Getting Disability for Soft Tissue Injuries or Burns

Soft tissue injuries and burns often heal in a relatively short amount of time. But after healing, scar tissue can form across joints and skin and can cause lasting functional limitations in the use of one's hands, arms, or legs.

Soft tissue injuries include accidents that damage the skin, muscles, tendons, and/or ligaments.

Social Security will actually evaluate electrical, chemical, and thermal burns as soft tissue injuries as long as you continue to have surgical procedures to improve function. If your surgeries and treatments are done and you're left with extensive skin lesions, Social Security will evaluate your condition under the listing for burns (discussed below).

Types of Soft Tissue Injuries

Muscle strains and sprains are the most common soft tissue injuries (see our article on whiplash for neck strain issues). Cuts, contusions, tendinitis, and bursitis are also soft-tissue injuries.

Most soft tissue injuries heal within a year, so people with these types of injuries don't usually apply for disability benefits through Social Security (which requires conditions to last 12 months). But Social Security does see applications from applicants who have experienced serious soft tissue injuries with multiple surgeries or surgical complications. Here are some examples of soft tissue injuries or complications that sometimes last the required 12 months:

• complete rupture of hamstring requiring surgical reattachment
• nerve damage, such as sciatica, sustained during a soft tissue injury
• extensive lacerations (sharp cuts through the skin) and avulsions (deep cuts that remove all the skin layers) from car accidents
• third-degree abrasions (road rash) from motorcycle or bicycle accidents, or
• rhabdomyolysis caused by crush injuries or extreme muscle strain.

Any of these soft tissue injuries can require surgery, and surgical complications that can lengthen the recovery period include wound infections, sepsis, deep vein thrombosis, and secondary surgeries.

Complications From Burns

Doctors use three degrees of burns to describe their severity, depending upon the extent of the burn. Below is an overview of the degree of burns, their symptoms, and possible complications.

• First degree. First-degree burns are red and painful when they're touched. However, they don't blister and they generally don't cause any complications.
• Second degree. Second-degree burns are red, swollen, and painful, often with blisters that might ooze clear fluid. Complications can include the formation of scar tissue that can shrink as it heals, restricting movement.
• Third degree. Third-degree burns reach the fat layer of the skin and are often not painful because the nerves underneath the burns are destroyed. The skin that has been burned becomes leathery and discolored. Complications can be extensive with these burns and include:
  • the formation of scar tissue that prevents joint movement ("joint contracture")
  • destruction of muscle tissue, which can harm the kidneys
  • infection that can spread into the blood stream (sepsis), and
  • thick, crusty skin (eschars) that becomes inelastic and can cut off blood supplies to other areas of the body.

Qualifying for Social Security Disability Benefits

To qualify for Social Security disability benefits (either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)), you must show that you meet the requirements of a medical listing from Social Security's "Blue Book" or prove that you're unable to do any work because of the functional limitations caused by your injuries.

First, we'll look at "meeting a listing."

Meeting a Listing for Soft Tissue Injuries or Burns

Soft tissues injuries and burns have two listings in the Social Security Blue Book. One listing covers injuries and burns that are still undergoing surgeries and other treatment, in an attempt to restore function to the injured area, and the other listing is for impairments left from burns after all treatments have been completed.

Injuries or burns that are being treated. To meet the listing for injuries and burns still being treated (listing 1.21), you must:

• have soft tissue injuries or burns to any body part, including the face or head
• be undergoing treatment by a surgeon in an effort to reconstruct or replace the affected part of the body (and the surgical management must be expected to last 12 months), and
• not have reached "maximum benefit from therapy." (Social Security will find you've received maximum benefit when there have been no significant changes six months after your last surgical procedure or your doctor doesn't expect any further improvement.)

Burns that are no longer being treated. To meet the listing for burns that are no longer being surgically treated (listing 8.08), you must have burns that resulted in chronic skin lesions that result in an inability to do one or more of the following areas:

• remaining stable when standing or walking due to lesions in both lower extremities
• getting up from a seated position and remaining stable upright due to lesions in any two extremities
• using both arms and hands (upper extremities) to independently start and complete work
• using one upper extremity to independently start and finish work, with a need for an assistive device (such as a cane) that you need the other upper extremity to use.

Examples of burns that might qualify for benefit under this listing include:

• burns on the palms of both hands that very seriously limit your ability to use your hands and fingers for small and large movements
• burns on the soles of both of your feet or in your groin area that very seriously limit walking, or
• burns that interfere with your knee joints and prevent you from being able to stand up without assistance or maintain your balance.

For burns that affect respiratory, cardiovascular, renal (kidney), or neurological functions, Social Security will evaluate the impairment under the listings for the body system that is affected. For example, if your lung function has been affected, you will be evaluated under the listings for respiratory disorders.

Medical Evidence Required to Meet a Listing

In evaluating soft tissue injuries and burns, Social Security understands that they often improve over time, so the agency wants to see an ongoing record of treatment and changes in functioning. Notes from your doctors' physical examinations and results from medical imaging are useful to back up the limitations reported by applicants.

For burns and injuries that are receiving ongoing surgical treatments, you should provide all medical records from each surgery and note any side effects of the surgery.

To prove the severity of skin lesions, you should provide evidence that shows the extent of your skin lesions, how often they flare up, how symptoms caused by the lesions (such as pain) limit your functioning, and the treatments you've received, including any side effects from those treatments.

Functional Limitations That Restrict Work

If you don't meet one of the above listings or equal another listing, you can still qualify for benefits if your functional limitations prevent you from doing any work. Social Security will assess your functional abilities using a Residual Functional Capacity (RFC) form, which looks at physical, mental, and sensory limitations.

Applicants who have had a long recovery from soft tissue injuries or burns often have limited use of affected joints or muscles. Physical limitations can also include problems with:

• lifting, pulling, pushing, or carrying items due to decreased strength
• walking, standing, or sitting due to pain from lesions or scarring, and
• the ability to bend and twist or make other movements because of scarring.

Social Security also looks for sensory limitations that affect the ability to "adapt to one's surroundings." Injuries to hearing and seeing, or to the sense of touch, can impair the ability to work in certain types of locations. The risk of infection can also limit the type of workplace in which an individual can work.

Ongoing, severe complications can cause frequent absences from work and even frequent hospitalizations. In determining whether an applicant is disabled, Social Security strongly considers not being able to have regular attendance at a full-time job.

To learn more about the RFC assessment and how your functional limitations affect Social Security's disability determination, see our series of articles on how Social Security decides if you can do any work.

How Do I Apply for Disability Benefits for Soft Tissue Injuries or Burns?

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 p.m. Monday through Friday. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.

You can apply for disability benefits in person at your local Social Security field office, when the COVID pandemic is over and field offices have reopened.