You may be eligible for disability benefits if you can't work because you still suffer from physical or mental injuries from a car accident. Car accident injuries can include hip and arm fractures, back problems, soft tissue injuries, and brain injury. You may also experience psychological trauma as the result of a car accident, such as depression and anxiety. If these disorders have persisted for at least a year (or are expected to last for that long), and have prevented you from working, then you should consider applying for disability benefits from the Social Security Administration (SSA).
Meeting a Disability Listing After a Car Accident
A straightforward way to be found disabled by Social Security is to meet the medical requirements for a disability listing. These listings are found in the Listing of Impairments (the “Blue Book”). The SSA generally requires strict adherence to the requirements, but in unique circumstances the SSA’s medical expert may find that your condition “medically equals” a listing.
Following are the most common disability listings related to car accident injuries and the criteria needed to qualify for disability benefits under the listings.
Fractures of the Leg or Arm
A fracture occurs when your bone breaks apart or is cracked as a result of trauma.
SSA's disability listing 1.06 discusses fractures of the thigh, shin, pelvic, or tarsal bones (in the foot). To meet this disability listing, you would need to prove you have:
- A non-healing fracture with no “solid union” of the bone, and
- An extreme impairment in your ability to walk that continues for at least 12 months. You would be unable to perform your daily tasks of living. You also would need a device such as a walker or two crutches that prevent you from using both of your arms effectively.
Listing 1.07 discusses fractures of the arm, wrist, or elbow bones. To meet this disability listing, you would need to prove you have:
- Nonunion of the bone,
- Ongoing medical treatment (that is, you have tried surgery and other treatments to help restore use of the arm), and
- No functional use of the arm for at least 12 months. You would be unable to pick up items with your hands and fingers or use your arm to carry objects.
A car accident may worsen a pre-existing back problem or cause a new injury. Listing 1.04 discusses disorders of the spine including degenerative disc disease, a slipped disk, or a broken vertebra. To meet this disability listing, you would need to prove you have one of the following conditions:
- Compression of a nerve root shown by an MRI or x-ray, limitation of the movement of the spine, muscle atrophy (loss of muscle) with weakness, decreased sensation or reflexes, and a positive straight-leg raising test (if the low back is part of the disability)
- A diagnosis of spinal arachnoiditis shown by a pathology report or operative note, and the need to shift positions more often than once every two hours, or
- A diagnosis of lumbar spinal stenosis shown by an MRI or x-ray, painful cramping, weakness, and an extreme impairment in your ability to walk.
For more information, see our series of articles on disability benefits for back injuries.
Soft Tissue Injuries
A car accident can cause injuries to tendons, ligaments, muscles, nerves, blood vessels, and skin. The SSA defines soft tissue injuries to also include burns.
Listing 1.08 discusses a soft tissue injury or burn of an arm, a leg, the torso, face, or head. To meet this disability listing, you would need to prove both of the following.
- You don't have functional use of the affected body part for at least 12 months. If the face and head are involved, you would need to show your vision, speech, or eating process has been significantly affected, and
- You are receiving ongoing medical treatment (generally this means you have tried surgery and other treatments to help restore use of that part of the body).
Listing 8.08 is specific to burns, but does not require evidence of ongoing surgical treatment. To meet this disability listing, you would need to prove that you have widespread skin lesions, lasting at least 12 months, that:
- significantly limit your functional use of at least two extremities (such as two arms, two legs, or one arm and one leg), or
- are on the palms of both hands and they significantly limit your ability to handle and finger objects, or
- are on the soles of both feet and they significantly limit your ability to walk and carry out the duties of everyday living.
Listing 5.02 discusses gastrointestinal bleeding (involving the esophagus, stomach, or intestines). To meet this listing, you would need to prove all of the following.
- You had blood transfusions at least three times during a six-month period.
- Each transfusion required at least two units of blood, and
- Each transfusion was spaced at least 30 days apart from each other.
Determining Your Residual Functional Capacity
Even if you do not meet one of the disability listings above, the SSA will determine your residual functional capacity (RFC) to see if you have any capacity to work even a simple job. When you have been involved in a car accident, the SSA will review your hospitalization records and consider whether your medical treatment has been successful and whether there were complications. In addition, the SSA will consider whether the medications you take are effectively controlling any symptoms of pain, whether you have complied with all of the treatment recommended by the doctor, and what limitations your doctor has put on your ability to work.
After assessing your ability to stand, walk, handle or carry objects, and interact with other people, the SSA will give you an RFC of sedentary, light, medium, or heavy work. For instance, if one of your arms was fractured and has not recovered, the SSA might give you an RFC limiting you to light work, with only occasional use of the hands.
But you generally need to be medically restricted to less than sedentary work to be found disabled (unless you are over 55 and can't transfer to a new type of work because you have no transferable job skills). If your RFC shows that there are jobs you can do, it is advisable to appeal, assuming you disagree with the SSA’s findings. For instance, if you are currently taking pain medication that affects your ability to concentrate, you might question whether you are able to do even sedentary work on a regular basis. You might also contend that your RFC should limit your fractured arm to no handling or fingering of objects due to weakness of the arm and hand muscles. This would make it unlikely that there are jobs you could do.