Social Security Disability Benefits for Osteoarthritis
If you have been diagnosed with osteoarthritis and the pain and stiffness resulting from the disease make it impossible for you to work, you may be eligible to receive Social Security disability benefits. The gradual loss of cartilage from your joints causes osteoarthritis. Cartilage is a tough tissue located between that joints that provides much needed cushioning. Without cartilage, your bones will rub together causing painful bone spurs and cysts making the condition continue to worsen.
Your “load-bearing” joints, such as your hips, feet, spine, hands, and knees are usually impacted with the disease starting in one joint then spreading to other joints. Osteoarthritis can be a primary or a secondary condition. If it is a secondary condition, you should include the primary condition and its symptoms in your claim to help support your case. Osteoarthritis is diagnosed by ongoing symptoms, x-rays, scans, and even blood tests that show an elevated inflammation rate.
How Your Ability to Work is Impacted
Osteoarthritis is a degenerative joint disease because the condition worsens over time. It can be a very painful condition that limits your functioning and impacts your mobility. Osteoarthritis is a chronic condition that requires ongoing medical care. Because of the severity of some cases, joint replacement surgery is sometimes necessary and you may even have to be hospitalized because of your condition.
Because your weight-bearing joints are affected, you may not be able to stand or sit for long periods without having to reposition. If your back, hips, or knees are involved, you may not be able to lift, bend, or squat repeatedly.
Having your hands, wrists, or elbows involved can also limit your ability to grasp, lift, carry, or reach. As the condition advances and your joints worsen, your mobility can be impacted even more. You may require the assistance of a cane or walker for walking as your condition advances. Pain medications and anti-inflammatory drugs are often prescribed to treat the condition. Pain medication can cause drowsiness or dizziness and the anti-inflammatory drugs can cause gastrointestinal issues.
How Your Ability to Perform Specific Jobs Are Affected
If your back or legs are impacted by osteoarthritis you won’t be able to stand long periods so that will prevent you from working construction, manufacturing, and retail jobs. Pain medications can cause drowsiness and dizziness that will prevent you from working with heavy machinery, driving a commercial vehicle, or being a machine operator.
Osteoarthritis in the knees, hips, or back can keep you from bending, squatting, or lifting items, which keeps you from working in a warehouse facility, maintain employment as a stock associate in a store, or working in a shipping and receiving department.
When your wrists, hands, or elbows are impacted by arthritis, your fingering skills may be impacted and you may find yourself unable to write regularly, use a keyboard, or grasp small items which can keep you from working data entry, office management and recordkeeping, and from doing assembly work in factory settings. As other joints become affected, your limitations may be greatly impacted.
The Disability Application Process
When applying for disability benefits with Osteoarthritis, you will need show you medically qualify. To do so, you will need to meet Blue Book listing. Osteoarthritis can be found under section 1.00, specifically sections 1.02 or 1.04.
Under section 1.02 Major dysfunction of a joint, you must show that you have major dysfunction of a joint that is characterized by anatomical deformity and chronic pain and stiffness with signs of limited motion. You will also need demonstrate that you have one major peripheral weight-bearing joint impacting your ability to walk/move or that you have one major peripheral joint in each upper extremity that causes an inability to perform fine movements.
Under section 1.04 Disorders of the spine, you need to prove your osteoarthritis is resulting in a compromised nerve root or spinal cord with proof that the nerve root compression is character by limitation of motion of the spine, motor loss accompanied with sensory or reflex loss or spinal arachnoidids or a lumbar spinal stenosis.
If you do not meet one of the Blue Book listings, you may be able to qualify using a medical vocational allowance. To do so, a doctor will need to fill out a Residual Function Capacity (RFC) form. This form will cover how osteoarthrosis impacts your work ability. The doctor will explain that based on the symptoms you are experiencing and that because of these you cannot work in the field you have been trained to work in and that there is no other work you can do. Your RFC can be submitted with your application.
The Social Security disability process is complicated and it can take months to be notified if your claim has been approved or denied. Your claim can be denied twice, but appeals can be filed both times. The final step in the process is to request a hearing before an administrative law judge for a ruling on your case. If you are denied at this level, you would have to start the process all over again. The key to a successful claim is providing detailed medical records and thorough documentation about your limitations and restrictions. You need to provide test results that show the diagnosis and the severity of your condition.
Completing an RFC
In some cases, your osteoarthritis diagnosis is not enough to qualify you for disability benefits under the Blue Book guidelines, but you can still qualify for benefits if you can prove that your condition prevents your ability to work. To do that, you should include a residual function capacity form with your application.
The RFC determines the maximum amount of work you are capable of performing based on your condition. If you are deemed able to perform any tasks whatsoever, then you would not be considered disabled and therefore unable to receive disability benefits.
The RFC will examine your ability to perform the physical and mental demands of work. Mental demands include being able to communicate, being able to remember procedures, the ability to follow directions and being able to read. Physical demands include being able to walk, sit, stand, lift and carry items and being able to bend over.
You might not be able to stand for prolonged periods of time, and so if you can work while sitting down then you would not be considered disabled. However, if you are unable to do any of the physical or mental demands of work, whether it is at your current position or in a different position based on your work experience, then you might be eligible to receive benefits.
If You Are Denied
The most important thing to remember if your initial disability benefits application is denied is that there is no need to panic. Roughly 30% of applications are approved on the first pass and that is due to incomplete applications, people who apply and don’t qualify or because information to support a claim is missing. You only have 60 days to file an appeal so you need to act quickly.
The first step is to file a request for reconsideration. With a request for reconsideration you are submitting your application again in hopes that a different Social Security evaluator takes a different view of your claim. You have a chance to include more information in your appeal, so if you can add more medical documentation or if there have been any updates since you initially applied, be sure to include those. Only about 13% of reconsideration requests are approved, so the next step is to move on to a disability hearing.
The disability hearing offers the greatest opportunity of success. At this level, you are able to present your case to an administrative judge who will consider all of the information you present, including witness testimony. This is the first opportunity you have to present your case in person, which allows you to present information about your case that might be specific to your particular situation. The disability hearing has an approval rate of 62%.
The final two options are the Appeals Council, which has an approval rate of only 13%, and taking your case to federal court. Federal court cases enjoy an approval rate of 40%.
The bottom line is that if your claim is denied, then you need to appeal because your chances of being approved increase dramatically in the appeals process. If you need help navigating the appeals process, you can hire a Social Security disability attorney to help ensure that you have all of the necessary information for your case and that you meet your deadlines.
You can start your claim online at www.ssa.gov or by calling 1-800-772-1213. A visit to your local SSA office can start the process in person. Because of the complexity of the claims process, having a disability attorney to represent you can significantly improve your chances of being awarded benefits. An attorney knows what documentation you need to prove your case and help convince Disability Determination Services that you are unable to work.