Dysfunction in the sacroiliac joints, two joints that connect your spine to your pelvis (from the sacrum to the iliac bones), can cause lower back pain, pain in the hips, and leg pain. SI joint dysfunction can lead to difficulty with movement and walking, which, for some, eventually leads to an inability to work.
Like other joints in your body, the sacroiliac (SI) joints are covered with a layer of cartilage, which helps with movement and flexibility and reduces shock. Osteoarthritis causes that cartilage to wear away, a common cause of sacroiliac joint dysfunction. Pregnancy and scoliosis can also cause sacroiliac joint dysfunction.
Sacroiliac joint dysfunction can also lead to inflammation in the SI joints, called sacroiliitis. The inflammation can be caused by osteoarthritis (wear and tear), by an inflammatory condition like ankylosing spondylitis or rheumatoid arthritis, or by trauma or infection.
The Social Security Administration (SSA) does not have a specific disability "listing" for evaluating whether sacroiliac joint dysfunction rises to the level of a disability. But if you have severe problems with your SI joint, you could be evaluated under Social Security's listing for "abnormality of a major joint in any extremity" (listing 1.18 in Social Security's Blue Book). If you suffer from sacroiliitis, Social Security might evaluate your condition with the listing for "inflammatory arthritis" (listing 14.09). Meeting the requirements of one of these listings would automatically qualify you for disability benefits (but is not the only way to get an approval—more on this below).
To meet the requirements of listing 1.18, you'll need to show that you have an abnormality in one or both of your SI joints (such as fusion or destruction of the sacrum or iliac bones or narrowing of the space between the bones) that causes chronic joint pain and stiffness and abnormal motion in the joint. In addition, the SI joint dysfunction must affect your hop function so severely that your doctor says you need to use a walker, bilateral canes or crutches, or a wheelchair or scooter that requires both hands.
Your medical records must include one of the following:
Limitations on movement due to pain and stiffness or pelvic instability can be proven through range of motion and other medical tests.
Listing 14.09 covers a large group of disorders, including ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and more. The rules for meeting the listing vary depending on whether you have ankylosing spondylitis or a type of inflammatory arthritis. For more information, see our article on disability and inflammatory arthritis.
If you suffer from sacroiliac joint dysfunction but don't meet the criteria under the listings discussed above, Social Security will look at your "residual functional capacity," or "RFC." Your RFC is what you can still do, despite the limitations caused by your medical condition.
Social Security uses an RFC assessment to list your limitations (both physical and mental) and determine the kind of work you're capable of doing. Common limitations of people with sacroiliac joint dysfunction include being unable to walk for extended periods of time, being unable to walk on uneven surfaces, and being unable to sit or stand in one position for extended periods of time. Many people also experience extreme pain, which can disrupt concentration and the ability to follow instructions and complete tasks. Your medical records should reflect any pain you are in as well as any limiting side effects you have from medication.
If Social Security finds that your RFC is not sufficiently limiting—that you are capable of performing a job you used to have or a less strenuous job—Social Security can deny your claim. But if Social Security determines that the symptoms associated with your impairment and treatment are so limiting that there is no job you can perform, you'll be awarded benefits under what is called a "medical-vocational allowance." For more information, read our article on how a limited RFC can lead to a disability approval.
If you think you are eligible for Social Security disability insurance (you must have enough work credits to qualify)), you can file your entire claim online on Social Security's website. If you're not comfortable filling out forms online, you can call Social Security at 800-772-1213 to get your claim started.
If you don't have enough work credits and you have low income, you can apply for SSI (Supplemental Security Income). Most individuals filing for SSI cannot file the whole application online, but they can get started on Social Security's website. For more information, see our article on how to apply for Social Security disability benefits.