Qualifying for Disability With Rheumatoid Arthritis

Qualifying for Disability With Rheumatoid Arthritis

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Arthritis is the leading cause of disability in America. There are more than 100 different types of arthritis and related conditions, and more than 50 million adults suffer from one form or another. One often-debilitating type of arthritis that affects 1.3 Americans is rheumatoid arthritis, or RA. According to the Arthritis Foundation:

“Rheumatoid arthritis is an autoimmune disease in which the body’s immune system—which normally protects its health by attacking foreign substances like bacteria and viruses-—mistakenly attacks the joints. This creates inflammation that causes the tissue that lines the inside of joints to thicken, resulting in swelling and pain in and around the joints.”

While RA commonly begins in the fingers and toes before working its way into other larger, commonly-used joints such as the hips, shoulders, and knees, it is a systemic disease, meaning it can eventually affect the entire body, including organs such as the heart and lungs, and tissues such as muscles, cartilage, and ligaments. 

RA is most common in women, who are three times more likely to get the disease compared to men. Hormones in both genders may be responsible for its onset or prevention. There are other contributing factors, including heredity, environment, and lifestyle (for example, smoking). RA generally develops between the ages of 30 and 60, but it can strike at any age and has even been seen in very young children. 

There’s no cure for RA yet, though there are many effective treatments that can lower inflammation and pain, prevent joint damage, and slow the progression and damage of the disease. Unfortunately, not everyone will respond to these treatments, and the pain of RA can greatly affect their job. People with RA are more likely to change occupations, reduce work hours, lose their job, retire early, and find themselves unable to find suitable work. Because of this, many people suffering from rheumatoid arthritis will attempt to obtain Social Security disability benefits.

How the SSA Classifies Rheumatoid Arthritis

Simply being diagnosed with rheumatoid arthritis will not qualify you to receive disability benefits from the Social Security Administration (SSA). The SSA needs sufficient documentation and support detailing how your rheumatoid arthritis prevents you from working and performing daily tasks that you otherwise would have been able to do. The SSA’s criteria for rheumatoid arthritis can be found in section 14.09 (“Inflammatory Arthritis”) of their Blue Book, a guide that lists out the various conditions that might prevent someone from working. The listing is quite detailed, however, so below we’ve broken it down into a more simplified version of how you may be considered disabled with RA.

  1. There is persistent inflammation or deformity in one or more weight-bearing joints, making it difficult to walk without assistance (such as a walker).

  2. One or more of your peripheral joints in each of your arms causes you to have difficulty performing movements, such as grasping a pen or holding files.

  3. There is inflammation or deformity in one or more major joints with moderate involvement of two or more organs and at least two RA symptoms are present, such as severe fatigue, fever, malaise, or involuntary weight loss.

  4. Severe ankylosing spondylitis develops (inflammation that, over time, causes some of the small bones in your spine to fuse resulting in a hunched-over stance and chronic pain) 

  5. There are repeated manifestations of inflammatory arthritis, with at least two RA symptoms present, resulting in a limitation of daily activities and social functions, or difficulty completing tasks in a timely manner.

According to the SSA, the administration uses Primer on the Rheumatic Diseases, considered the most prestigious and comprehensive text on arthritis, to make these determinations.

Qualifying for Disability with Rheumatoid Arthritis

Along with meeting the SSA’s medical listing requirements above, to qualify for disability benefits with RA you must be unable to perform your daily work tasks. To make an RA claim, you’ll need to have a detailed medical history of your RA symptoms. Because RA is a progressive disease, it’s helpful for your case if your medical records reflect health deterioration over time. 

You’ll also need to present a physical examination from your rheumatologist. Your doctor should record any symptoms related to your RA and make observations about your ability to ambulate. A blood test may also prove beneficial to your case; while there is no singular blood test to confirm RA, sufferers often have an elevated sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP). Additional blood work can be done to highlight the involvement of the organs, if applicable. Other forms of evidence you can present include x-rays and imaging that shows the progression of your RA.

According to federal regulations, the Social Security Administration determines whether your rheumatoid arthritis disability benefits will continue or end based on how your RA responds to medical treatment. Even if you are still testing positive for rheumatoid arthritis, but—through medical treatment—your swelling and impairment decrease in severity, the SSA may or may not continue awarding your benefits. They would evaluate whether your impairment is still conflicting with your ability to work.

Lastly, if you don’t meet all the technical requirements, you may still be eligible to receive disability benefits for your rheumatoid arthritis. The SSA will assign a “Residual Functional Capacity” (RFC) form for you to complete. This will help them evaluate your capacity to perform work tasks and determine your eligibility for disability benefits.

Need Help? Contact the Disability Experts of Florida

If you’re suffering from rheumatoid arthritis and are applying for SSDI, having a compassionate and experienced disability advocate assist with your application can help ensure you’re awarded your benefits the first time. And, because rheumatoid arthritis is a progressive disease that worsens over time, if you’ve applied before and been denied, you may be eligible now. Either way, we can help by organizing your medical documents, recommending further medical examination, completing federally-required paperwork, presenting your case, and preparing for an appeal if necessary. And, it won’t cost you a thing; we only get paid unless you do.

Contact us today for help in getting the benefits you deserve.

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