Hip Replacement Surgery Complications: Can I Get Disability Benefits? (2023)

If you continue to experience pain and mobility symptoms beyond the normal recovery time from hip surgery, you may be eligible for disability benefits.

Hip replacements are one of the most common surgeries in the United States. Each year, doctors perform more than 450,000 total hip replacements. The vast majority are safe and effective and can help relieve arthritis pain that limits your activities or prevents you from working.

However, as with any surgery, hip replacement surgery has risks and benefits. You can expect some limitations as you recover from surgery. However, if these limitations last longer than 12 months and have caused you to stop working during that period, you may be eligible for disability benefits from the Social Security Administration.

Recovering from hip replacement surgery

Many people who have had hip replacement surgery are able to leave the hospital the same day. If you have another medical condition that requires monitoring, you may need to stay overnight in the hospital. Some people with more complex operations, such as bilateral hip replacements (both hips), benefit from starting their recovery in an inpatient unit, which requires a longer hospital stay.

The first step in recovery is to allow the surgical wound to heal properly. The small incisions made for hip surgery usually heal in about six weeks. However, even if you have strictly followed your doctor's instructions, there is a chance that the wound could become infected. Depending on the severity of the infection, it could take weeks or months for you to recover.

The second step in recovery is “post-operative” physical therapy. This phase of rehabilitation involves getting used to regular movement and practicing basic everyday activities, such as getting out of bed or chair. After that, you will gradually progress to more difficult tasks, such as climbing stairs or walking longer distances. Broadly speaking, in terms of general recovery, the situation can be expected to return to normal within three months, but a complete recovery can take up to a year.

Symptoms of a failed hip replacement

While most hip replacements go without a hitch, a number of issues can significantly delay your rehabilitation schedule. How long the pain lasts after surgery and how long your recovery will take depends on whether you got an infection or fell after surgery and whether there are problems with your artificial hip or its placement.

infections

Infections are rare, but they can develop after the hospital stay is over, or sometimes even many months after surgery. Signs and symptoms of an infected joint replacement include:

Improper placement or defect in the artificial hip

Some patients may need follow-up surgeries (called revision surgeries) because the artificial hip was misplaced or the hip itself was defective. Revision surgeries can be more difficult than initial hip surgeries.

Sometimes a surgeon positions the artificial hip incorrectly. In this case, the pain may come from the hardware used in the implant or from bone loss around the implant. Other times, the implant comes loose on its own, either due to wear, excess weight or joint overload.

If the prosthesis (artificial hip) itself is faulty or the wrong size, the surgeon may need to replace it.

Likewise, you may need to replace your prosthesis with a new one if you are injured following a fall or accident shortly after hip replacement surgery.

Signs that you may need an artificial hip replacement include:

pain in the hip, groin, or thigh
limited mobility
difficulty walking or
a feeling of looseness or "sag" in the hip.

Often, an unsuccessful hip operation will require a surgical “revision” to repair incorrect positioning, faulty prosthesis, or damage to the prosthesis, which will increase the time needed for recovery.

When do you know if your hip surgery was a failure?

Ultimately, the goal of recovery after hip replacement surgery is to lead you to what doctors call “maximum medical improvement” or “MMI”. Maximum medical improvement does not necessarily mean you will be 100% like new; it just means the doctors don't think additional physical therapy, procedures, or time will benefit you. If you are still experiencing pain when you reach the stage of maximum medical improvement, your treatment focus may shift to medication management alone.

If after one year any of the following are still true, you may be disabled under Social Security Administration guidelines:

the pain continues to persist
you are still limited in your daily activities, or
you are unable to return to work despite achieving maximum medical improvement.

When hip replacement complications last longer than 12 months

Unlike many private insurance providers, Social Security does not provide temporary or short-term disability benefits. To qualify for disability benefits, you must prove that you have been unable to work due to complications from your hip replacement for at least 12 months.

It is important to establish the 12-month period during which hip pain prevented you from working. This period may include the period before hip replacement surgery when you have been unable to work because of hip pain.

Sometimes Social Security will approve you for benefits even if you haven't left work for 12 months. For example, if your doctor says you need revision surgery eight months after your first surgery, chances are you won't be fully recovered until after a year.

