Does Arthritis Qualify Me for Disability Benefits?

May 9, 2019 in
Does Arthritis Qualify Me for Disability Benefits? | LaBovick Law Group of West Palm Beach, Florida

Did you know that arthritis affects approximately 54.4 million Americans? That is about 1 in 4 adults in America, with the average age of presentation being between 30 and 50 years of age. Because of its commonality, arthritis is the major cause of workplace disabilities. Someone who has been diagnosed with arthritis typically will struggle with joint pain in various parts of the body. Arthritis is defined as the inflammation of one or more of your joints. The commons symptoms include joint pain and stiffness. Early signs of arthritis may include fatigue, morning stiffness, joint stiffness, pain, swelling, fever, number and tingling, or limited motion.

There are many types of arthritis with the most common types being osteoarthritis and rheumatoid arthritis. Osteoarthritis is concerned the wear and tear arthritis. It occurs when the protective cartilage on the ends of your bones wears down over time. On the other hand, rheumatoid arthritis is an autoimmune disease where the body’s immune system mistakenly attacks the joints.

How Arthritis Is Diagnosed

Arthritis can be diagnosed by your primary care provider, but the typical specialist you would treat with for arthritis is a rheumatologist. A rheumatologist will obtain blood tests and imaging of the affected areas to determine the type and treatment of your pain. No matter the type of arthritis you are diagnosed with, the typical treatment includes pain medications, injections and physical therapy. Medications would typically be nonsteroidal anti-inflammatory drugs that help to reduce pain and inflammation. Some over-the-counter NSAID’s include ibuprofen and Aleve. For more severe conditions, your doctor will likely prescribe an NSAIDs such as meloxicam or Celebrex.

If you suffer from arthritis that is affecting your ability to work, you may be eligible for Social Security Disability benefits. Social Security Disability is a form of insurance that is federally mandated. The federal government governs this benefit through the Social Security Administration. To qualify for this mandatory insurance coverage, an individual must pay taxes from their earnings into the Social security system. Once you have paid a certain amount in taxes you will be eligible to apply for disability benefits. Keep in mind, this benefit is not automatic. Simply because you have paid into the system does not mean you may automatically claim and receive these benefits. To receive these benefits, you must meet Social Security’s definition of disability.

How to Be Found Disabled

To be found disabled, Social Security requires you to show that you suffer from a severe physical and/or mental condition that affects your ability to earn substantial gainful activity for an expected time frame of 12 months or more. Or, if your condition has been noted to be terminal you will be found disabled.

Social Security reviews claims for disability benefits using a five-step sequential evaluation process. This means they evaluate each step in order. The first step is determining if you are currently working. If you are working, earning over substantial gainful activity, you will be automatically ineligible for the program. Substantial gainful activity is the amount an individual earns per month through working income. If the amount you are earning is over approximately $1,100 per month you are not eligible for disability benefits. However, if your working income is less than SGA, or non-existent, you will be able to proceed to step two of the evaluation.

Step 2 considers whether you suffer from a severe physical or mental impairment. The severity threshold is quite low, requiring a showing of more than a minimal impact upon your ability to work. In terms of a stroke, as long as you continue to experience symptoms or limitations you will likely pass this stage as well.

The third step in the analysis considers whether you meet or equal one of social security’s listed impairments. SSA has a list of medical conditions which they have deemed to be so severe as to automatically qualify you for disability benefits. To prove you meet or equal one of the listings you must have medical evidence documenting the condition. Social Security evaluates arthritis under Listing 14.09 for inflammatory arthritis.

The Listing

Social Security Disability Attorneys | RFC Assessment | LaBovick Law GroupThere are four potential ways to meet or equal the Listing for arthritis. The first is suffering from persistent inflammation or persistent deformity of one or more major peripheral weight-bearing joints resulting in the ability to ambulate effectively or one or more major peripheral joints in the upper extremity resulting in the ability to perform fine and gross movements effectively. The second possibility would be to show inflammation or deformity in one or more major peripheral joints with the involvement of two or more organs/body systems with at least one of the organs/body systems involved at least a moderate level of severity. You also need to show at least two constitutional symptoms such as severe fatigue, fever, malaise, or involuntary weight loss. The third way would be to prove a diagnosis of ankylosing spondylitis with fixation of either the cervical or lumbar spine. The fourth and final way you could prove you meet this Listing is to show repeated manifestations of inflammatory arthritis, with at least two of the conditional symptoms and one of the following at marked level: limitation of ADL’s, limitation in maintaining social functioning, or completing tasks in a timely manner.

If you are found to meet a Listing then the analysis would stop at Step 3 and you would be found disabled. Proving you meet one of the above-mentioned scenarios is done through medical evidence including treatment notes, diagnostic testing, and statements from your treating provider. It is uncommon to be found disabled at Step 3. What is more common, is after an analysis of Step 4 and Step 5 to be found disabled. When reviewing Steps 4 and 5, social security will first determine what you are physically and or mentally capable of doing in spite of your conditions. Once they have determined your capabilities, they will evaluate whether you are able to perform your past work. If you are not able to perform your past work, then they will consider whether there is other work you could perform in spite of those limitations. If it is found that your conditions result in limitations that are work preclusive then you will be found disabled.

As you can imagine, there are a significant number of factors to be considered when applying for disability benefits. To pose the best possible application, it is recommended you enlist the assistance of an experienced Social Security attorney. At the LaBovick Law Group, we provide free consultations to determine if this is the right program for you. If you have questions about whether you may qualify, please call us at (561) 623-3681.