Getting approved for disability benefits due to arthritis can be challenging. But, if you can show that your condition prevents you from doing any type of work, then your chances of receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) increases.
Arthritis is a general term that refers to joint pain and inflammation, which can have a wide range of causes. Generally, arthritis sufferers experience stiffness in the joints, pain while moving, and swelling around affected areas. There are over 100 types of arthritis, and they vary in symptoms and severity. According to the Centers for Disease Control and Prevention (CDC), approximately 54 million American adults have some form of arthritis.
While the cause of some forms of arthritis is unknown, others are the result of age-related wear-and-tear or an infection or injury. Osteoarthritis, for example, is typically caused by aging; whereas rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by swelling and deformity of the joints, and gout is usually caused by too much uric acid in the blood.
The effects of arthritis can be extremely debilitating, affecting the joints and mobility; but certain lifestyle changes—such as regular exercise and losing excess weight—can help alleviate symptoms. Controversially, many people believe that alternative therapies such as acupuncture and medications can also provide relief from chronic pain.
Managing symptoms is key to trying to improve quality of life with arthritis; however, understanding eligibility criteria for disability benefits is also critical to relief from financial hardship due to limited ability to work or pursue daily activities. The following section will discuss information on determining eligibility for disability benefits for those living with arthritis.
- According to the Centers for Disease Control and Prevention, over 54 million adults in the United States have some form of arthritis.
- In 2010, 1 in 5 disability applications were related to arthritis, making it one of the most common reasons for Social Security disability applications.
- A study published in 2019 found that up to 64.2% of individuals who apply for Social Security Disability benefits because of arthritis are approved.
Determining Eligibility for Disability Benefits
When an individual is contemplating how to increase their chances of receiving disability benefits for arthritis, it is important to begin by understanding the eligibility requirements for such benefits. Generally speaking, individuals can receive disability benefits for arthritis if they are unable to engage in substantial gainful activity (SGA) due to their arthritis. To determine whether a person is unable to engage in SGA, the Social Security Administration (SSA) considers multiple factors. These include medical evidence from doctors, statements from family and friends concerning the person’s symptoms, work history, educational background, age, and any other relevant information used to demonstrate impairments caused by arthritis.
The SSA typically looks at such various factors because they are interested in understanding how significantly the condition affects your everyday life. Depending on the circumstances, there are both pros and cons when evaluating SGA as an eligibility requirement. On one hand, expecting proof of SGA as an eligibility criterion allows the SSA filtration system to deny those who are more likely able to do some form of work regardless of their condition. On the other hand, though, this can put unnecessary strain on individuals whose chronic joint pain renders them incapable of regular SGA despite their best efforts.
Therefore, it is important to understand how to effectively prove or disprove the notion that arthritic symptoms prevent you from engaging in regular work activities. Ultimately this step can be a gateway for applicants if completed satisfactorily due to its status as one of the main criteria for eligibility for disability benefits for arthritis.
Now that we have discussed determining eligibility for disability benefits for arthritis, let’s move onto examining how the severity of your arthritis can impact the amount of disability benefits you can receive if you can demonstrate you meet all other criteria required.
Determining the Severity of Your Arthritis
When determining the severity of your arthritis, it is important to remember that Social Security looks at both functional and medical factors when deciding whether or not to approve a disability claim. Functional impairments can include things like difficulty completing everyday tasks, such as preparing meals, bathing, cleaning, and carrying out simple errands. Whereas medical factors to consider include the type of arthritis, current limitations caused by arthritis, and any treatment options that may have been unsuccessful in alleviating the condition.
In regard to specific types of arthritis, rheumatoid arthritis (RA) is considered one of the more severe conditions. People with RA may be eligible for disability benefits if they experience a certain level of joint destruction as indicated by three or more radiographic assessments of damaged joints within a 12 month period. However, those with less extreme cases may still qualify if they can prove a sufficient level of functional impairment.
Osteoarthritis (OA) often does not present enough evidence to support a disability claim due to its nature as a degenerative condition. OA progresses slowly over time and normally does not cause the same degree of functional impairment often seen with RA. OA sufferers may potentially qualify for disability benefits if they experience chronic pain related to their condition despite receiving treatment. Furthermore, they must prove an inability due to OA to engage in any physical activity that requires bending and repetitive motion.
