work.
If you're experiencing severe limitations because of osteoporosis, there are a few ways to be approved for Social Security disability benefits. Social Security uses a 5-step process to determine if you're eligible for disability. In these five steps, Social Security determines:
Step two is a screening step to make sure your medical records contain evidence that you have a serious condition that limits your abilities. Social Security will find that your osteoporosis is a severe medical impairment at step two if the limitations caused by the condition interfere with basic work-related activities.
Social Security will consider all of your symptoms, including pain and weakness, in deciding this, but symptoms alone don't provide enough evidence that you have a severe impairment. You must also have medical "signs" or laboratory tests that can prove your diagnosis and impairment. Osteoporosis is diagnosed based upon a bone density test, or DEXA scan. Your doctor may also order several blood tests to confirm the presence of osteoporosis, as well as bone x-rays, CT scans, or MRIs to determine whether you've had bone fractures due to osteoporosis.
If you pass this screening step, you move on to step three.
At step three, Social Security uses its disability evaluation handbook, called the "blue book," which outlines the criteria for disability that are specific to certain medical conditions. These rules are called "listings." Osteoporosis doesn't have a specific listing, but if you've had bone fractures, Social Security may evaluate your symptoms under listing 1.19, for "pathologic" fractures (fractures not caused by force or impact). The listing states that you must have:
Meeting the criteria explained in the listings can be difficult. In fact, most disability claims that are approved for benefits don't meet the criteria of one of the listings contained in Social Security's blue book. Instead, Social Security approves them because disability applicants' symptoms and limitations make them unable to perform their previous jobs and they're unable to transition into another type of work. So, even if you don't meet one of Social Security's listings, you may still be found disabled under Social Security's other rules, starting with step four.
At step four, Social Security will analyze your work history over the past fifteen years and determine the skills and strength that were needed to perform your past work. Social Security will then evaluate your ability to perform your past work by determining your Residual Functional Capacity (RFC). Your RFC is the most intensive work you can still do (medium, light, or sedentary), despite the limitations caused by your medical conditions.
If you suffer from severe osteoporosis, you may experience sharp sudden back pain, pain with lifting or carrying weight, pain with heavy manual work, pain with bending, pain with reaching or gripping objects, and pain with prolonged sitting, standing, or walking. An RFC for a person with severe osteoporosis might include limitations in walking, standing, sitting, lifting, carrying, pushing, pulling, stooping, crouching, crawling, kneeling, bending, twisting, reaching with both arms, grasping with both hands, avoiding uneven terrain, or avoiding narrow, slippery, or moving surfaces.
For example, if you're suffering from osteoporosis with a history of fractures, your RFC might include the following:
Someone with these limitations would likely be unable to perform most jobs, because they would be unable to complete a full work shift, and even if they could, they would be unable to perform most of the physical requirements of even a sit-down job.
If Social Security finds you can't do your past work, you'll move on to step five.
At step five, Social Security looks to see whether your RFC would allow you to perform some other type of less demanding work. If you're under 50, Social Security's answer is generally yes, there's some type of sit-down work that you can do. But once you obtain a certain age, Social Security doesn't expect you to switch to other work, because the Medical-Vocational Guidelines state that even if you have the physical ability to perform work activity, you won't be expected to learn a new field unless you're a highly educated or highly skilled worker. For more information, see our article about how age affects your disability eligibility.
An easy way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. You can also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information, please see our article about applying for Social Security disability benefits.
If you'd like help with your application, think about 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. You can try to get a case evaluation with a disability lawyer or advocate to determine if your osteoporosis or osteopenia qualifies for benefits.
Updated October 21, 2021