The Social Security Administration (SSA) considers Rheumatoid Arthritis, or RA, a qualifying disability, but it must be advanced RA to meet the SSA’s eligibility requirements. Proving your condition meets the SSA’s criteria can be challenging. Use the following tips to your advantage when applying for Social Security Disability (SSD) benefits.
Ensure Your Medical History is Lengthy and Detailed
RA is a progressive disease and the SSA needs to see how your illness has worsened over time. They must have a formal diagnosis, including the date of the disease’s onset, in addition to detailed medical records showing you have consistently:
- sought qualified medical care
- followed prescribed treatments.
Detailed medical records are the key to approval for disability benefits and a lengthy medical history ensures the SSA has the proof necessary to evaluate your claim. Details records allow the disability examiners to understand the full extent of your RA symptoms and how your symptoms affect your ability to perform everyday job functions.
Work Closely with Your Rheumatologist to Confirm Work Limitations
Although the SSA has a standard disability listing under which RA is reviewed, they will likely need to see a residual functional capacity (RFC) evaluation from your doctor as well. This report must detail your symptoms and the limitations they place on your everyday abilities.
The opinion of a rheumatologist holds the most weight, though another doctor considered an expert in RA is also appropriate. Work closely with your doctor to accurately reflect your everyday limitations and remember that your doctor works for you.
If your current physician is not willing to work with you in the way you need, find another specialist to provide:
- ongoing treatment,
- the kind of support required when applying for SSD benefits.
Clearly Establish Your Work Limitations through Medical and Work History Records
Some people with RA can continue to work for many years following their diagnosis. Even after workers are unable to perform more strenuous and physical job duties, many can still do sedentary work, at least for a time.
To be approved for SSD, you must ensure your medical records and your work history show you are no longer able to keep a physical or even sedentary job. Be sure to document specific job duties and the symptoms that now prevent you from completing those duties. Use the following to achieve your goal:
- answers in the disability application,
- work records, including performance evaluations and attendance documents,
- statements from former employers,
- and reports completed by your doctor.
What Is An RFC
In some cases, the Social Security Administration will not be able to confirm that your condition qualifies as a disability, but you might still be unable to work. You will need to have your physician fill out a Residual Function Capacity form (RFC) to certify how much work, if any, you are capable of performing given your condition.
The RFC is crucial when it comes to applying for benefits because it is a determination of the maximum amount of work you are capable of performing, and since your doctor is the one who certifies it, the SSA can rely on these findings to make their decision.
The SSA will decide whether your condition would allow you to work in a different job, or perhaps with accommodations, or if work of any kind is out of the question.
Your doctor is your greatest ally when it comes to filling out your RFC form. While your doctor cannot inflate your symptoms, your doctor is able to describe how you are actually doing, which is something that the Blue Book cannot do.
Your doctor has examined you and can see if you struggle to stand up or are unable to grasp pens and pencils, or if you are having adverse reactions to medications that you are taking.
Make sure you talk with your doctor early on about your intention to file for disability benefits so that your doctor can keep notes that will help him or her to fill out the RFC form in a timely manner.
Closest Blue Book Listings for Arthritis
The Social Security Administration relies upon the Disability Evaluation Under Social Security, commonly known as the Blue Book, to help understand how a medical condition impacts the ability to work. The Blue Book is a comprehensive, though not exhaustive, list of medical conditions.
Rheumatoid Arthritis falls under section 1.00 Musculoskeletal System. When completing your application for disability benefits, you will want to include all imaging results used to reach your diagnosis including x-rays, sonograms, MRIs and any other imaging that was done.
This is important because the SSA will not pay to obtain imaging results, and that means you need to provide everything that they will need for their decision.
In addition to the imaging results, be sure to include a complete medical history of your condition, including the diagnosis, test results and treatment plan. Talk with your doctor about your application so that your doctor can help you obtain the information you need to support your claim.
Percentage of People Initially Denied
The Social Security Administration receives tens of thousands of disability benefits applications each year. Surprisingly, 70% of applications are denied the first time around.
This is a huge number, but when you consider the number of people who apply and don’t qualify, how many people submit incomplete applications and how many people do not provide enough medical documentation, then suddenly that number starts to make sense.
When you set out to apply for Social Security disability benefits, it can be an overwhelming task to gather all of the necessary medical documentation and information about your work history. You also have to be sure that the application has been completed properly.
If you don’t have anyone who can help you with the application process, or if you need more help beyond what your friends and family are able to provide, you might consider working with a Social Security disability attorney who is an expert when it comes to filing disability claims.
Disability attorneys understand the process and will make sure your application has everything it needs, and they can help you obtain any additional information that will help to make your claim as strong as possible.
While working with a disability attorney does not guarantee that you will win your case, having an advocate working on your behalf will greatly improve your chances of being approved.
Hire a Lawyer to Assist throughout the Application and Review Processes
Although rheumatoid arthritis is a qualified disability in its advanced stages, you may need help to prove your disabled status to the SSA. If you are unable to precisely meet the listing for Inflammatory Arthritis as it appears in Section 14.09 of the SSA's Blue Book, you will need to qualify for benefits through an RFC analysis instead.
A Social Security lawyer or disability advocate familiar with how the SSA handles RA claims can help you:
- prepare your application,
- collect the necessary evidence for supporting your claim for benefits,
- understand communications you receive from the Social Security Administration.
An attorney can also help in a number of other ways throughout the application and review processes, including handling your appeal, if you are initially denied benefits.