Understand SSDI Eligibility for a Broken Hip

Before you apply for SSDI, it’s important to know whether you meet the SSA’s eligibility criteria. To qualify for SSDI benefits, you need to show that:

• Your injury is severe enough to prevent you from performing substantial gainful activity (SGA) for at least 12 months or result in death.
• You must have worked and paid into Social Security for a sufficient period, accumulating the required number of work credits.

The SSA will evaluate how the broken hip affects your ability to work. Mobility limitations, severe pain, and the need for ongoing treatment can contribute to meeting the SSA’s definition of disability.

Determine If Your Condition Meets the SSA’s Blue Book Criteria

The SSA’s Blue Book lists conditions that can qualify you for SSDI benefits. Although a broken hip is not listed as a specific impairment, it may be evaluated under the musculoskeletal system section. The SSA may consider a broken hip a qualifying condition if it severely limits your ability to walk, stand, or engage in other work-related activities. The SSA will specifically look at:

• The severity of your broken hip: If it leads to long-term mobility issues or requires significant ongoing medical treatment, it may qualify.
• Recovery and complications: The SSA will also consider complications like chronic pain, difficulty with physical therapy, or the need for a hip replacement.

Gather Your Medical Documentation

When applying for SSDI for a broken hip, strong medical evidence is crucial. The SSA requires detailed documentation to support your claim. Here’s what you should gather:

• X-rays and diagnostic imaging: Provide X-rays, MRIs, or CT scans showing the extent of the fracture.
• Medical records from your doctor: Include notes from your treating physician, including your diagnosis, treatment plan, and progress.
• Physical therapy records: If you’ve undergone physical therapy, include records showing how your mobility is impacted.
• Pain management documentation: If you are receiving treatment for pain, provide records from your pain management specialist.
• Surgeon’s notes: If you required surgery to repair the hip, provide the surgeon’s notes and post-surgery evaluation records.
• Functional limitations: Documentation on how the broken hip prevents you from performing work-related activities, such as walking, standing, or bending.

Complete the SSDI Application

Once you have all your medical documentation, you can begin the application process. There are two ways to apply:

• Online: The easiest and fastest way to apply is through the SSA’s online portal at www.ssa.gov. This allows you to fill out your application and submit your documentation electronically.
• In Person or Phone: If you prefer, you can apply in person at your local SSA office or call 1-800-772-1213 to schedule an appointment.

Be Detailed and Honest in Your Application

When filling out the application, be sure to include as much detail as possible:

• Describe how your broken hip affects your ability to work: Be specific about your functional limitations. If you can’t walk for extended periods or need assistance with daily activities, explain how this impacts your ability to perform job duties.
• Provide thorough medical information: Ensure that all medical records are submitted to show the extent of the injury, any surgeries, and the ongoing limitations you face due to the broken hip.
• Explain your recovery process: If you’re still recovering, provide information on your current treatment plan and whether you expect to make a full recovery or if the disability will be long-lasting.

Understand the SSDI Approval Process

After submitting your application, the SSA will review it and decide whether you meet the criteria for SSDI benefits. The review process typically takes 3 to 5 months but can take longer depending on the complexity of your case and any additional information the SSA needs.

If your application is denied (which is common), you have the right to appeal. The appeals process involves several stages, including:

• Request for Reconsideration: If your claim is denied, the first step is to request reconsideration, where a new claims examiner will review your case and any additional evidence you submit.
• Request for a Hearing: If reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ) who will hear your case in person.
• Further Appeals: If the ALJ denies your claim, you can appeal to the Appeals Council and ultimately to federal court if necessary.

Be Prepared for a Possible Denial

It’s common for initial SSDI applications to be denied, even if you have a legitimate disability. Many applicants are denied because they don’t have enough medical evidence, or because the SSA doesn’t fully understand how their condition affects their ability to work.



If your SSDI claim is denied, don’t get discouraged. Appealing the decision is the next step, and many claims are approved at later stages in the process. It may be helpful to consult a Social Security Disability attorney to guide you through the appeal and increase your chances of success.