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Question: I am 55 years old and was a money counter in a casino for years. Last year I finally had to stop working due to such severe Duyptren's contracture in both my hands that I am no longer able to open my hands to count money. My doctor is considering amputation of my ring and pinky finger on my right dominate hand. Can I get disability?

Answer: According to the Mayoc Clinic, Dupuytren's contracture is a hand deformity that usually develops over years. The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin - eventually creating a thick cord that can pull one or more fingers into a bent position.

The affected fingers can't be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.

Dupuytren's contracture mainly affects the two fingers farthest from the thumb, and occurs most often in older men of Northern European descent.

Dupuytren's contracture can make it difficult to perform certain functions using your hand. Since the thumb and index finger aren't usually affected, many people don't have much inconvenience or disability with fine motor activities such as writing. But as Dupuytren's contracture progresses, it can limit your ability to fully open your hand, grasp large objects or to get your hand into narrow places.

If you cannot be treated effectively for Duyputren's contracture, your ability to use your hands may be affected to the point that you can no longer use them to perform certain hand-related tasks. This could count as a severe non-exertional impairment.

While Social Security might agree this non-exertional limitation prevents you from doing your old job, you still have to prove you can't do any other work either in order to win your claim. Social Security will try to bring up many examples of jobs that don't require fine digital manipulation of both hands that it will say you can do.

This is how Social Security works: A person age 51 filed for disability due to Duyputren's contracture in his dominant hand. Surgery was not successful, and his ring and pinky fingers remained curled to his palm. His past job had been as a house painter, but the condition prevented him from doing his job because he could no longer move his hands to hold paint brushes. Because of his age, SSA determined that there were other simple sit-down jobs he could do, such as working as a storage facility rental clerk. The claimant was denied benefits.

A person aged 56 filed for disability because of severe Duyputren's contracture in both hands. His condition could not be treated and, as a result, the middle, ring, and pinky fingers of both hands curled tightly into his palm. His past work had been in construction, which Social Security determined he could no longer do. Social Security did decide, however, that he had the capacity to do at least light work. However, because he could no longer use his hands to effectively grasp, turn, or otherwise manipulate any large or small objects he was prevented him from doing not only his old job, but any other work.

So, the not so short answer, is it really depends on what kind of work you have done in the last 15 years, your age and your capacity to do other work as it is performed in the national economy. The most likely outcome for you is the example for the person aged 56.

An Accredited Disability Representative with more than 20 years experience, Diana Wade believes her clientele can be comfortable knowing that she is recognized by SSA and is a charter member of NADR. To contact Ms. Wade call (661) 821-0494, email dianapwade@att.net or visit http://www.CaliforniaDisability.net.