Can I Get Social Security Disability If I’m Injured in a Fall?

If I have become disabled as the result of falling can I qualify for Social Security Disability?

Author Attorney Lloyd Bemis:

Summary: Can I get disability benefits if I am suffering from the effects of a fall?

More than 2.8 million injuries treated in emergency departments each year are the result of falls. While some people experience only a small bump or bruise that heals in a short time period, other injuries can be very serious and develop into long-term disabilities.

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The biggest challenge in getting approval for Social Security Disability benefits may be proving that a fall resulted in a disability so severe it is expected to last 12 months or longer and prevent you from working.

Injuries which only last a few months are often covered by short-term disability insurance, but if you cannot work for several months, a loss of income can create financial strain.

If you incur an injury during a fall and are unable to work because of that injury, you may be eligible for Social Security Disability Benefits.

Falls occur in a variety of circumstances at work or at home.

•    You can slip on a wet floor or an icy sidewalk.
•   You can fall from a ladder or off a bike.
•   You may trip on a crack in the sidewalk or on a loose rug.
•   An individual can be pushed over by accident or while playing a sport.

Though falls can be accidental or caused by a moment of inattention, sometimes there is an underlying medical condition responsible or contributing to the circumstance:

•    Medications that cause dizziness or drowsiness
•   Muscle weakness
•   Balance problems
•   Postural hypotension (blood pressure drops when a person gets up too quickly after lying down)

Regardless of how or why a fall happens, you must meet certain basic requirements in order to be eligible for disability benefits.

Social Security Disability Income (SSDI) is available to individuals whose disability will last at least 12 months, or is fatal. If you suffer an injury during a fall but recover before a year is up, you are not eligible for SSDI; your medical condition must prevent you from working at any job for which you are qualified. Additionally, you must not be working in a job and earning income over Substantial Gainful Activity (SGA), ($1550 per month in 2024).

Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits for being injured in a fall. If you have been denied disability don’t give up!

Social Security lists impairments that qualify for disability benefits in its Blue Book. A significant number of disabilities are caused by injuries suffered during falls:

•    Cognitive and physical disabilities due to sudden injuries to the head or spine. This includes skull fractures, concussions, spinal column fractures, spinal cord injuries, and traumatic brain injuries
•   Complex bone fractures
•   Paralysis resulting from spinal cord trauma
•   Sensory disabilities such as blindness or deafness
•   Limb deformation resulting in mobility impairments
•   Psychological trauma

The biggest challenge in getting approval for Social Security Disability benefits may be proving that a fall resulted in a disability so severe it is expected to last 12 months or longer and prevent you from working.

Some impairments, such as a traumatic brain injury, easily qualify, while others are more difficult to determine. For example, if you fall and break your leg, it is likely the fracture will heal in a few months and you will be back to work. In that case, you would not be eligible for SSDI. But if your broken leg becomes infected, or requires one or more surgeries, chances are good that you would qualify. You will need to provide all your medical records including x-rays, MRIs, and results of any other medical tests. You should also provide statements from your medical providers detailing the limitations of your condition and how it impacts your work and your home life. For example, do you need help with daily tasks like dressing, bathing or cooking?

Even if your medical condition does not match an impairment listed in Social Security’s Blue Book, you may still be able to qualify for disability benefits if you can prove that your injury is “medically equivalent” or equal in severity and duration to any of the listed impairments.

You will need to show that you are as disabled as a person who does meet the listing criteria. In order to equal a listing, in addition to submitting all the above medical records and information normally required, your doctor should provide written statements detailing how your disability limits you as much as if you matched the criteria of a Social Security impairment listing. Your doctor’s opinion will carry substantial weight with Social Security, as long as it is backed up by solid medical evidence.

If your medical condition does not match a specific impairment listing, it may be very difficult to prove you are disabled.

A qualified disability attorney who is familiar with all of Social Security’s Blue Book listings can help you determine eligibility. A disability attorney will work with your doctor and gather all the supporting medical evidence necessary to prove your case.

If you have suffered an injury in a fall and are unable to work, you may be eligible for Social Security Disability benefits.

Unum LTD Ruptured Rotator Cuff Claim

A Round Rock Sales Support Analyst for a large computer company suffered a complete rupture of her rotator cuff and other injuries after a fall.She was awarded SSDI and was receiving LTD benefits.
Unum denied benefits after three years. Mr. Roach got her a settlement.

In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

1.   Are you working?   Your disability must be “total”.
2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.

More details can be found on our Qualifying for Disability page.

Author: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court - all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.