Femoroacetabular Impingement (FAI), commonly known as hip impingement, is a hip joint condition where the abnormal shape of the hip bones causes friction and damage within the joint. For many individuals, FAI is a painful chronic condition that profoundly limits daily activities and the ability to work. Whether hip impingement qualifies as a legal disability depends entirely on the severity of the functional limitations it imposes, not the diagnosis alone. This article explores the medical nature of FAI, the specific legal criteria for disability, and the practical steps required to demonstrate that the condition meets the necessary standards for a claim.
Understanding Femoroacetabular Impingement (FAI)
Femoroacetabular Impingement occurs when the ball and socket of the hip joint do not fit together perfectly, causing the bones to rub against each other during motion. This friction can damage the articular cartilage lining the joint and the surrounding labrum, a ring of soft tissue that acts as a seal and cushion for the socket. The condition is categorized into three types based on where the bony overgrowth occurs: cam, pincer, or a combination of both.
Cam impingement involves an extra bone growth on the head of the femur, the “ball,” making it irregularly shaped and unable to rotate smoothly within the socket. Pincer impingement results from an overgrowth of bone on the rim of the acetabulum, the “socket,” which causes the labrum to be pinched during hip movement. The resulting mechanical stress produces common symptoms such as stiffness, a sharp or aching pain primarily located in the groin area, and a limited range of motion.
The pain is often exacerbated by activities involving deep hip flexion, such as prolonged sitting, squatting, or walking long distances. If left unmanaged, the repetitive friction can lead to premature joint deterioration and the development of osteoarthritis. Initial management involves activity modification, physical therapy to strengthen surrounding muscles, and anti-inflammatory medications. If conservative methods fail and pain remains severe, surgical options like arthroscopy may be pursued to reshape the bones and repair damaged tissue.
Establishing the Legal Definition of Disability
A medical diagnosis, even one requiring surgery, does not automatically grant legal disability status; instead, the determination centers on functional capacity. Governmental bodies, such as the Social Security Administration (SSA), define disability based on an inability to engage in Substantial Gainful Activity (SGA) due to a medically determinable physical or mental impairment. The impairment must be expected to result in death or to have lasted, or be expected to last, for a continuous period of at least 12 months.
The SSA uses a five-step process to evaluate a claim, beginning with an assessment of current work activity and the severity of the impairment. At the third step, the SSA checks if the medical condition meets or equals the criteria listed in the official Listing of Impairments, often referred to as the Blue Book. For a musculoskeletal disorder like FAI, the relevant section is 1.00, which includes Listing 1.18 for an abnormality of a major joint in any extremity.
Meeting a specific listing requires objective medical evidence demonstrating an extreme limitation in the ability to initiate, sustain, or complete work-related activities. Most disability claims based on FAI will not precisely meet a Blue Book listing. If the condition does not meet a listing, the SSA evaluates the applicant’s Residual Functional Capacity (RFC). The RFC assessment is a formal review of the most an individual can still do in a work setting despite their limitations, making it the central focus of the claim.
Translating FAI Limitations into a Disability Claim
The success of a disability claim for FAI rests almost entirely on documenting the precise functional restrictions caused by pain and limited joint mobility. This documentation must translate the medical condition into concrete, work-related limitations that preclude all forms of gainful employment. The RFC assessment measures these specific limitations, evaluating abilities such as how long a person can sit, stand, or walk, and how much they can lift or carry.
For FAI, the primary limitations often involve postural and exertional activities. The inability to sustain a reasonable walking pace or stand for extended periods, perhaps due to sharp groin pain, directly affects the capacity for most jobs classified as light or medium duty. Similarly, the pain and stiffness caused by hip flexion, a common FAI symptom, can severely limit the ability to sit comfortably for the required six to eight hours of a typical workday.
Objective medical evidence is paramount to substantiate these limitations. A claimant must provide several types of documentation to demonstrate the severity and persistence of the impairment:
- Imaging studies, such as X-rays or MRIs, to confirm the presence of bony deformities characteristic of cam or pincer impingement.
- Surgical reports from hip arthroscopy or osteoplasty, particularly if the procedure did not result in a full functional recovery.
- Physical therapy notes documenting failed conservative treatment.
- Objective measurements of reduced range of motion.
The strongest evidence is a detailed RFC form completed by the treating physician, who can connect the documented FAI pathology directly to the specific limitations in sitting, standing, bending, and lifting. This medical source statement must clearly articulate that the individual’s pain and physical restrictions prevent them from performing even the least physically demanding jobs, such as sedentary work. Proving that FAI, despite treatment, has resulted in a severe, long-term restriction on the ability to ambulate and maintain a consistent work posture is the mechanism for a successful disability determination.