It is also worthwhile to consider consulting with an attorney that specializes in Social Security Disability cases prior to filing an application as they can provide insight into understanding policies and provide relevant documentation needed during the application process. Additionally, legal representation can increase your chances of achieving success when filing your claim.
As the severity of your arthritis will determine your eligibility for Social Security Disability benefits, it is important to understand all applicable factors associated with your current condition before making a decision about filing for disability. Now that you have an understanding of determining the severity of your arthritis, let’s move on to fulfilling Social Security’s requirements for qualification in our next section.
Fulfilling the Social Security’s Requirements
When seeking disability for arthritis, it is important to understand the rules and requirements mandated by the Social Security Administration (SSA) for disability benefits. To qualify for Social Security Disability (SSD) or Supplemental Security Income (SSI), applicants must meet certain criteria. These criteria include demonstrating that they have a long-term, debilitating condition that is expected to last at least 12 months, or could result in death. Also, the applicant must be able to demonstrate that he or she is not able to perform substantial gainful activity (SGA) because of their condition.
In addition to providing evidence of disability, applicants need to provide sufficient proof that they can no longer engage in their previous type of work, often referred to as “past relevant work”. This includes jobs they were recently engaged in as well as positions they may have held at any time during the past 15 years. A person’s age and educational background will also be considered when determining eligibility for benefits.
Some people argue that these requirements are too strict, resulting in many deserving people who cannot obtain the benefits they need. However, other people support the stricter eligibility requirements as an essential way for the SSA to save money and reduce fraud.
Regardless of individual opinions on the matter, it is clear that fulfilling the Social Security’s requirements for proving one’s level of disability is an important step for anyone looking to increase their chance of being awarded disability benefits due to arthritis. By understanding and adhering to these rules, an applicant has a better chance of securing assistance when needed most.
The next section will discuss The Disability Evaluation Procedure – how applicants can use physical and mental evaluations as evidence of their disability and how this process works in practice.
The Disability Evaluation Procedure
The Disability Evaluation Procedure begins after your application is filed and reviewed. During this time, your individual case is assessed based on the severity of your arthritis and evidence from a medical examination. If you’re applying for disability insurance due to arthritis, it’s important to understand all aspects of the evaluation procedure.
First, the Social Security Administration will review your work history and determine if you meet all requirements for Social Security benefits. This means, at minimum, you have worked during five out of the last ten years while paying into social security. If you meet these criteria, then your eligibility for service-related benefits may be considered.
Next, claims examiners will review the medical evidence you submit with your application such as doctor reports, medical records and X-ray or pathology images. Your medical professional must provide definitive proof that your condition was caused by an event in which you performed under military service. The reason disability can’t be awarded without sufficient proof is because any physical injury or illness resulting from service is already covered by veterans’ compensation benefits. If it isn’t clear how your condition relates to military service, you may not receive your benefits.
If you meet these requirements then the Social Security Administration will evaluate each case individually to accurately rate its severity and the level of disability granted to each applicant. Each applicant’s situation is unique so it’s important for those applying for disability due to arthritis to continue gathering evidence throughout their evaluation period and keep in constant contact with the Social Security Assignee throughout the process. This can be difficult if travel is required or if application processing takes a long time but it’s important to stay organized during the process so that all claims are substantiated and processed quickly and correctly.
Based on these criteria, certain applicants may face an uphill battle when trying to get approved for disability due to arthritis while others may have an easier time being accepted for their claim. With enough evidence, understanding of the process and attention paid to individual details there are high chances of success for getting approved for disability through Social Security.
Leading into the next section about: “Submitting the Medical Evidence”. No matter what type of evidence you submit when filing a claim for disability due to arthritis, it must be complete and comprehensive in order to be successful in having the claim accepted by Social Security. In the following section we’ll discuss how to best go about submitting medical evidence in support of a claim for disability due to arthritis.
Submitting the Medical Evidence
When applying for disability due to arthritis, medical evidence is essential. Because it’s necessary to prove your diagnosis and to document the severity of the illness, your medical paper trail has to be complete and thorough. If you can present evidence that shows how your arthritis affects your ability to work over a period of time, then your chances of getting disability will increase.
