Getting Disability Benefits for Injuries From a Gunshot Wound

Even in the most optimistic scenario, a gunshot will cause damage to the skin, muscles, tendons, or ligaments. While these soft-tissue injuries tend to heal quickly, the resulting scar tissue can cause substantial functional limitations with range of motion, strength, or flexibility. In some cases, these impairments don't become apparent until years after the initial injury.

Many gunshot victims are able to make substantial recoveries and return to work within weeks or months. But those who experience severe complications from the wound that keep them from working full-time for at least a year might qualify for Social Security disability benefits. Before you submit your application for SSDI or SSI benefits, it’s a good idea to become familiar with Social Security’s rules about when somebody is considered disabled.

Is a Gunshot Wound a Disability?

The Social Security Administration (SSA) awards disability benefits to people who have a medically determinable impairment that prevents them from engaging in substantial gainful activity for twelve months or longer. The “twelve-month” durational requirement means that gunshot wounds that heal within one year and don’t cause any residual limitations won’t count as a disability.

Long-lasting, chronic medical issues that result from gunshot wounds may be considered disabling, however. This often depends on the location of the wound. Injuries to the back, chest, or head especially can be seriously debilitating, but taking a bullet to the arm, leg, or foot may also significantly affect the ability to complete work tasks. People with such injuries may qualify for benefits by meeting a listed impairment or having functional limitations that rule out all jobs.

Gunshot Wounds and the Blue Book Listing of Impairments

Many victims of gunshot wounds experience life-altering injuries. One of the most severe non-fatal outcomes results in damage to the spinal cord, which can cause paralysis or cognitive impairments involving speech and memory problems. Such serious injuries may qualify you for disability benefits by meeting a listing in Social Security's “Blue Book” of medical conditions.

The Blue Book is a category of certain disorders that you can get disability for automatically, provided you have specific evidence in your medical records. For example, a gunshot that damages your spinal cord might be evaluated under listing 11.08, Spinal cord disorders, or listing 1.15, Disorders of the skeletal spine resulting in compromise of a nerve root.

Depending on the nature and extent of your injuries, other listings that Social Security may consider when evaluating your disability application could include:

• listing 1.20 for gunshot wounds requiring amputation
• listing 1.21 for a soft tissue injury under regular surgical management
• listings 1.22 or 1.23 for non-healing or complex bone fractures
• listings 2.02, 2.03, or 2.04 for vision loss
• listing 11.18 for traumatic brain injury, and
• listing 12.15 for trauma-related mental disorders.

Meeting the requirements of a listing can be tricky, however. Consider asking your doctor to provide a medical source statement showing how you meet (or equal) a listing.

How Gunshot Wounds Can Reduce Your Residual Functional Capacity

Even if your condition isn’t severe enough to meet the requirements of a Blue Book listing, you can still be eligible for benefits if limitations in your residual functional capacity (RFC) show that you can't perform any jobs. Your RFC is a short paragraph containing restrictions on what you’re still able to do in a work setting despite your injury.

What’s In Your RFC?

Any physical limitations you have, such as restrictions in movement caused by scar tissue at the bullet entrance or exit wound, should be reflected in your RFC. Social Security will then address how those limitations affect your ability to perform the following tasks:

• reaching, handling, and fingering
• lifting, carrying, pushing, and pulling
• sitting, standing, and walking, and
• climbing, balancing, kneeling, stooping, crouching, and crawling.

If you’re receiving mental health treatment for issues related to your gunshot wound (like anxiety or PTSD), your RFC will contain additional limitations on how well you’d function at work with regards to:

• maintaining attention and concentration for extended periods
• working in coordination with others
• interacting appropriately with coworkers, supervisors, and the general public
• maintaining adequate attendance and punctuality, and
• completing a workday without substantial interruption from psychological symptoms.

Social Security will review your medical records and your activities of daily living when assessing your RFC. Make sure that Social Security has the records of all medical treatment you've received related to your gunshot wound, from the initial urgent care records to the ongoing treatment by your family physician or specialist. Records of surgeries, physical examinations, and X-ray and MRI imaging are especially important when determining your RFC.

How Does Social Security Use Your RFC?

Social Security uses your RFC to determine whether you could return to your past work or any other jobs in the national economy. Say your RFC contains restrictions against working in an environment with loud noises that could trigger flashbacks to the shooting incident, for example. If you previously worked in a construction area with lots of noisy machinery, the agency is unlikely to find that you could do that job again with your current RFC.

If you can’t do your past jobs, then Social Security will see whether other jobs exist that you can do given your RFC. Claimants younger than 50 generally need to have an RFC that rules out even the easiest sit-down jobs in order to get disability—for example, being off-task at work for 20% or more of the day due to pain. Claimants older than 50 can have an easier time qualifying for benefits under a special set of rules called “the grid.” Either way, if Social Security finds you can’t do any type of work, you’ll be granted a medical-vocational allowance.

Sample RFC Form for a Gunshot Wound

Social Security values the opinions of medical professionals who've seen you on a regular basis and are therefore more likely to have special insight into any limitations or complications you have as a result of your injury. If you've established an ongoing relationship with one or more doctors, ask them to fill out an RFC form on your behalf. Click on the thumbnail below to see an example of a helpful RFC statement from a doctor with a patient who is applying for disability based on complications from a gunshot injury.

Gunshot Wounds Resulting From the Commission of a Felony

Somebody who is shot while committing a felony won’t be eligible for disability benefits based on that impairment if they’re subsequently convicted. (SSR 83-21). But it can still make sense in that case to file for Social Security Disability Insurance (SSDI) in order to take advantage of the “disability freeze.” Social Security doesn’t award benefits during the “frozen” earnings record, but future retirement benefits or dependent payments won’t be reduced due to lack of income due to your disability.

How to File for Disability Benefits

Applying for SSDI or SSI is a fairly straightforward process. You can choose from one of the methods below to begin your claim.

• One easy way is to file your claim online. You don’t have to complete the application in one sitting, and you’ll get a tracking number so you can check the status of your claim.
• You can also apply over the phone by calling Social Security at 800-772-1213 (TTY 800-325-0778) 8 a.m. to 7 p.m., Monday through Friday.
• If you prefer to file in person, you can schedule an appointment with a representative at your local Social Security field office.

Don’t delay filing because you don’t have all the documents or information you need, as waiting to apply could reduce the amount of disability back pay you can get. Social Security will help you gather whatever you’re missing, including your medical records

What If My Application Is Denied?

Few disability applicants are awarded benefits on their first try. If you're denied, you’ll need to submit an appeal. Most people who are awarded disability don’t get approved until after a hearing with a judge, a process that can take about a year (or more, in some cases.)

If you need help with your disability application, consider hiring an experienced disability attorney. A lawyer can handle communications with the Social Security Administration, represent you at a hearing in front of an administrative law judge, and increase your chances of getting benefits. Disability attorneys work on contingency—meaning they get paid only if you win—and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.