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How Severe Does my Arthritis Need to be to Qualify?

How severe does my arthritis have to be to get disability benefits?

Social Security disability insurance (SSDI) currently benefits millions of Americans and their families. However, many people who could benefit from the program are either unsure that they qualify or are intimidated by the process.

To see if your arthritis could qualify for SSDI, we must first understand how disabilities are evaluated

The “Blue Book”

Every application for SSDI is reviewed during the Disability Determination Process, or DDS. During this process, a reviewer will look over your case and see if it fulfills the requirements for benefits laid out in the Social Security Blue Book. The Blue Book, which can be viewed online, contains a list of all disabilities (and their severities) that qualify for Social Security.

For example: if you are looking to see if your inflammatory arthritis qualifies for benefits, you would see section 14.00 - “Immune System Disorders”. Under this section is outlined four different qualifications for inflammatory arthritis to receive benefits. Either

  • There is persistent inflammation or deformity of your major joints,
  • There is inflammation or deformity of your joints along with organ systems,
  • There is an inflammation or deformity of the spine and/or its surrounding organs, or
  • There are repeated manifestations of inflammatory arthritis which limit your movement, social functioning, and daily life.

Overall, the Social Security Administration (SSA) is more likely to qualify you for benefits the more severe your impairment is. If your arthritis is consistent, untreatable, severely debilitating, and/or prevents you from earning a living for more than one year, then the chances you will receive benefits are high.

If you do not meet the standards outlined in the Blue Book, however, there may still be an option.

Medical Vocational Allowances

A sizable portion of people receiving SSDI do not have a Blue Book-verified impairment. This is due to medical vocational allowances. These are awarded when the SSA determines that your disease is not listed in the Blue Book, but is severe enough to require benefits anyway. If your type of arthritis is either unlisted in the book or is questionably severe, you may still qualify for social security through a medical vocational allowance.

To qualify, you must prove in your application that your arthritis is severe and debilitating enough to keep you from leading a normal life. This means including evidence of every aspect of your impairment, from doctor’s notes to medical bills to tests, lab results, and surgery reports. You can even have your doctor fill out an RFC form, which is an official medical assessment that demonstrates your ability to function with your impairment (these can be downloaded online for free).

Seeking Additional Advice

If you are considering applying for Social Security benefits, you should first consult with your primary care doctor. Not only can they provide copies of the paperwork necessary to apply, but their understanding of your medical history can help inform your decision.

You should also strongly consider speaking with a Social Security disability attorney. Their legal knowledge can help present your case as favorably as possible when applying for Social Security benefits, which is especially useful when your chances of qualifying are unsure.

For more information, you can review the Blue Book and application requirements on the SSA’s website.

Comments

I am 62 years old and currently receiving LTD from an employer sponsored policy. They have required me to apply for SSDI even though I have not been determined to be permanently disabled. I had lung cancer and have had my right lung removed. If I am determined to be permanently disabled they will offset my SSDI. My question is that I am also a widow of 20 years who had never remarried. I am thinking about applying for my widows benefits since I don't know if I'll be around long enough to collect it at age 66. If I take my widows benefit now can they offset that income now and also if I do receive SSDI? Thank you.

yes, I don't see anything on the parttme work. so if ithis is the way to do it can someone help?