If you suffer from a moderate to severe case of rheumatoid arthritis, you may be eligible to receive Social Security disability. In order to qualify for disability benefits you have had to work enough to earn sufficient credits and to pay enough in taxes to the Social Security Administration (SSA). The SSA oversees Social Security Disability Insurance (SSDI), which is a program that provides a monthly benefit check to those who are unable to work because of a medical condition or an injury.
Rheumatoid arthritis, known as RA, is an autoimmune disorder. RA occurs when your immune system attacks the membranes around your joints, causing inflammation. While anyone can be affected by RA, it is most common in women, people ages 40 to 60, those who smoke, and those who have a family history of RA. Usually starting in the hand and feet joints, RA progresses into other areas, such as the hips, shoulders, and knees.
Because RA is a chronic condition that cannot be cured, it can also affect your mental health. It may cause you to be depressed or suffer from anxiety. These symptoms must also be noted and considered as part of your claim. Provide as much detail and documentation as possible in regards to your condition and its effect on your overall wellness.
RA has many debilitating symptoms with the main symptoms being warm, swollen, stiff joints. Tissue bumps, called nodules may also appear. You can also suffer from fatigue, weight loss, and fevers. Symptoms can vary in severity, sometimes being better than others. Over time, RA can cause you to have permanently deformed joints. Because of the severity of the condition, you may end up with mobility issues and be unable to work. If you have severe symptoms from RA, you may qualify for SSDI.
The Cost of Treating Rheumatoid Arthritis
Because RA is a chronic autoimmune disorder, you will require lifelong medical treatment. According to Web MD, many of the medications used to treat RA are expensive, ranging from $1,000 to $3,000 per month. Even with health insurance, the co-pays and coinsurance can add up to hundreds or thousands of dollars per year.
Of course there are ongoing doctor visits to your primary care provider, rheumatologist and orthopedic specialist. These visits also require co-pays. For severe episodes, hospitalization may be required. On average, someone with RA can expect to pay out $1,500 per month for treating their condition.
The SSA Evaluation and Medical Qualifications
The SSA uses a medical guide, which is called the Blue Book, to determine whether or not an individual is disabled per the guidelines set forth by the SSA. The Blue Book lists bodily systems and specific conditions as well as the symptoms and criteria that must be met for immediate approval.
Arthritis is considered under the criteria for musculoskeletal body systems and has several medical listings and categories. In order to meet the specific guidelines that are set forth for the listing, an individual with RA, which is also called inflammatory arthritis, must suffer from:
- Persistent swelling
- Limitation of joints, such as the hip, knee, ankle, shoulder, elbow, or hands and wrist
In order to back up your claim and prove the severity of your condition, you need to provide as much medical documentation as possible, including test results, physician notes, medications and the side effects, and any symptoms you experience.
The SSA will look at how your RA impacts your ability to work and the severity of your symptoms. They will determine if you are unable to do your past line of work or perform any other kind of work to earn substantial income.
Meeting Disability Criteria with an RFC
If you don’t meet the criteria set forth in the Blue Book listing, you may still be eligible to receive SSDI. SSA also has a medical-vocational allowance which involves using a residual functioning capacity (RFC), which shows your limitations and the severity of your symptoms and how your life is impacted.
This process involves considering your age, education, work experience, skills, and physical and medical condition to determine if you are able to perform any other kinds of work. The medical-vocational rules vary according to your age. As an example, if you are younger than 50 and the RA symptoms leave you unable to perform sedentary work, you are disabled. Sedentary work requires you to be able to lift a maximum of 10 pounds at a time, sit six hours, and occasionally walk and stand up to two hours per eight-hour work day.
At any age if the RA has caused a psychological impairment that keeps you from doing even simple, unskilled work, you will be determined to be disabled. In order to prove your disability, the RFC must be specific and explain your limitations. As an example, if you take medication for your RA that causes nausea and fatigue, that will be considered. If your RA leaves you unable to stay in one position for more than two hours without repositioning that may also be considered.
Applying Specific Medical Tests to Your Case
While here is no single test to positively diagnose RA, blood tests will show the likelihood of its presence. A chronic condition with no cure, there are treatments that help reduce the symptoms, such as medications, lifestyle changes, therapy, and in some severe instances, surgery.
Provide as much documentation as possible to back up your claim and prove your condition and its severity. If your RA is proven to be a moderate to severe case, you may be determined eligible to receive SSDI. The SSA may order a medical evaluation with the physician they choose at their expense. This is for informational purposes only and will help determine the severity of your condition and symptoms.
Suffering from a chronic condition can also have an impact on your mental health. You may be sent for a mental evaluation as well. Depression, stress, and anxiety caused by the RA must also be taken into consideration when determining whether or not you are disabled. RA is a debilitating disease that can impact you physically and mentally.