If You Have Arthritis, Can You Qualify for SSDI Benefits?

Submitted by Shane on Tue, 09/22/2020 - 04:00

If your arthritis is severe enough to prevent you from being able to work and support yourself, you may be wondering if you can qualify for Social Security Disability benefits to help ease the financial burden. You can qualify for Social Security Disability Income (SSDI) with arthritis if you meet the Blue Book listing.

Arthritis can be a very painful and debilitating condition to live with. While the severity of arthritis will vary on a case-by-case basis, many people who suffer from the condition are unable to work because of the pain and limited movement that rheumatoid arthritis can cause.

Anyone who has suffered from the disabling condition understands that arthritis can cause agonizing pain. Some people who suffer from arthritis are unable to get out of bed when the flare-ups are at their worst, let alone manage to make it to work and function on a day-to-day basis.

How the SSA Categorizes Arthritis

The Social Security Administration has a set of criteria that it uses to determine whether or not someone qualifies for Social Security Disability benefits.

These criteria are referred to as "Blue Book Listings" and these Listings are what the Administration uses to approve or deny someone for Social Security Disability benefits.

Arthritis is among the disabilities in the Blue Book Listings that qualify a person for Social Security Disability benefits, but it is important to understand that even if you have been diagnosed with arthritis, you do not automatically qualify for disability.

Arthritis X-ray For Disability Benefits

Arthritis in the Blue Book

You can find the medical requirements for arthritis in the Blue Book under section 14.00 Immune System Disorders. According to listing 14.09 Inflammatory arthritis, you will need to meet the following requirements:

  • Persistent inflammation or deformity of:
    • One or more peripheral weight-bearing joints resulting in the inability to move effectively

OR

    • One or more major peripheral joints in an upper extremity resulting in the inability to preform fine movements

OR

  • Inflammation or deformity of one or more major peripheral joints with:
    • Involvement of two or more organs/body systems with one of the organs/body systems involved in moderate level of severity AND
    • At least two of the constitutional symptoms (fever, malaise, involuntary weight loss, severe fever)

OR

  • Ankylosing spondylitis or other spondyloarthropathies

OR

  • Repeated manifestations of inflammatory arthritis with at least two of the constitutional symptoms (malaise, involuntary weight loss, severe fatigue, fever) and one of the following:
    • Limitation of daily living activities
    • Limitation in maintaining social functions
    • Limitation in completing tasks in a timely manner

It is best to look over the Blue Book with your doctor. If there are any tests or medical evidence you are lacking, your doctor can orchestrate getting these done. Many claims are denied due to lack of medical evidence, so having all required tests and documentation is imperative to your claim.

Arthritis qualifies for SSDI

If You Don’t Meet the Blue Book

If your arthritis does not meet the Blue Book listing, you may still be eligible for disability benefits. You will need to request to a residual functional capacity (RFC) assessment. This assessment will be used to prove that you cannot work in your trained field due to your arthritis.

The RFC form will need to be filled out by a doctor. It will explain your symptoms and how these impact your work ability.  A doctor will outline things like how long you can stand, sit, walk, how much you can push or pull, and any other limitations.  Once completed, you can submit your RFC to support your claim for SSDI.

How to Prove Your Case

When applying for Social Security Disability benefits, you need to understand that the Social Security Administration focuses on one thing. The one focus is how your illness affects your ability to work and produce a substantial income.

If you cannot work and produce an income due to arthritis, then you may very well qualify for Social Security Disability benefits. The challenge, however, is to prove that your arthritis condition does indeed prevent you from working.

The first thing you need to know is the specific type of arthritis you have. If you have rheumatoid arthritis, you will need to prove that you experience persistent pain and swelling and that your joint movement is limited due to the arthritis.

If you are suffering from osteoarthritis, you will need to prove that your arthritis limits your ability to move your arms and hands and that you experience significant problems with standing or walking.

Documenting Your Arthritis

Documenting the arthritis itself is not going to be enough to approve you for Social Security Disability benefits. You will need to have your arthritis documented, and that documentation must reflect that your arthritis has had a direct impact on your ability to work.

Even if you have been going to the doctor for the past five years, complaining of arthritis pain and getting treatment for it, if the records do not indicate that the arthritis is interfering with your ability to work, you will not have sufficient proof that your arthritis qualifies you for Social Security Disability benefits.

If you do not have enough medical documentation to prove your Social Security Disability case, then you may be asked to meet with another doctor for an evaluation. At this point you may be required to undergo x-ray examinations and other laboratory testing to determine the severity of your arthritis.

The results of these tests will all play a part in determining whether or not you qualify for Social Security Disability benefits.

So just how do you prove that your arthritis is severe enough to warrant Social Security Disability benefits? How does the Social Security Administration make their determination?

If you can prove that your arthritis prevents you from sitting for six hours per day, occasionally walking or standing for two hours per day and that you cannot lift ten pounds due to your condition then you will be approved for Social Security Disability benefits.

It is important, however, to sit down with your doctor and discuss how your arthritis is preventing you from working so you can have the documentation you need for a successful Social Security Disability application.

Medical Documents for SSDI

Other SSDI Requirements

Once you establish if your arthritis is eligible for disability benefits, you will need to meet other non-medical requirements. To qualify for SSDI, you will need to have earned enough work credits. Work credits are earned by working and paying into Social Security taxes.

The amount of work credits you need depends on your age. Typically, if you worked 5 of the past 10 years, you will likely have enough work credits to qualify for SSDI.

SSDI Application for Arthritis

Get Help With Your Arthritis Claim

Once you do apply for Social Security Disability benefits, the time it takes for an actual approval will vary. In most cases it will take anywhere from three to five months before you receive a decision as to whether or not you have been approved for Social Security Disability benefits.

If your initial disability application is denied, your first appeal can take three months or more to process. If, at that point, you are still denied Social Security Disability benefits, you can request a hearing. This hearing will take approximately 12 more months to complete.

However, you may want to consider hiring an attorney at this point to help you through this stage of the application process and to protect your interests in your disability claim. Complete the Free Case Evaluation on this page today to get in touch with a lawyer that takes cases in your area! 

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