What this listing covers
An amputation is the surgical or traumatic removal of a limb or part of a limb. Under SSA guidelines, this includes the loss of upper extremities at or above the wrist or lower extremities at or above the ankle. These conditions are evaluated based on how the loss affects your ability to perform basic work-related tasks.
The loss of a limb significantly impacts your ability to perform fine and gross movements, such as gripping, reaching, or lifting. For lower extremity amputations, the primary challenge is often the ability to walk or stand for extended periods. These physical limitations can make it difficult to sustain the demands of a full-time work environment.
How SSA evaluates a claim under this listing
Under Listing 1.20, the SSA evaluates the level of your amputation and your ability to use assistive devices. They look for specific scenarios, such as the loss of both hands, a hip disarticulation, or a combination of upper and lower limb loss. If you have lost one arm and one leg, the SSA assesses your need for mobility AIDS like walkers or your inability to perform tasks with your remaining hand.
For lower extremity amputations, the SSA requires evidence that you cannot use a prosthesis effectively. You must also demonstrate a documented medical need for a walker, bilateral canes, or a seated mobility device that requires the use of both hands. These limitations must be expected to last for a continuous period of at least 12 months to satisfy the severity requirements. An attorney can help you gather the evidence needed to meet these criteria.
Evidence that strengthens a claim
Strong claims rely on detailed medical records that document the level of your amputation and any complications with your residual limb. You should provide operative reports from your surgeries and clinical notes that describe your physical examination findings. If you use a prosthesis, include reports from your medical team regarding your ability to walk or perform fine motor tasks while using the device.
Non-medical evidence is equally vital for your claim. This includes statements from your doctors about your specific functional limitations and how they prevent you from working. Third-party reports from family members or former coworkers can also help illustrate your daily struggles with mobility, balance, and the use of your hands in a work setting. An attorney can help you organize this evidence to build a stronger case.
How an attorney helps
A disability attorney helps by ensuring your medical records clearly map to the specific requirements of Listing 1.20. They can assist in obtaining detailed functional capacity statements from your doctors that highlight your inability to use a prosthesis or perform work-related movements. By organizing your evidence and preparing you for potential hearings, an attorney helps you present the most accurate picture of your limitations to the SSA.
Frequently asked questions
No. While amputation is a serious condition, you must meet the specific criteria in Listing 1.20 regarding the level of the amputation and your functional limitations. The SSA evaluates whether you can use a prosthesis and your need for assistive devices. An attorney can review your medical records to see if your situation meets these regulatory standards.
If you can use a prosthesis effectively, your claim may be evaluated based on your remaining functional capacity rather than the amputation itself. The SSA looks at whether you can still perform work-related activities despite the loss of the limb. An attorney can help you document any complications or pain that make using a prosthesis difficult or impossible in a work environment.
You need medical documentation showing that you cannot use a prosthesis and that you require a walker, bilateral canes, or a seated mobility device. This evidence must come from an acceptable medical source and cover a period of at least 12 months. An attorney can help you gather the necessary clinical notes and physical exam reports to support your claim.
If your claim is denied, you have the right to request a reconsideration and, if necessary, a hearing before an ALJ. You must file your appeal within the specific deadlines provided in your denial notice. An attorney can help you identify gaps in your evidence and prepare a stronger case for your appeal.