To best support your claim, make sure you submit all relevant medical documents from doctors, hospitals and other healthcare professionals that provide an accurate record of your case history. This should include copies of lab results such as X-rays, MRIs and blood tests that were done when testing for your arthritis. If possible, also include any documentation related to therapies or treatments you have undertaken for your condition such as physio therapy or occupational therapy. Finally, make sure you submit statements from treating medical professionals that explain in detail how long the treatments are expected to take and the level of disability they expect due to the arthritis.
It is important not to leave out any parts of this medical record. It’s also important not to inflame symptoms by exaggerating them in order too make yourself look worse than you actually are. A doctor may be able to identify inconsistencies; some symptoms have specific tests used to diagnose them accurately, so it’s important that all information presented is accurate and truthful. On top of that, providing details on activities like hobbies or sports can help illustrate impairment from your arthritis so don’t overlook these activities either.
To ensure a successful application for disability due to arthritis, make sure you submit comprehensive medical evidence of all types, presenting an accurate account of treatment and diagnosis throughout its progression over time. Your next step should now be towards completing the Clinical Evaluation.
Completing the Clinical Evaluation
Completing the clinical evaluation is an important step in increasing your chances of getting disability for arthritis. A medical professional must review and evaluate your medical records to certify you are eligible. The most common clinical professionals to be used are rheumatologists, endocrinologists, neurologists, specialists in internal medicine, orthopedists, psychotherapists or general practitioners.
When submitting an application for disability from the Social Security Administration (SSA), it’s important your doctor provide a single detailed statement that outlines how and why your arthritis affects your activities of daily living versus providing multiple documents with conflicting information about the diagnosis and level of severity. To help make sure your application is accurate and complete, it’s recommended you discuss strategies with your doctor on how to increase clarity in the report.
It’s also important to note that while the SSA reviews applications across all states, some states have different criteria and guidelines than others. This means if you apply through a state program, the medical requirements and amount of proof required may vary drastically. For example, some states use an equation called the “Beck Disability Score” to review applications while others require MRI or X-ray evidence to confirm a diagnosis.
As with any medical situation it can be difficult to know what information is necessary when completing an application for disability related to arthritis. Therefore it’s best to consult with doctors experienced in this process as well as local disability organizations that may offer guidance on paperwork completion specifically for the jurisdiction you are applying in.
After completing the clinical evaluation, now comes the approval process where the SSA will determine whether you receive benefits or not.
The Approval Process
The process of receiving disability benefits starts by submitting your application to either Social Security or the Veterans’ Administration (VA), depending on which agency covers you. Once the agency has received your application, it will be reviewed and approved or denied in accordance with the eligibility requirements. Generally, in order to receive disability benefits for arthritis, you must be able to provide consistent medical evidence that shows that your condition is severe enough to interfere with your ability to work and hold gainful employment.
There are two distinct stages to the approval process: administrative review and judicial review. The first stage of administrative review is handled by a Disability Determination Services (DDS) team, which will use a five-step evaluation process to make a final decision about whether or not to approve the claim. The DDS team will review available medical records, assess the claimant’s residual functional capacity (RFC), examine vocational background, and take into account state and federal regulations surrounding disability tax credits related to arthritic conditions. If the DDS team determines that all requirements have been met, they can choose to approve the claim on their own accord.
In some cases, however, it may be necessary for a claimant to go through a second stage of judicial review. This is most likely when the initial claim is rejected because of insufficient evidence or lack of proper documentation. If this happens, a claimant may appeal their case before an administrative law judge at a hearing before the Social Security Appeals Council. During this hearing, both sides will present evidence and make arguments for or against the claim being awarded benefits. Ultimately, it will be up to the Appeals Council to decide whether or not to grant benefits based on the evidence presented.
If approved at any point during these two stages of review, applicants should receive notification and start receiving payments within 6 months of submitting their initial application. It is important to note that each case is unique, so some may have a faster resolution while others may take more time.
Getting rejected can be a difficult outcome but there are steps you can take if you wish to appeal your case. In the next section we’ll discuss what you can do if you find yourself getting denied disability benefits for arthritis.
If you find yourself rejected for disability for your arthritis, don’t give up. There are several steps you can take to help increase the chances of getting approved.
First, you will need to appeal the decision. You can do this by asking for a reconsideration of your initial application. This gives you a chance to address any issues that may have caused your first claim to be denied. Some things to consider are making sure all the correct documents were filed and that all information was completed correctly. Additionally, providing further or updated medical evidence may help prove your case, as it can highlight how severe the arthritis is and explain why it affects your daily life.
