How to Qualify for SSDI Benefits with Arthritis in 2023

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 Insurance (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.

Can You Get Disability for Arthritis?

Yes, you can get disability for arthritis. However, in order for you to get disability for arthritis, your arthritis needs to be so severe that impacts your ability to work full time for at least year.

Additionally, if you can no longer work because of your arthritis, and both your symptoms and medical records back up the listing for arthritis in the Social Security Administration's (SSA) Blue Book, you will be able to get disability for arthritis.

In order for you to get disability for arthritis, you need to meet both the work and and medical requirements for Social Security disability for arthritis. Since SSDI is a program for workers who at one point could work full time, but now are unable to because of a disability, such as arthritis, the SSA requires a set number of work credits to quality for disability.

If you have arthritis and will be out of work for at least 12 months, you may be able to get disability Work credits are calculated by your age and how long you have worked. As of 2023, you earn one work credit for every $1,640 you have earned. The maximum amount of work credits you can earn in a year is four work credits.

When you meet the work credits required for people to potentially get disability for arthritis, the SSA will then look at your disability application, as well as medical evidence you have provided to see if you medically qualify for disability with arthritis.

When you send in your disability application, the SSA will review it and see if it matches the listing that the SSA has for inflammatory arthritis.

The listing for inflammatory arthritis is in section 14.09 of the Blue Book. The Blue Book provides four ways in which inflammatory arthritis qualifies for disability.

If you are able to show the SSA through your application and medical evidence that you can match one of those listings, then you will be able to get disability for arthritis

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 either approve or deny someone for Social Security Disability benefits.

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

Arthritis in the Blue Book

The Blue Book is the list of conditions that qualify for disability. 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 disability due to lack of medical evidence, so having all required tests and documentation is imperative to your claim.

If You Don’t Meet the Blue Book

Can you get disability for arthritis even if you don't meet the Blue Book listing? If your arthritis does not meet the guidelines and/or criteria of 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 as a result of 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.

Considering applying for Social Security disability benefits but not sure how much you’ll earn per month? Our Social Security Disability Calculator can help you determine how much you’ll receive from the SSA before you file for disability.

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.

If you have arthritis and will be out of work for at least 12 months, you may be able to get disability 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 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.

Other SSDI Requirements

Once you establish whether or not 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.

What Are My Chances of Getting Disability with Arthritis?

So, now that we've provided more insights on the question—can you get disability for arthritis—let's talk about your chances of getting disability for arthritis. 

Your chances of getting disability with arthritis vary and are dependent on different factors such as, the medical evidence you provide, prior denials, not working with a doctor and the claimant’s ability to continue working.

Generally, around 63% of disability applications for SSDI are denied on the initial application. However, there are some ways to increase your chances of getting disability with arthritis.

If you have arthritis and will be out of work for at least 12 months, you may be able to get disability One of the most important ways to increase your chances of getting disability for arthritis is by having as much medical evidence as possible to show the SSA that you are unable to work full time because of your arthritis.

Medical evidence goes a long way with the SSA when they are evaluating your claim for disability. Another important way to increase your chances of getting disability with arthritis is to continue to work and follow your treatment advice from your doctor.

If the SSA notices that you are not following your doctor’s recommendations on how to treat your arthritis, they might think that you are still able to work full time and not have your arthritis effect it.

The more evidence that you can provide the SSA that shows that can no longer work anymore because of your arthritis, the better your chances are of getting approved for disability.

 

Find Out If You Qualify For Disability In Minutes

 

2 Minutes To See If You Qualify

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 disability lawyer or disability advocate that takes cases in your area! 

Additional Resources

Add new comment