Social Security Disability for Sacroiliac Joint Dysfunction

Dysfunction in the sacroiliac (SI) joints—two joints connecting your spine to your pelvis (from the sacrum to the iliac bones)—can cause lower back pain, hip pain, and leg pain. SI joint dysfunction can lead to difficulty with movement and walking, which, for some, eventually leads to an inability to work.

What Causes SI Joint Dysfunction?

Like other joints in your body, the sacroiliac joints are covered with a layer of cartilage, which helps with movement and flexibility and reduces shock. Osteoarthritis causes the joint's cartilage to wear away—a common cause of sacroiliac joint dysfunction. Pregnancy and scoliosis can also cause SI joint dysfunction.

Sacroiliac joint dysfunction can 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. Sacroiliitis can be temporary, as in pregnancy, but if you have inflammatory arthritis, it can cause permanent damage.

Symptoms of Sacroiliac Joint Dysfunction and Sacroiliitis

The signature symptom of SI joint dysfunction is pain that usually starts in the lower back (where the spine meets the pelvis). But the pain can affect your buttocks, thighs, groin, or upper back. Often, SI joint pain affects only one side of your body.

SI joint pain can be sharp or dull and achy. It might be worse in the morning and get better throughout the day. Your SI joint pain might worsen when you stand up, climb stairs, or after you sit for a long time. Because of the pain, you might limp when you walk or have trouble standing from a seated position.

Is SI Joint Dysfunction a Disability Under Social Security's Listings?

The Social Security Administration (SSA) doesn't have a specific disability "listing" for evaluating whether your sacroiliac joint dysfunction qualifies as a disability. But there are a couple of impairment listings in Social Security's Blue Book that your SI joint trouble might meet.

If you have severe problems with your sacroiliac joint, you could be evaluated under Social Security's listing for "abnormality of a major joint in any extremity" (listing 1.18). 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 isn't the only way to get approval—more on this below).

Does Your SI Joint Dysfunction Meet Listing 1.18: Abnormality of a Major Joint?

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 hip 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. (Alternatively, if one hand is unavailable, you could meet this listing if you only needed one cane, one crutch, or a wheelchair that requires only one hand to operate.)

Your medical records must include one of the following to meet this listing:

• medical imaging (such as an X-ray or MRI) that shows either joint space narrowing, ankylosis, or the destruction of bone, OR
• clinical notes from your doctor detailing an abnormality on a physical exam, like contracture (tightening) or bony or fibrous ankylosis (stiffness due to fused bone or adhesions).

Limitations on movement due to pain and stiffness or pelvic instability can be proven with range of motion tests and other medical tests.

Does Your SI Joint Dysfunction Meet the Inflammatory Arthritis Listing?

Listing 14.09 covers a large group of disorders, including the following:

• ankylosing spondylitis
• rheumatoid arthritis
• psoriatic arthritis, and
• other inflammatory joint impairments.

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.

Qualifying for Disability Because You Can't Work Due to SI Joint Dysfunction

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 on a regular and sustained basis, given your medical condition.

Social Security uses an RFC assessment to list your limitations (both physical and mental) and determine the kind of job you're capable of doing despite those limitations. You'll receive an RFC for sedentary work (a desk job), light work, or medium work.

The RFC you receive will depend on how your SI joint symptoms affect your daily functioning. Common limitations of people with sacroiliac joint dysfunction include:

• being unable to walk for extended periods
• being unable to walk on uneven surfaces, and
• being unable to sit or stand in one position for extended periods.

For example, if your sacroiliitis makes you unable to stand and walk for more than an hour a day (during an 8-hour work shift), you'd likely receive an RFC for sedentary work. But if you also can't sit for extended periods due to your SI joint trouble, your RFC might be for "less-than-sedentary" work. If you can't even do sedentary work, Social Security will find you're disabled.

Many people with SI joint dysfunction 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're in, as well as any limiting side effects you have from medication. (Learn more about how Social Security considers pain in deciding if you're disabled.)

If Social Security finds that your RFC isn't sufficiently limiting—that you're capable of performing a job you used to have or a less strenuous job—Social Security can deny your claim. But if the SSA determines that the symptoms associated with your impairment and treatment are so limiting that there's no job you can do, 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 disability approval.

Medical Evidence: Proving Your SI Joint Dysfunction Is a Disability

Social Security will use the medical evidence in your file to decide whether your sacroiliac joint dysfunction is a disability. So, whether you're trying to prove that your SI joint impairment meets one of the above listings or that it prevents you from working, you'll need sufficient medical evidence.

In general, Social Security will need to see objective medical evidence from an "acceptable medical source" (like your doctor) that shows you have a "medically determinable impairment" that has lasted or is expected to last at least a year. (Learn more about these terms.)

For SI joint dysfunction, the evidence should include:

• physical examination reports with a detailed description of your doctor's objective clinical findings (not based solely on your symptom complaints)
• test reports from accepted diagnostic tests, such as:
• imaging tests (like X-rays and MRIs) showing unilateral or bilateral sacroiliac joint degenerative changes, and
• positive muscle function tests
• operative reports (if you've had surgery on one or both SI joints)
• information about the medical treatments you've tried, including:
• their effectiveness, and
• any side effects.

If you use an assistive device, like a walker or wheelchair, your need for the device should be documented in your medical file.

You'll also need evidence from medical sources (like your doctor or physical therapist) describing how your SI joint disorder affects your ability to function day-to-day—particularly in a work setting. A statement from a non-medical source, like your employer or coworker, about how you function (or can't function) on the job can also help.

Starting a Disability Claim for SI Joint Dysfunction

If you think you're 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 a low enough income, you can apply for SSI (Supplemental Security Income). Adults filing for SSI can start their applications online, and Social Security will contact them to finish the application.

For more information about your options, see our article on how to apply for Social Security disability benefits.

VA Disability Rating for Sacroiliitis and Sacroiliac Joint Dysfunction

The VA rates sacroiliac joint dysfunction and sacroiliitis (SI joint inflammation) using the "General Rating Formula for Diseases and Injuries of the Spine" under diagnostic code: 5236 Sacroiliac injury and weakness. (38 CFR § 4.71a.) Spinal impairments can receive disability ratings between 10% and 100%—depending on how much the spinal movement is affected.

Because ratings of 30% or higher require that at least part of your spine be stuck in flexion (bent forward), extension (arched backward), or upright, SI joint dysfunction or sacroiliitis isn't likely to receive a VA disability rating higher than 10-20%. Ratings in this range can be based on limitations in your range of motion and whether your SI joint dysfunction causes muscle spasms or guarding (stiffness or hesitation due to pain), whether or not it affects how you walk.

Your sacroiliac joint dysfunction or sacroiliitis must be service-connected to receive a VA disability rating. That is, your SI joint impairment must result from an event (injury or illness) that occurred while you were on active duty in the United States military—whether your service caused your condition or aggravated a pre-existing condition.

Learn more about establishing a service connection for VA disability.

_{Updated April 26, 2024}