Applying for Disability Benefits with Arthritis

June 22, 2020

This blog is a guest post provided by Cendy Moliere of Disability Benefits Help.

According to the Arthritis Foundation, over 53 million Americans are affected by some form of arthritis. While arthritis is more common in older individuals, arthritis can afflict anyone at any time, causing crippling levels of pain, swelling, impaired mobility, and other disabling effects. At present, it is the leading cause of disability in the United States.

If you have a form of arthritis with especially severe symptoms, the time may arrive when you are no longer able to maintain a full-time job. If that happens, you may be able to qualify for Social Security disability benefits, which will provide monthly financial support for you and your family as well as make it possible to obtain the medical treatment and support you need.

Medical Eligibility with Arthritis

All government-funded long-term disability benefits are offered through the Social Security Administration, or SSA. When you apply for disability benefits, the SSA reviews its medical guide known as the Blue Book, which is its official catalog of disabilities and the medical criteria needed to qualify for each one. Because there is more than one type of arthritis, the Blue Book contains more than one listing for the condition.

Autoimmune-related joint conditions such as psoriatic and rheumatoid arthritis are covered under listing 14.09, Inflammatory arthritis. These conditions occur when your immune system attacks the lining of your joints, eventually injuring your cartilage and bones. To meet this listing, you must experience joint deformity or persistent inflammation in:

  • A weight-bearing joint in your hip, knee, or ankle and at least one peripheral joint such as your shoulder, elbow, or wrist OR
  • One or more peripheral joints and problems with at least two body systems or organs, causing a minimum of two ongoing symptoms such as fever and weight loss OR
  • Your “dorsolumbar” (lower back) or cervical spine, making bending impossible

You will also medically qualify for disability benefits with inflammatory arthritis if you have two of the common symptoms of the condition (fatigue, fever, weight loss), and at least one of the following:

  • Severe limitations of activities of daily living, which include dressing yourself, preparing food, or traveling
  • Severe limitations in your ability to maintain social functioning
  • A severe limitation in your ability to complete tasks in a “timely manner,” due to the pain associated with your arthritis.

Other forms of arthritis are typically covered under listings that pertain to the body part being affected by the disease. Osteo and facet arthritis, for example, appear in Listing 1.04 Disorders of the spine, requiring that you experience the following to be approved for benefits:

  • Compression or entrapment of the nerve roots, causing difficulty moving your hands or legs
  • A narrowing of the spinal canal, causing weakness, pain, and impaired mobility OR
  • Inflammation of the spinal cord connective tissues, making it impossible for you to be in a single position for more than two hours

You can also qualify if you are unable to walk or move properly due to arthritis in your hip, knee, or ankle, or your shoulder, wrist, or hand are so afflicted by arthritis that you can’t perform routine tasks, such as writing, typing, getting dressed, or other dexterous movements

The entire Blue Book is online at the SSA’s website, so you may review the appropriate listing beforehand to see if you might qualify.

Receiving Benefits Without Meeting a Listing

If you do not meet a listing but arthritis symptoms leave you unable to maintain gainful employment, don’t give up! You may qualify for a medical vocational allowance, which is intended to support genuinely disabled applicants who did not meet a condition listed in the Blue Book. To determine your eligibility, the SSA looks at factors such as:

  • Functional capacity (how much your arthritis prevents you from working)
  • Employment history (if you’ve historically done physically challenging jobs)
  • Age (Applicants 50+ have an easier time qualifying, as the SSA believes they’ll have a tougher time getting retrained for a new job)

When applying via a medical vocational allowance, you should ask your physician to fill out a residual functional capacity (RFC) evaluation, which is a standard SSA form that details the various ways that arthritis makes it challenging for you to work at a job you are trained and qualified for. You can download an RFC for your physician online.

Applying for Disability Benefits

The easiest way to apply is online on the SSA’s website. You will not need to physically send in any of your medical records, but it will be important to note where the SSA can gather the following data:

  • Mobility evaluations
  • Blood work that documents evidence of inflammatory arthritis
  • Imaging results such as X-rays, CAT scans, PET scans, or MRIs
  • Other lab work that confirms inflammatory arthritis symptoms, such as gout

If you’d prefer, you can apply in person at your local SSA office: simply call 1-800-772-1213 to schedule an appointment. Arthritis can present challenges in your ability to keep a job, but Social Security disability benefits could enable access to the treatments you need while providing for your financial needs and those of your family.