Broken bones (or "fractures") can occur in any bone in your body. How the broken bone impairs your ability to function will depend on two things:
While most fractures heal without permanent injury, complications can occur with broken bones that sometimes lead to disability. In particular, broken ankles and legs that don't heal well can affect your ability to walk and stand for long periods. But broken bones qualify for Social Security disability benefits only if the complications from the fractures affect your ability to work long-term—that is, for a year or more.
This article will examine the complications from bone fractures that might qualify you for disability benefits and when the Social Security Administration (SSA) will pay you disability benefits for broken bones.
Although most broken bones heal within a few months, sometimes the bones don't heal properly. Fractures can also cause other complications that can lead to long-term impairments. Some of these complications occur at the time of injury, while others show up days, or even months, later.
Breaking a bone is trauma to your body, and when a bone breaks, it can cause immediate complications that can be very serious, and sometimes disabling. Some possible immediate complications of bone fracture include the following:
If you suffer broken bones in a serious accident and lose a lot of blood, you could develop hypovolaemic shock (also called hemorrhagic shock), which can cause major organs to stop working. That can sometimes lead to long-term impairments.
Some complications won't surface until a few days or weeks after you break a bone. Some of these complications can be dangerous and even life-threatening, such as:
Broken bones can sometimes lead to late or delayed complications. These are medical issues that don't occur until weeks or months after the fracture. Some of these complications can sometimes be debilitating, such as:
Whether you're applying for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI), to get disability benefits, you must qualify medically and non-medically. There are two ways to qualify medically for Social Security disability benefits or SSI. You can either:
Whether your condition meets a listing or you plan to show your condition keeps you from working, you'll need to back up your claim with solid medical evidence. (Learn more about the medical evidence you'll need to win a Social Security disability claim.)
There are two listings in the Blue Book that cover broken bones. Specifically, there's one listing that covers certain bones in the pelvis, leg, and foot, and another listing that covers broken bones in your arms. (Social Security assesses back injuries and head injuries—including impairments caused by spine or skull fractures—under the listings for neurological disorders.)
To meet one of the listings for bone fractures of the legs, feet, or arms, your doctor's treatment notes should include an explanation of your limitations (lack of functional abilities), which should be supported by medical evidence, such as X-rays or MRIs. Physical therapy reports that show real functional limitations can also bolster your claim.
The bones in your lower extremities are all important for mobility and bone fractures that have a long-term impact on your ability to walk can sometimes meet the listing.
The lower extremity fractures covered in listing 1.22 include breaks in any of the following bones:
To meet the requirements of the listing, you'll need:
To approve you for disability, Social Security generally requires that your broken leg or foot hasn't healed for at least six months and that you have a doctor's opinion (backed up by evidence) that says it's unlikely to heal for a total of at least 12 months. But Social Security typically only grants disability to applicants with fractures when it's been over a year and the disability applicant still has trouble walking.
Bone fractures in your upper extremities (arms) are covered in listing 1.23. The listing requires that:
You also must have one of the following:
Note that you can only meet the requirements of the listing for a non-healing broken arm bone if you're awaiting additional surgery or medical treatment that's expected to improve function in your arms. If your doctors are done treating your fractures and you still have problems using your arms and hands, you won't meet the listing, but you can try to prove you can no longer work any job (see below).
If your bone fractures don't meet or equal a listing, you could still be eligible for disability benefits if you're unable to do any job. Here's what will happen next.
If you had a complex or non-healing bone fracture, you might have any of the following:
In evaluating whether your lasting complications make you unable to do any work, Social Security will use a Residual Functional Capacity (RFC) form, which assesses your physical and mental limitations.
For example, if you broke bones in your arm, your RFC will detail how your condition has affected your ability to do things like:
Similarly, if you fractured leg bones, your RFC will include the difficulty you now have with things like:
If you're filing a Social Security disability claim after bone fractures, you'll likely apply based on your physical difficulties. But your mental abilities might be affected as well—especially if you're experiencing significant, ongoing pain.
Living with constant pain can affect your ability to work. It can be distracting and make it difficult to stay focused on tasks. And if the pain interrupts your sleep, your concentration might be further limited due to fatigue. Additionally, round-the-clock pain can make it hard for you to deal with stressful situations or conflicts with co-workers.
If you claim that pain or fatigue affects your ability to work, or this is mentioned in your medical records, Social Security will use a mental RFC form to assess your ability to function in the following areas:
For Social Security to properly weigh the effects of the pain on your overall impairments, you must provide medical documentation that proves the possible sources of the pain. (For more information, read our article on how Social Security evaluates chronic pain.)
After Social Security assesses all the above limitations, the agency will consider whether your limitations keep you from doing your prior work. If they do, the agency must then decide whether there's other, less demanding work that you could adjust to, considering your:
Social Security follows specific guidelines in deciding whether your RFC allows you to do your prior jobs or any other jobs. Learn more about how Social Security decides whether or not you can work.
Updated July 13, 2023