Another option is to request a hearing with an Administrative Law Judge (ALJ). During this hearing, you can explain the medical evidence and how the condition limits your activities, if applicable. It’s also important to bring witnesses at this stage too if possible, such as family members or doctors who are familiar with how the arthritis affects you day-to-day. Having emotional support from those who understand your situation can also be beneficial in showing just how much pain and hardship living with arthritis brings into your life.
On the other hand, it’s valuable to keep in mind that only a small percentage of rejections are overturned on appeal and during ALJ hearings. Furthermore, appeals can take months or even years to be resolved – so understand that there may not be an immediate result when appealing for disability benefits for arthritis.
CONCLUSION: No matter what the outcome of your claim for disability benefits due to arthritis is, it’s important to stay positive and keep trying until you achieve the desired result. This article has highlighted ways in which you can increase your chances of being approved for disability benefits due to arthritis and steps to take if your application is initially rejected. In conclusion, we’ll discuss strategies for managing these situations in the following section.
When considering applying for disability due to arthritis, it is important to understand the application process, including what types of medical evidence and documentation is needed. With the right degree of preparation and understanding, applicants can increase their chances of receiving disability benefits.
Those interested in seeking disability benefits should ensure they have secured an experienced disability attorney before beginning the application process. This will help to ensure no detail is missed throughout the process and that applicants are fully informed about their rights, responsibilities, and all possible options available. Accurately recording symptoms, a complete history of treatment, documentation from all healthcare providers, and any other relevant healthcare information will be necessary in order to apply for disability. In addition to seeking an experienced attorney, patients can also benefit from obtaining a Disability Certificate which lists their disabilities as well as providing additional support for their claim.
There is no guarantee that one will successfully receive disability benefits; however, being prepared with accurate information and seeking professional assistance can dramatically increase the chance of approval. The most important factor in obtaining approval for disability due to arthritis is to be able to demonstrate that the level of impairment caused by the condition significantly affects one’s ability to work. By researching eligibility requirements and taking the appropriate steps when applying for disability benefits, those suffering from arthritis have a greater chance of securing entitlements which can provide valuable financial relief and assurance during difficult times.
Responses to Common Questions with Detailed Explanations
What evidence is required to be approved for disability benefits for arthritis?
In order to be approved for disability benefits for arthritis, you must have substantial medical evidence of the condition that is provided by a qualified healthcare provider, such as your doctor or specialist. This evidence should include a detailed description of the severity and frequency of your symptoms, as well as any lab or imaging tests that have been completed and the results. You should also explain how your condition has impacted your ability to work or lead a normal life, such as any restrictions on physical activity or the need for repeated doctor visits. Finally, if you are able to work, provide clear and concise information about how much it limits you in terms of earning potential. By providing this detailed and comprehensive evidence with your application, you can maximize your chance of being approved for disability benefits for arthritis.
What types of arthritis are typically eligible for disability benefits?
There are several types of arthritis that can be eligible for disability benefits. Some of the most common conditions include: osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
Osteoarthritis is a degenerative joint disease that causes chronic pain, swelling and stiffness in joints. It can affect people at any age, but symptoms are more commonly seen in those over the age of 65. Rheumatoid arthritis is an autoimmune disorder where the body’s immune system attacks its own tissues and organs causing inflammation in the joints and other areas of the body. Psoriatic arthritis is caused by an overactive immune system that causes inflammation, swelling and damage to joints as well as the skin and nails. Ankylosing spondylitis is another form of autoimmune arthritis that affects the spine as well as other parts of the body including the feet, hands, hips and shoulders.
In order to qualify for disability benefits related to arthritis, you must have medical documentation showing that your arthritis has been diagnosed by a healthcare professional and that it has severely impaired your ability to work.
Are there any requirements to be approved for disability benefits for arthritis?
Yes, in order to be approved for disability benefits for arthritis, you must meet the requirements outlined in the Social Security Administration’s Listing of Impairments. This includes having a diagnosis of arthritis from a healthcare professional, plus evidence of substantial interference with basic work activities due to your impairment. In addition, at least one of the following criteria must be met: an inability to do past relevant work; an inability to do other work in the national economy based on age, education and skill level; or severe functional limitations caused by your impairment resulting in an inability to function independently without assistance.