Arthritis Patients Applying for Social Security Disability

According to the Center for Disease Control, Arthritis is one of the most common causes of disability in the United States. 

 

Before addressing how a person with Arthritis can qualify for Social Security Disability Benefits, it is necessary to explain the nature of this condition.  Arthritis is a disorder affecting the joints and is characterized by inflammation and joint pain. It is most prevalent in the thumbs, fingers, feet, hips, knees, neck, back, and shoulders.  The joints are integral for many body movements, and arthritis can limit range of motion and prevent necessary movements. Arthritis is typically seen in older individuals but can affect children as well.  There are three main types of arthritis: osteoarthritis, rheumatoid arthritis and psoriatic arthritis. About twice as many women are affected by arthritis than men.

Osteoarthritis (OA):  also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes—hereditary, developmental, metabolic, and mechanical—may initiate processes leading to loss of cartilage. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.

Rheumatoid Arthritis (RA):  An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis can also affect your whole body with fevers and fatigue.  Rheumatoid arthritis is much more common in women than in men and generally occurs between the ages of 40 and 60. Treatment focuses on controlling symptoms and preventing joint damage.  Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.  RA can lead to the formation of tissue that can harden and form a bony ankylosis which is a fusion of the joint that prevents any movement of the joint.  Rheumatoid arthritis can be diagnosed by a blood test that reveals a rheumatoid factor (antibodies) in the blood. X-rays are also used to determine if there is swelling of the effected joints.

Psoriatic arthritis: is a form of arthritis that affects some people who have psoriasis — a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.  Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

 

There are two basic ways that a person can qualify for Social Security benefits due to arthritis.   An individual can meet the requirements of a listing set out in Social Security's list of qualifying impairments or show that he or she is unable to work. 
 

The list of impairments is essentially a "Blue Book" used by the Social Security Administration to determine whether an individual meets the Social Security definition of disability. If a person’s condition “meets or equals” the listing, then that person is automatically deemed to be disabled. The listing for rhematoid arthritis and psoriatic arthritis is contained in Section 14.09 of the listing.  The listing refers to these conditions as "inflamatory arthritis".  In other to meet Section 14.09 of the listing, a claimant must prove that he or she has one of the following conditions:

 

RA or psoriatic arthritis present in a joint in the legs, causing significant difficulties in walking.

RA or psoriatic arthritis that affects joints in both arms, preventing a claimant from performing many types of tasks with the arms (involving both large muscle movements and small manipulations).

An inflammation or permanent deformity in one or more major joints, along with moderate involvement of at least two more organs or body systems, causing at least two symptoms out of these four: severe fatigue, fever, malaise, and/or involuntary weight loss.

Ankylosing spondylitis or another spondyloarthropathy, with fixation of your spine of at least 45 degrees.

Ankylosing spondylitis or another spondyloarthropathy with fixation of your spine of at least 30 degrees, along with moderate involvement of at east two or more body systems, or

Repeated flare-ups of RA or psoriatic arthritis with at least two of symptoms (such as fever, extreme fatigue, malaise, or weight loss) that cause limitations in activities of daily living, social functioning, or ability to complete tasks.

In cases of osteoarthritis, a claimant can also seek to prove that his or her condition meets Section 1.02 of the Listing, which is the Section that deals with "Major Disfunctions of the Joints".  In order to meet this Section of the listing a Claimant must have:

Major dysfunction of a joint;

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).

If your condition is severe but not at the same or equal level of severity as a medical condition on the list on Section 14.09 or Section 1.02, then the Social Security Administration must determine if it interferes with your ability to do the work you did previously (during the last 15 years).

If you cannot do the work you did in the past 15 years, the Social Security Administration will see if you are able to adjust to other work. The Social Security Administration will consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.