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Arthritis is a condition that can cause pain and inflammation in the joints. It can make it difficult to move and do everyday activities. For some people, arthritis is such a painful condition that makes it hard to work.
As a law firm with extensive experience in working with clients who deserve benefits from the Social Security Administration (SSA), we can authoritatively state that arthritis is a condition that can qualify you for benefits.
Summary of the Key Findings
- Arthritis is a chronic process that causes pain, stiffness, and inflammation.
- The Social Security Administration recognizes severe arthritis as a disabling condition.
- If you cannot work because of arthritis, you may be able to receive Social Security Disability benefits.
When Is Arthritis a Disability?
Arthritis is a disability when it meets the requirements set out in the Social Security Administration's Blue Book. The Blue Book is a list of conditions that qualify people for Social Security Disability benefits.
The disability requirements vary depending on the type of arthritis you may have.
For degenerative arthritis, you need to meet the medical criteria of chronic joint pain or stiffness; abnormal motion, instability, or immobility; anatomic abnormalities; and physical limitations over 12 months .
The anatomic abnormalities must have medical evidence like x-rays or a physical examination. The physical limitations must lead to the medically documented need for an assistive device like a walker or crutches, or a demonstrated inability to use an upper extremity to do work-related activities.
"Arthritis affects a person's overall function and mobility, which can result in activity and other limitations. It is a leading cause of work disability among US adults." - Centers for Disease Control and Prevention.
For inflammatory arthritis, there are many more ways to qualify for arthritis-related disability benefits. These include :
- Persistent deformity or inflammation of one or more major peripheral joints in a lower extremity and medical documentation of needing an assistive device like cane or wheelchair, or an inability to use one upper extremity for work-related activities; or
- Deformity or inflammation in one or more major joints of an upper or a lower extremity that has also involved at least two body systems, and at least two systemic symptoms like fever or fatigue; or
- Ankylosing spondylitis with fixation of the spine to 45° or more of flexion from the vertical position (zero degrees); or fixation of the spinal cord to 30° or more with two or more organ systems moderately involved; or
- Repeated manifestations of arthritis, with at least two systemic symptoms like malaise or involuntary weight loss and one major dysfunction at the marked level in completing tasks, social functioning, or activities of daily living.
What Is Arthritis?
Arthritis is a disease that causes pain, stiffness, and swelling in the joints. It can affect people of any age, but it is most common in adults over the age of 65.
The SSA recognizes two categories of arthritis: degenerative and inflammatory.
Osteoarthritis is the most prevalent type of degenerative arthritis, and it is caused by wear and tear on the joints. This arthritis increases in severity over time as the joints deteriorate. It is more frequently seen in older adults.
Rheumatoid arthritis is the most frequent type of inflammatory arthritis, and it occurs when the body's immune system harms the tissues of the joints. This form of arthritis can lead to deformities in the joints over time and is characterized by destructive inflammation of the joint lining.
The symptoms of both types of arthritis may include:
- Joint pain
Some people with arthritis only experience mild joint symptoms, while others may have severe symptoms that make it difficult to do everyday activities.
Osteoarthritis has a few more symptoms that can occur, such as bone spurs, bone on bone contact from loss of joint cartilage, and a restricted range of motion.
Inflammatory arthritis can cause fever, weight loss, and fatigue. As the disease progresses, it also can destroy the affected joints, which may cause deformities.
Without treatment, arthritis can lead to disability. The chronic pain and inflammation from the disease can make it difficult to do everyday tasks, such as dressing, bathing, cooking, and cleaning. It also can make it very difficult to perform necessary job functions.
There is no one-size-fits-all approach to treating arthritis. The treatment will depend on the type of arthritis and the severity of symptoms. Some common treatments include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These are medications that help reduce inflammation and discomfort.
- Disease-modifying antirheumatic drugs (DMARDs) – These are medications that can slow the progression of rheumatic arthritis and help prevent joint damage.
- Corticosteroids – These are medications that can help reduce inflammation.
- Physical therapy – Physical therapy can help improve range of motion and strengthen muscles around the affected joints while reducing joint dysfunction.
- Surgery – In some cases, surgery may be necessary to repair or replace damaged joints.
Even when you do not fully meet the Blue Book qualifications for arthritis disability, the SSA will still consider your case. If you have severe symptoms preventing you from working, you may still qualify for Social Security benefits through a medical-vocational allowance.
For the SSA to determine what work you can perform despite your arthritis, you will have to have a residual functional capacity assessment (RFC), which is a free disability evaluation. If the SSA determines you cannot do any type of work that exists in the national economy, then you will be approved for disability benefits.
The RFC requires a detailed analysis of your symptoms, how they affect you, and how they limit your ability to work. The SSA will also consider your education, age, work experience, and any other impairments you have besides arthritis. They will also look at any transferable skills you may have.
You and your physician will fill out a form that explains how your arthritis affects you and what treatments you are currently undergoing. The form is comprehensive and will cover things like how long you can sit, stand, or walk; how often you experience pain; and whether you can use your hands and fingers to push and pull.
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Frequently Asked Questions
What type of arthritis qualifies for disability?
Any type of arthritis can qualify for disability benefits, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout.
How much disability will I get for arthritis?
The average Social Security disability payment is $1,172 per month . Receiving Social Security benefits is based on the strength of your disability claim and how your arthritis limits your ability to perform a substantial gainful activity.
How do they determine how much disability you get?
Your benefits are based on your past income. The higher your earnings before developing arthritis and receiving disability, the higher your benefit amount will be. They adjust the average of your per month earnings for inflation so that benefits paid in the future are of equal value.
How Severe Does Your Arthritis Need to be to Qualify?
If you cannot work because of arthritis, you may be able to receive Social Security Disability benefits. Benefits can be obtained when you meet the requirements listed in the Social Security Administration's Blue Book.
If you do not qualify for benefits, you may want to consider appealing the decision. The appeals process can be complex, but an experienced disability attorney can help you navigate it. To contact one of our expert and independent attorneys, click here.