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Osteoarthritis and Social Security Disability

Osteoarthritis - Condition and Symptoms

Osteoarthritis is a type of arthritis that is characterized by a gradual loss of cartilage in the joints. Cartilage is tough tissue that provides cushioning between the bones that make up the joints. Loss of this protective cushion often results in bone spurs and cysts and allows bones to rub on each other, which is extremely painful. The affected joints are usually “load-bearing” joints located in the knees, hands, hips, feet, and spine, although the condition often starts in a single joint. Osteoarthritis is also known as degenerative joint disease and as “wear and tear” arthritis.

Osteoarthritis is classified as either a primary or secondary condition.

Primary Osteoarthritis is so called because it is the root cause of the symptoms that a person is experiencing. It results primarily from stress on weight-bearing or weakened joints. Primary Osteoarthritis may be aggravated by excessive weight or metabolic irregularities.

Secondary Osteoarthritis, in which the arthritis is itself a symptom of a separate primary condition, generally results from injury to the joint . It can be aggravated by repetitive stressful movement, inflammation from other diseases, such as gout, or poor bone alignment (from bad posture to badly set bones to defects in development).

Osteoarthritis is an entirely different condition than Rheumatoid Arthritis, which is a chronic, inflammatory type of autoimmune disease that attacks not only the joints but also other organs of the body.

In order to diagnose Osteoarthritis, your doctor will perform a physical examination and may order x-rays or other diagnostic imaging. The physical exam will rule out the presence of fever or rash that might indicate another condition. The doctor will touch and move your joints to determine which joints are involved. X-rays may indicate other symptoms, such as cysts, bone spurs, and narrowed joint spaces. An MRI or CT scan will show cartilage damage. Laboratory tests are not used to diagnose this condition, but may be used to rule out other medical problems contributing to your symptoms.

People with Osteoarthritis may experience pain, stiffness, and joint enlargement in their arthritic joints. Osteoarthritis usually attacks one or two joints in the beginning - usually the hip, knees, spine, or hands. While symptoms of pain and stiffness are mild at first, they may progress to the point of being so severe that the person is unable to perform daily tasks. The pain often manifests as a deep ache in the affected joint that tends to get worse as the day wears on. Often the stiffness in the affected joint lessens as the day progresses. In the worst cases, permanent loss of range of motion is possible. In addition, as the cartilage thins, the joint can become unstable. Osteoarthritis can also cause “referred pain”, which is pain that is not felt in the affected joint, but in other areas of the body.

Treatment options include medications to deal with pain (from Tylenol to corticosteroid shots to COX-2 enzyme inhibitors), physical therapy to increase range of motion and keep joint cartilage pliable (such as swimming, walking, yoga, massage, and heat therapy), and occupational therapy to help a person find alternate ways to perform daily tasks that take less of a toll on the joints. In severe cases, surgical treatment to replace a damaged joint or to remove damaged bone from the joint may be recommended. Osteoarthritis can also respond favorably to changes in the diet and to nutritional supplements such as glucosamine and chondroitin sulfate.

While the symptoms of Osteoarthritis can be eased and its progression can be slowed, there is no known permanent cure for this condition.

Filing for Social Security Disability with a Diagnosis of Osteoarthritis

The Social Security Administration (SSA) classifies Osteoarthritis under Section 1.00 - Muskuloskeletal System. Generally speaking, to file for disability benefits under this section, your medical records will have to prove that you meet one or more of the listing requirements below and that your Osteoarthritis and the pain it causes is severe enough to prevent you from working and that it curtails your ability to perform routine daily tasks such as walking and moving about. Your medical records must also show the extent of any treatment you have received and how that treatment affects you.

Section 1.02 of the SSA’s Impairment Listing Manual, or “Blue Book,” addresses joint dysfunction. To qualify for disability benefits under Section 1.02, your affected joint(s) must be characterized by “gross anatomical deformity,” chronic pain, stiffness, and a loss of range of motion. The SSA will ask for imaging that shows joint space narrowing, bony destruction, or ankylosis (stiffness or fusion) of the affected joint(s).

In addition, you must show that one or more of your major weight-bearing joints (hip, knee, or ankle) is affected to the extent that:

  1. You are seriously impaired in your ability to walk independently without the use of an assistive device that limits the functioning of both arms (such as crutches or a walker) and in sustaining a reasonable pace when walking a sufficient distance to be able to carry out your daily activities such as getting to and from work or school.
  2. OR

  3. Your shoulder, elbow, or wrist and hand are impaired to the point that you are unable to effectively perform fine or gross movements such as reaching, pushing, pulling, and fingering (sorting files, preparing meals, etc.).
  4. Section 1.04 addresses disorders of the spine (including the affects of Osteoarthritis) that result in:

    1. The compromise of a nerve root or the spinal cord with evidence of nerve root compression characterized by pain, loss of spinal motion, motor loss, and reflex or sensory loss.
    2. OR

    3. Medically confirmed spinal arachnoiditis (inflammation of the middle layer of membranes covering the brain and spinal cord), with symptoms of severe burning or painful distortion of the sense of touch resulting in the need for changes in position or posture more than once every two hours.
    4. OR

    5. Medically confirmed lumbar spinal stenosis resulting in painful cramps and weakness which impair your ability to walk effectively (as discussed in Section 1.02 above). The SSA considers obesity a factor when considering your residual functional capacity under Section 1.00. Medical records supporting your disability claim should therefore reflect any treatment of your obesity and your response to that treatment.

    Your Osteoarthritis Disability Case

    If you are disabled because of Osteoarthritis that is so severe it prevents you from working, you may be entitled to Social Security Disability (SSDI) benefits. Working closely with medical professionals and a qualified Social Security disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Social Security Administration (SSA) will help to ensure that your Osteoarthritis disability case will have the highest possible chance of success.