amputation disability benefits

An amputation is the loss of one of the body’s extremities: arm, hand, leg, or foot. Routine amputations are done surgically due to complications from diabetes or other diseases, but sometimes traumatic accidents can result in limb amputation. Under certain circumstances, if an amputation leaves a person unable to work, the amputee might be eligible for Social Security disability benefits. 

Amputation alone does not automatically qualify you for disability benefits unless both hands are amputated, a leg is amputated through the hip joint, or you have a pelvic amputation. For any other amputations, you have to prove to Social Security that you are unable to work. The Social Security Administration has a checklist of possible disability coverages, but you still may be able to prove your disability even if you don’t meet the official listing requirements. 

Official Listing Requirements

According to the Social Security Administration (SSA), you must have suffered one of the following to be considered for disability:

  • Amputation of both hands
  • Amputation of one hand and one lower extremity at or above the ankle, interfering with the ability to walk 
  • Amputation through the hip joint (hemipelvectomy) or pelvis (hip disarticulation)
  • Amputation of one or both lower extremities resulting in the inability to use a prosthetic device or a cane to walk properly

The inability to walk, as defined by the SSA is the inability to walk effectively with two hands while using the assistance of a cane, walker, crutches, or needing help getting to work or using public transportation. An issue that might arise is whether a prosthetic device could help restore the ability to walk or do daily activities. If you are able to use a cane with a prosthetic, this would not qualify you, as you would only need one hand to walk. 

Reduced Functional Capacity

Most employees cannot qualify under the above impairment listing, as the use of prosthetic devices would work to assist them, so their disability request claims would be denied. However, you might be able to qualify for disability benefits if your amputation has reduced your functional capacity in such a way that there is no work available given your age, education level, or experience. The SSA will give you a rating based on the type of work it thinks you can do: sedentary, light, medium, or heavy. Also, if your doctor has given specific restrictions such as no crawling, kneeling, or heavy lifting, these will affect your rating. 

Your rating or residual functional capacity (RFC) will determine the job the SSA chooses for you. 

The lower your RFC, the fewer jobs you can do. Still, if you’re under 50 years old, the chances of getting disability benefits through a medical vocational allowance are low. 

For example, if you have a sedentary RFC, high school education, and limited skills, you might be considered disabled if you are over 50. However, if you are younger than 50 and illiterate, the SSA will presume you can learn a new job. 

Medical Evidence 

The SSA will request records from your treating doctor and should include proper documentation of your amputation, your ability to use a prosthetic device, and your mobility. 

Your doctor should also address the likelihood of long-term issues with your amputated limb, and if your functional limitations will improve or stay the same. In order to get Social Security disability benefits, your disability must last at least 12 months.

Apply for Social Security Disability

In general, in order to apply for Social Security disability, you must first fill out the SSA’s standard application, and then complete a medical release form to grant permission to the SSA to view your medical records. After the SSA has examined your medical records and reviewed your application, they will determine your eligibility for amputation disability benefits. 

Benefits of Presumptive Disability

When you apply for Supplemental Security Income (SSI), you might be eligible for immediate cash payments if you have one of the following: 

  • Double amputation of two limbs
  • Amputation of a leg at the hip

This type of disability is called presumptive disability and typically applies to people of low income and resources. Generally, with a presumptive disability, the SSA will start making payments right away until your claim is approved or denied. After six months, if your claim is denied, you do not have to repay the presumptive disability benefits. 

BioTech Limb and Brace has a team of experts who support the limb loss community. If you have any questions about prosthetics, we can set you up with one of our trusted prosthetists. Contact us today.