Applying for Disability After an Amputation

People often associate amputations with combat injuries, but about half of all amputations, are due to diabetes or other vascular conditions (including peripheral artery disease or arteriosclerosis). Accidents, equipment malfunctions, or other trauma cause the other half.

The most common amputation surgery is amputation of the lower leg, an impairment frequently seen on applications for Social Security disability insurance (SSDI) and SSI. Amputations of the foot and/or ankle joint due to foot ulcers are common in diabetic patients.

You might think that having an amputation would guarantee you disability benefits, and it probably should, but only certain types of amputations qualify for benefits. For instance, leg amputations that are considered "minor" (at the ankle joint or below) don't usually qualify for disability benefits, unless the claimant has additional severe medical conditions.

Major leg amputations are those performed at or above the ankle joint—either above or below the knee. But Social Security feels that even those who have had major amputations may be able to work, as prosthetics (artificial limbs) make it possible for many people to lead active lives following an amputation. But certain types of amputations or stump complications following surgery might not allow you to use a prosthetic effectively and may make it very difficult or impossible to work.

Qualifying for Disability Benefits After an Amputation

Social Security doesn't take into account how you lost a limb—whether through an accident or a condition like diabetes. Instead, the agency looks at the remaining abilities you have post-amputation. Social Security can find you disabled "medically" or "vocationally."

Social Security will find you are disabled "medically" if your medical records clearly show that you've had a certain surgical procedure, or have certain limitations, that are set out under its listings of disorders. If you don't, Social Security will look at your vocational factors, like your age and the type of work you can do. In both cases, you need to be unable to work for at least 12 months, although this can include the time leading up to the surgery as well as the recovery time.

Qualifying Under the Medical Listing for Amputations

Social Security will find you disabled if your amputation meets the criteria in Social Security's official listing for amputations, listing 1.20. The listing describes five types of amputations.

• amputation of one or both legs (at or above the ankle)
• amputation of one leg (at or above the ankle) and one hand or arm (at or above the wrist)
• amputation of both hands or arms (at or above the wrist)
• amputation of one leg up to the hip (hip disarticulation), and
• pelvic amputation (hemipelvectomy).

If you've had surgery for one of the last three items on this list (hemipelvectomy, hip disarticulation, two wrist disarticulations, or amputation of both arms), Social Security will approve you automatically for disability benefits. After you file your application, Social Security needs only your medical records and surgical notes.

If you've had your leg or part of your leg amputated, the amputation listing has further requirements:

Amputation of one or both legs. You need to show that you have all three of the following:

• long-term complications of your residual limb
• an inability to use a prosthesis (artificial leg), and
• documentation that you can't walk without the assistance of a walker, two crutches, two canes, or a wheelchair that requires both hands.

Amputation of one leg and one arm. You need to show that you have one of the following:

• documentation that you need a cane or another one-handed, hand-held assistive device or wheelchair requiring the use of the other arm
• documentation that you can't walk without the assistance of a walker, two crutches, two canes, or a wheelchair that requires both hands, OR
• an inability to use your remaining arm to independently start, maintain, and finish work involving small and large hand movements.

Other Amputations That Cause Problems Working

Many people have had amputations or complications that don't fit the criteria listed above. Here are a few:

• amputation of your dominant hand
• amputation of your fingers, and
• amputation of your foot.

If one of these "minor" amputations prevents you from working, you may still be eligible for disability benefits.

Your RFC. To see if your work-related activities are limited because of your amputation, Social Security will assess your "residual functional capacity," or "RFC." Your RFC is a list of the things you can still do despite the amputation and the limitations it has caused. For instance, Social Security might look at whether or not you can walk effectively on an artificial leg, whether you can use your hand(s) for finger work or your arm(s) for lifting and carrying items, and whether you are capable of doing work sitting down.

Typical restrictions. If you've had a lower limb amputation, you may be restricted in what kinds of surfaces you can safely walk on, in addition to having restrictions around crawling, kneeling, climbing, bending at the knees, and activities that require good balance. Upper limb amputations may limit your ability to type or write (especially if your dominant hand was amputated), grasp things, and lift objects.

Social Security will then use your RFC to figure out if there is any kind of work you are still capable of doing, despite the limitations from your amputation. If Social Security finds that you're capable of performing any job you used to have, the agency will deny your claim.

Under 50 rules. What happens next depends on your age. If you're under 50 or 55, Social Security will check to see if there are other types of jobs you can do that could accommodate your limitations, such as "surveillance system monitor" or "mail sorter." If there are, Social Security will deny you. But if Social Security determines that your amputation was so limiting that there is no other job you can perform, the agency will award you benefits under what's called a "medical-vocational allowance." Learn more about the RFC and medical-vocational allowances here.

Over 50 rules. While the majority of trauma-related amputations happen to people under the age of 45, most other amputations (such as those caused by diabetes or peripheral artery disease) happen to older people. If you're older than 50 or 55, Social Security uses a different set of rules called the "grid rules." At older ages, Social Security is more likely to find that you can't adjust to any other work—unless you have a highly skilled job background and you can still do some of the tasks you used to do. For more information, see our article on Social Security's grid rules.

What Evidence Does Social Security Need?

You or your doctor will need to submit medical records showing your surgical notes and your doctor's post-surgical clinical notes from follow-up visits, along with any x-rays or MRIs. It also helps to have your doctor fill out a "medical source statement," or an RFC form, stating what you can and can't do. The RFC form should cover the following issues:

• how long you can walk and whether you need to use a cane, crutches, or walker
• whether you can walk on uneven surfaces
• how long you can stand
• whether you can crouch, stoop, kneel, or bend
• whether you can lift or carry heavy objects,
• whether you can do finger work (called "fine motor movements"), and
• whether you can climb stairs alone or with the use of a railing.

Social Security will also want to see what treatments you've tried post-surgery, such as pain medication, physical therapy/rehabilitation, prosthetics, and therapeutic injections.

Social Security will also look at notes from your physical therapy visits following your amputation to help determine your progress and your remaining limitations.

If you suffer from phantom limb pain, keep a diary about how your chronic pain impacts your activities of daily living—such as driving, housekeeping, grocery shopping, or socializing—as well as activities that require concentration, so that Social Security can consider these limitations when deciding your claim.

Presumptive Disability for Certain Amputations (SSI only)

As you may know, Social Security administers two different programs that provide payments to disabled individuals: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Through SSI, people who are disabled and have very little income and resources receive monthly disability payments to help them obtain at least some of the necessities.

If you're applying for SSI and you've had two limbs amputated, or one leg amputated at the hip, you will be granted "presumptive disability benefits" as soon as you apply. This means you'll start to get payments right away—even before you are officially found disabled. To continue receiving SSI after six months, you'll have to wait for the final decision. But the good news is that, if Social Security grants you presumptive disability benefits, but then finds you ineligible for SSI for some reason, you won't have to repay the presumptive disability payments. Learn more about presumptive disability benefits here.

How to Apply for Disability Based on an Amputation

If you're applying for Social Security disability insurance (SSDI), you can file your entire claim online on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim.

Most individuals filing for SSI only can't file the whole application online, but they can get started on Social Security's website. For more information on applying for either SSDI or SSI, see our article on 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.

_{Updated November 5, 2021}