Social Security has proposed changing to its listings for musculoskeletal disorders. Social Security’s listings are impairments used by Social Security in making disability determinations by judging the severity of impairments. We will be presenting a series on the proposed changes, first looking at the current listing Social Security considers, followed by the proposed new listing. Next up is 1.02, a listing that would be replaced by 1.18.
1.02 Major dysfunction of a joint(s) due to any cause (Current listing)
Characterized by gross anatomical deformity (e.g., subluxation, contracture, bony or fibrous ankylosis, instability) and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s). With:
- Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively, as defined in 1.00B2b;
OR
- Involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively, as defined in 1.00B2c.
1.18 Abnormality of a major joint(s) in any extremity (New listing)
1.18 Abnormality of a major joint(s) in any extremity (see 1.00I), documented by A, B, C, and D:
- Chronic joint pain or stiffness.
AND
- Abnormal motion, instability, or immobility of the affected joint(s).
AND
- Anatomical abnormality of the affected joint(s) noted on:
- Physical examination (for example, subluxation, contracture, bony or fibrous ankylosis); or
- Imaging (for example, joint space narrowing, bony destruction, or ankylosis or arthrodesis of the affected joint).
AND
- Impairment-related physical limitation of musculoskeletal functioning that has
lasted, or can be expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following (see 1.00E):
- A documented medical need for a walker, bilateral canes, or bilateral crutches;
or
- An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements, and a documented medical need for a one-handed assistive device that requires the use of the other upper extremity; or
- An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements.
