Upper Extremity Fractures and SSDI Eligibility

Listing 1.23 covers non-healing or complex fractures of the humerus, radius, or ulna. These are significant breaks in the upper arm or forearm that fail to mend properly despite ongoing surgical intervention. SSA focuses on cases where your bone structure remains compromised, preventing your limb from returning to its normal function.

These injuries often make basic daily tasks difficult or impossible. You may struggle with lifting, reaching, or gripping objects, which are essential for most work environments. When you cannot use your arm for fine motor tasks like typing or gross motor tasks like lifting, maintaining steady employment becomes a major challenge. An attorney can help you determine if your specific injury meets these criteria.

Under Listing 1.23, SSA looks for two main components. First, you must have a non-union or complex fracture of the humerus, radius, or ulna that is currently under active surgical management. This means you are undergoing procedures specifically aimed at restoring the functional use of your arm.

Second, you must provide medical evidence showing an inability to perform work-related activities involving fine and gross movements. This limitation must have lasted, or be expected to last, for at least 12 continuous months. SSA requires documentation that your injury prevents you from sustaining these movements in a typical work setting. An attorney can help you gather the necessary documentation to prove your functional limitations.

Strong claims rely on detailed medical records, including operative reports from every surgery you have undergone. You need clear imaging, such as X-rays or CT scans, that confirms your fracture is not healing as expected. These records must show that your medical team is actively pursuing surgical solutions to restore your arm function.

Functional evidence is equally vital. Statements from your doctors describing exactly what you can and cannot do with your arm are essential. If you have had physical therapy, reports detailing your progress or lack thereof help SSA understand the severity of your limitations. An attorney can help you ensure your medical records clearly document your functional capacity.

Many claims are denied because the medical record fails to link your fracture to a long-term functional loss. SSA often denies cases where your injury is expected to heal within a year or where you have not followed through with recommended surgical treatments. If your records do not clearly document why you cannot perform fine or gross motor movements, the agency may conclude that you are capable of returning to work. An attorney can help you avoid these common pitfalls by ensuring your evidence is complete.

A disability attorney helps by ensuring your medical records directly address the specific criteria of Listing 1.23. They can work with your medical providers to obtain detailed functional capacity evaluations that clearly explain your limitations to the SSA. By organizing your evidence and preparing you for potential hearings, an attorney helps you present the most accurate picture of your condition to the decision-makers.