Why Was My Osteoarthritis Claim Denied?

It can be tricky for disability applicants to qualify initially with osteoarthritis. While a great deal of evidence shows that this disorder can be severely crippling, it can be difficult to measure the pain it causes with standard medical testing.

However, if your initial osteoarthritis claim was denied, it is not time to give up hope! Here, we will first delve into your application to see why it may have been denied. Then, we will look forward to your disability hearing and determine what resources you need to prepare.

Reasons for an Osteoarthritis Denial

Osteoarthritis is only officially referenced in the Social Security Blue Book under Section 1.04: “Disorders of the Spine”. Because spinal osteoarthritis is generally the most severe, it is officially listed here, requiring evidence of things like limited spinal movement, motor loss, or nerve root compression to get benefits. If your osteoarthritis mainly affects your spine, compare this Blue Book entry to your initial application to be sure you presented all medical requirements.

If your osteoarthritis affects you in an area outside of the spine, this may make it more difficult to get benefits. While it isn’t mentioned outright, osteoarthritis can also be covered by Section 14.09: “Inflammatory Arthritis”. Here, you must show that your arthritis severely affects either a) your weight-bearing joints, or b) two or more organs/body systems that prevents you from living normally.

Learn More: Appealing After A Denial

Osteoarthritis Social Security Benefits

The terms for this section are a bit more vague, so it is vital that you provide as much medical evidence as possible here. Try getting updated testing, new forms of testing (MRIs, CT scans, motor function tests, etc.), and compiling new medication/hospitalization history to better exemplify your disorder. And, as always, consult with your physician to determine any other evidence that may help.

Preparing For Your Disability Hearing

Disability hearings are the next step after an initial claim denial. To schedule a hearing, you must go to your nearest Office of Disability Adjudication and Review (ODAR), which can be located using the SSA’s online ODAR locating tool. Hearings are assigned to one of the ODAR’s administrative law judges (ALJs). Because there is a wait list for most disability hearings, it is best to schedule as soon as possible and prepare evidence in the time leading up to your hearing.

When preparing for your hearing, you should prepare the following evidence for your case:

  • all the medical and financial paperwork provided on your initial application
  • updated tests, hospitalization records, medication lists, therapy notes, or physician assessments to compare to your initial application
  • testimonies (either written or in-person) from physicians, therapists, old bosses, coworkers, friends, or family members that can attest to the severity of your condition
  • updated financial information (especially if your initial claim may have been denied because of your income)

Contacting a Disability Attorney

Disability attorneys are especially useful when moving forward to your disability hearing. In fact, the majority of attorneys are hired during this time, and are statistically shown to increase your chances of getting benefits. Their knowledge of required evidence and legal proceedings can give you a definite edge when convincing your ALJ that you need disability benefits. And, better yet, disability attorneys work only on contingency, meaning you only pay them if they help you to win your case.

Consider a free consultation with a disability attorney today to help you receive the disability benefits you deserve.