Note that hip arthroscopy recovery, which is a much less invasive surgery used for labrum tears and femoroacetabular impingement (FAI), is less likely to drag on. Initial recovery usually takes two to three months, but the chances of complications are much lower than with hip replacement surgery. However, if you have symptoms of failed hip arthroscopy, such as decreased range of motion and pain or stiffness, Social Security will evaluate your condition in the same way as hip replacement complications (below).

Eligibility for disability benefits for hip replacement complications

In deciding your claim, Social Security may consider you “medically” or “occupationally” incapacitated. Social Security will find you to be “medically” incapacitated when your medical records contain information, such as documented symptoms or test results, that the administration has already determined is sufficient to consider you incapacitated on its lists of illnesses.

Medical list eligibility for major joint surgery

Social Security provides a specific list under which hip replacement complications can be assessed. (If you haven't had surgery, you may get the benefits belowlist of degenerative hip joints.) The hip is defined as the “main link” of Social Security, and can therefore be evaluated underuse 1.17, for reconstructive surgery of a large weight-bearing joint. To be considered disabled on this list, you must provide the following Social Security documentation:

documentation that you had hip surgery or surgery
evidence, such as medical certificates and tests, that you have difficulty moving as a result of the hip operation, and
proof that you need assistance to walk, such as a walker, crutches, two canes or a wheelchair.

You must be able to show how you meet each of these requirements to be considered medically disabled. The last requirement is perhaps the hardest. If you had complications from your hip replacement but don't require the use of a walker, two canes, or other assistive device, Social Security probably won't consider you medically disabled. However, you may still be considered “professionally” disabled if you can demonstrate that your symptoms are severe enough to prevent you from working.

Eligibility according to medical professional guidelines for hip complications

Social Security does not expect that everyone who has hip replacement surgery will be able to return to work, nor does it expect that everyone with a hip replacement will have complications so severe that they will no longer be able to walk. Most disability candidates with hip replacement complications will fall somewhere in between. The process Social Security uses to determine what you can and cannot do in a work environment is called an "assessment of your remaining functional capacity."

Your remaining functional capacity, orRFC, is what you can physically do despite your limitations. For example, your RFC might say that you can lift 20 pounds frequently, but you can't stand for more than two hours a day. To see which jobs you can take, Social Security compares your RFC to the job requirements.

As most people who have hip replacement surgery are over the age of 50, Social Security will be particularly interested to know whether your RFC prevents you from returning to any of the jobs you previously held. If you can't, you have a good chance of being considered disabled. Here's why. If you are unable to carry out your previous job, Social Security will check whether you can switch to other less demanding jobs. But for someone over 50, Social Security considers additional factors, such as your exact age, education and whether you have job skills, when determining whether you can switch to a different type of job. These factors are referred to as medical-professional guidelines (or sometimes, "on-line").

The Grid's guidelines can make it easier for people over 50 to be considered disabled; they don't have to demonstrate that they can't perform less physically demanding tasks. For example, if you worked as a plumber before your hip replacement and you can't return to that job because it would be too hard to bend, Social Security may consider you disabled, even if they think you'd be able to work in an office. The same does not apply to those who are 30 or 40 years old. But the grid can be tricky. If your previous job was working at a desk and you have no difficulty sitting down after your hip replacement, Social Security is unlikely to consider you disabled, as you could return to a similar job (regardless of your age). For more information you can read aboutmedical supplements.

How can I apply for disability benefits due to hip replacement complications?

An easy way to start your disability claim is tofile online with SSA. You don't need to fill out the form right away; just make sure you keep track of the app number you get when you launch the app so you can access it again if you ever need to get back to it.

You can also apply for disability benefits over the phone by calling 800-772-1213 from 8:00 am to 5:30 pm. Monday to Friday. If you are deaf or hard of hearing, you can call the TTY number at 800-325-0778.

Finally, you can apply for disability benefits in person at your local Social Security office. You can find your field office here. (Please note that this option is temporarily suspended in response to the ongoing COVID-19 pandemic.)

If you would like help with your application, consider working with an SSDI expert. according to aexamof our readers, candidates who submitted an initial application without expert help were rejected 80% of the time. If your application with the help of an expert is good enough to pass in the initial application phase, you could save up to a year waiting for an appeal.

_{Updated November 1, 2022}