How To Qualify for SSDI for a Non-Healing Fracture to an Upper Extremity

How To Qualify for SSDI for a Non-Healing Fracture to an Upper Extremity

Posted by Derek Cervoni on Apr 22, 2021 2:17:14 PM

Over 6 million Americans suffer bone fractures each year, whether through accidental falls or a direct trauma inflicted to the bone area from car accidents or a direct blow.

Usually, broken bones, including broken arms (fractured upper extremities), heal within 6 weeks. 

But what happens if you experience complications in the healing process? 

What happens if you find it difficult to return to your job or you can no longer return to work due to the pain caused by your non-healing fracture?

In this case, you may be eligible for Social Security Disability Insurance (SSDI) to help you get needed financial assistance.

Read on to learn more about non-healing fractures of upper extremities and how to qualify for SSDI benefits.

How Broken Arms Should Heal

When you break your arm – meaning you fracture one of the 3 bones in your arm: the humerus, radius, or ulna – there are 3 things needed for your bone to heal properly. These 3 things are common with every comprehensive bone fracture treatment.

  • Good blood supply after the injury
  • Adequate stabilization
  • Sufficient new tissue formation

You might need surgery to initially repair the fracture and, afterward, your doctor may ‘set’ your arm in a cast and/or recommend the use of a splint, sling, or brace. You’ll receive a list of recommendations from your doctor to help move the healing process along. And usually, your broken bone will heal completely in about 6 weeks.

Sometimes, though, broken bones – and commonly, fractures of upper extremities – have trouble healing. You might develop what’s called a ‘delayed union,’ ‘malunion, or ‘nonunion,’ all terms that refer to a complex or non-healing fracture of the humerus, radius, or ulna bones.

Symptoms of a Non-Healing Complex Arm Fracture

According to a recent study, as many as 20% of bone fractures turn into delayed union, malunion, or nonunion fractures. And it’s hard to pinpoint the exact causes of the inability of your bone to heal. The most common symptoms of this condition include:

  • Feeling pain at the site of the break long after it has been set
  • A visible gap with no bone fusion at the fracture site, as evidenced in medical imaging
  • No progress shown in bone healing after repeated imaging at regular intervals

Treatments for a Non-Healing Complex Arm Fracture

It’s important to work closely with your doctor to evaluate all of your options for treatment of your non-healing fracture. There are numerous treatments available and you may need a combination of therapies in order to heal your bone and stop your ongoing pain.

Treatments to heal complex non-healing fractures (for upper extremities and others) include:

  • Surgery to remove any infection, stabilize the fracture, and stimulate bone growth with the use of a bone graft
  • Surgery that may involve internal or external fixation treatment. This may consist of metal plates, rods, screws or an external fixation device to further stabilize the bone
  • Nonsurgical treatment, in which a bone stimulator device that is used daily with ultrasonic or electromagnetic waves to promote healthy healing

Requirements for Qualifying for SSDI with an Upper Extremity Fracture

If in the course of your complex non-healing fracture treatment, you experience complications that may prevent you from working as you normally would, you may be eligible for SSDI assistance.

The Social Security Administration ‘Blue Book’ defines the requirements for evaluation and qualification for SSDI when you have a non-healing fracture of an upper extremity. According to the SSA Blue Book, the SSA will examine your medical records to evaluate your disability according to the following.

1.23 Non-healing or complex fracture of an upper extremity (see 1.00N), documented by A and B:

A. Nonunion or complex fracture, of the shaft of the humerus, radius, or ulna, under continuing surgical management see 1.00ksO1) directed toward restoration of functional use of the extremity.


B. Medical documentation of an inability to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 1.00E4) that has lasted, or is expected to last, for a continuous period of at least 12 months.

Contact Me for Help in Your Case

The SSA evaluates many more factors when examining whether or not your bone fracture case qualifies you for SSDI - from your ongoing treatment results to your doctor’s prognosis. If you have questions about your eligibility, need assistance with your SSDI application, or have received a denial, I can help you. Reach out to me at 703.241.2625 or contact me for help with your case and in getting the SSDI benefits you need.