How Severe Does My Arthritis Have to Be to Receive Benefits?

Severe arthritis, specifically rheumatoid arthritis, may be so crippling and painful that you may meet the criteria established by the Social Security Administration (SSA) for a disability benefit. To qualify for a benefit, you must meet the criteria listed in the SSA’s Blue Book, be unable to work for the next 12 months or more, and may also be asked to have a residual functional capacity (RFC) assessment made by your doctor. The benefit may be granted under either the SSDI program or the SSI program depending on your work history and income and assets assessment.

Blue Book Listing

The symptoms associated with severe rheumatoid arthritis (RA) that may affect daily life and the ability to continue working could include any combination of the following:

  • swollen or tender joints, often starting in the extremities, such as fingers and toes
  • progressive deterioration of joint pain, extending to major joints such as the knees, shoulders, and hips
  • gradual and often permanent deformation of the affected joints over time

Rheumatoid arthritis is not described as an exact match in the Social Security Administration’s (SSA’s) Blue Book but is covered in listing 1.00, which describes musculoskeletal disorders. If the symptoms of RA do not match the listing, then you may find that you can still be granted a benefit under the listing for inflammatory arthritis.

To diagnose rheumatoid arthritis, your past medical records detailing the progressive onset of the disorder are necessary. The SSA will want to review all imaging results which demonstrate the deterioration in your joints. These include X-rays, CT scans, MRI scans, and sonograms. A residual functional capacity (RFC) assessment may be requested, which can demonstrate what you are physically capable of doing or not doing. The RFC assessment helps to establish that you are too disabled to work for any length of time.

How Severe Does My Arthritis Have to Be to Receive Benefits?

Applying for a Disability Benefit

Even if you think that your RA condition is so severe that you should qualify for a disability benefit, you may still be denied initially. Over two-thirds of initial disability benefit applications are denied by the SSA. This is often because SSA examiners are unsatisfied with the amount of medical evidence submitted or because the evidence of an inability to work is insufficient. A disability attorney can work with you to help prepare your benefits application more thoroughly, or help you work your way through the appeal process.

The Potential Effects of a Disabling Medical Condition on You and Your Family

Serious disabling conditions like rheumatoid arthritis don’t just affect you alone. They affect your family as well. Negative effects include:

  • being unable to perform supposedly simple everyday tasks without assistance
  • being in a constant state of financial strain
  • falling short in providing the income your family needs to survive and thrive
  • Feel unable to partake in most, if not all, of the once-fun activities
  • feeling excessive stress stemming from your disability and the financial pressure it may impose
  • suffering mentally and emotionally because of your health condition.

Next Steps

Help from an experienced disability attorney can overcome difficulties completing the benefits application and ensure you have evidence that should satisfy the SSA that your symptoms meet the criteria established by the Blue Book listing for musculoskeletal disorders, including arthritis, and that you have sufficient evidence to show that you cannot work for the next 12 months. Complete a free case evaluation today.

Additional Resources