Avascular necrosis (AVN), or osteonecrosis, is a condition where bone tissue dies due to inadequate blood supply, leading to bone collapse and joint destruction. This disease most frequently affects the ends of long bones, particularly the femoral head in the hip, but also the knees, shoulders, and ankles. The pain, stiffness, and loss of motion associated with AVN can make maintaining gainful employment difficult or impossible. Qualification for disability benefits depends entirely on the severity of the condition’s impact on a person’s physical functions.
Medical Definition and Progression of Avascular Necrosis
Avascular necrosis (AVN) begins when blood flow to a segment of bone is disrupted, causing bone cells to die. This interruption can be caused by trauma, long-term use of corticosteroids, excessive alcohol consumption, or underlying medical conditions like sickle cell anemia. Without the ability to repair and regenerate, the weakened bone structure develops tiny internal fractures.
These microfractures eventually cause the bone to collapse, severely damaging the smooth cartilage surface of the adjacent joint. This process leads to chronic pain, limited range of motion, and secondary osteoarthritis. If AVN affects a weight-bearing joint like the hip, the resulting pain and instability can cause a noticeable limp and make walking difficult. The progression often necessitates surgical interventions, such as core decompression or, in advanced stages, a total joint replacement.
Criteria for Official Disability Recognition
A diagnosis of avascular necrosis alone does not guarantee disability recognition; the condition must meet specific thresholds of severity. Disability criteria are often structured around the loss of function within the musculoskeletal system. For the most straightforward path to approval, the condition must meet the criteria of a pre-defined medical listing.
Avascular necrosis is usually evaluated under listings for major dysfunction of a joint or fractures that do not heal. For a weight-bearing joint like the hip or knee, the criteria require gross anatomical deformity—such as bony destruction visible on imaging—combined with chronic pain and stiffness. The condition must also result in the inability to “ambulate effectively.”
The inability to ambulate effectively is defined as the inability to walk without an assistive device requiring the use of both hands, such as a walker or crutches. If AVN affects both shoulders, the criteria shifts to the inability to perform fine and gross movements effectively with both upper extremities. If the condition meets these specific functional and medical requirements, it is considered disabling.
Documenting Functional Limitations for Approval
Many individuals with avascular necrosis may not meet the strict, objective criteria of the medical listings, yet their condition still prevents them from working. In these cases, the decision relies on an assessment of the individual’s Residual Functional Capacity (RFC). The RFC determines the maximum amount of work-related physical and mental activity a person can still perform despite their medical impairments.
The applicant must provide thorough documentation detailing all functional restrictions, including how long they can sit, stand, walk, or lift. Medical records must include diagnostic scans like MRI or CT, and detailed notes from the treating physician. These notes should describe the severity and frequency of symptoms, the effects of pain, and how the condition limits daily activities.
The physician’s opinion on the patient’s limitations is particularly important in establishing the Residual Functional Capacity (RFC). This documentation helps demonstrate that AVN prevents the individual from performing any past work or any other substantial gainful activity. The overall impact of the condition, substantiated by medical evidence and physician statements, must establish that the impairment is expected to last for at least 12 months.