In my office, I regularly get calls from clients who allege disability in whole or in part due to arthritis. According to the CDC, about 50 million adults have arthritis or related condition such as rheumatoid arthritis, lupus, fibromyalgia or gout. Arthritis cases can be winners but they do present a challenge. Most people as they age develop some form of arthritis – usually osteoarthritis.
Osteoarthritis (OA), sometimes referred to as degenerative joint disease, is a chronic joint disease of the hands, hips, knees and spine which primarily affects adults age 55 and older. It is caused by the breakdown of cartilage in the joints. Physical therapy and medications can help control the pain, but in severe cases, when the joints become sufficiently damaged and nonfunctional, replacement surgery can be the only option available.
Social Security judges see arthritis is medical records all the time and most judges believe that mild arthritis creates uncomfortable, but not disabling symptoms. In my experience mild to moderate osteoarthritis generally will not produce a favorable disability decision. Unusually severe osteoarthritis, osteoarthritis plus some other condition, or a severe form of inflammatory arthritis such as rheumatoid arthritis or psoriatic arthritis is much more likely to result in a finding of disability.
Depression is commonly associated with arthritis. A national study of nearly 1,800 people with arthritis reported by the Centers for Disease Control and Prevention (CDC) found that one-third people with arthritis also experience anxiety and depression.
Rheumatoid arthritis cases are more likely to result in favorable disability decisions. In addition to being a form of inflammatory arthritis, it is also an autoimmune disease. The immune system is designed to protect our health by attacking foreign cells such as viruses and bacteria. RA instead attacks a thin membrane that lines the joints, the synovium. This results in fluid build-up in the joints, causing pain and inflammation throughout the body.
When it reviews SSDI applications to make its disability determination, the SSA requires that the medical condition be severe enough to prevent your ability to work. This makes it important to fully explain to your doctor any and all limitations that your arthritis imposes on you, and any associated physical symptoms such as pain, stiffness, swelling, and fatigue. It is important to recognize and inform your doctor of any emotional/mental health concerns you experience associated with your arthritis. Anxiety and depression are two such ‘emotional’ or mental health concerns that often accompany arthritis.
Social Security Ruling 96-2p requires the SSA to give your treating physician’s medical opinion controlling weight in any adjudication of your disability claim, if your medical evidence supports this opinion. This makes it all the more important that you provide your doctor with complete and up-to-date information at every visit. Fully explain the limitations you experience from your arthritis and associated symptoms, including pain, stiffness, swelling, and fatigue.
Your doctor should document this information in your medical record, as this medical record is an important part of your application and plays a major role in SSA’s determination of your SSDI eligibility.
Neither of the two most common types of arthritis described above, OA and RA, are on SSA’s compassionate allowances conditions list thus you will have to prove that you have listing level arthritis, that you meet a grid rule because of your physical limitations or that your functional capacity for work has been so eroded by your symptoms that you cannot perform even simple, entry-level work.