Can I Get Disability for Rheumatoid Arthritis

Can I Get Disability for Rheumatoid Arthritis?

If you have a severe case of rheumatoid arthritis (RA), you may qualify for Social Security Disability benefits. In one study, more than 1/3 of RA patients had to stop working within ten years after their diagnosis. To qualify for Social Security disability benefits for RA, you must meet the Social Security Administration’s (SSA’s) eligibility requirements.

This means that to qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits for rheumatoid arthritis, your RA must be so severe that you will be unable to work for at least one year.

Rheumatoid arthritis is an autoimmune disorder, which can impact the lining of your joints. It can ultimately cause painful joint swelling that can lead to bone erosion and joint deformity. RA can start with swollen and/or tender joints, often in your fingers and toes. As rheumatoid arthritis progresses, the joint swelling and pain can “move” to your knees, wrists, shoulders, and hips.

Because rheumatoid arthritis is a progressive disease, SSA will need to see how your condition has worsened over time. To be found disabled, SSA will need to see a formal RA diagnosis (including the date the condition was diagnosed) as well as ongoing medical records, showing that you have sought medical care for your rheumatoid arthritis and have followed prescribed treatments.

Work Limitations

While some people can work for years, or even decades, after being diagnosed with RA, not everyone can. Some people may be able to adjust from a physical job to a more sedentary job.

To be approved for Social Security disability benefits with rheumatoid arthritis, your medical records and work history will need to support the fact that you can no longer work. To help support your case, you may need to document your job duties and the symptoms/limitations you have that make it so you can no longer perform those job duties.

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An attorney can help file your application for Social Security disability benefits, help collect evidence to support your claim, and translate correspondence you receive from the Social Security Administration throughout your claim.

How to Get Disability for Rheumatoid Arthritis

To qualify for Social Security disability benefits for rheumatoid arthritis, you must meet certain medical requirements. Your rheumatoid arthritis must be so disabling that you are unable to work full-time because of it.

When you file your claim for Social Security disability benefits with rheumatoid arthritis, SSA will first see whether your case meets the Blue Book listing for inflammatory arthritis. If you do not meet or equal the listing, SSA will look to your residual functional capacity to understand your limitations. If SSA believes that your condition results in limitations that preclude full-time employment, you will be found disabled.

When it comes to rheumatoid arthritis, SSA will need to see a longitudinal medical record that shows the severity of your condition. Detailed medical records are important in disability claims for rheumatoid arthritis as they allow SSA to understand the extent of your conditions and symptoms. Medical records also help SSA understand how your symptoms impact your ability to perform activities of daily living.

Work With Your Rheumatologist to Confirm Work Limitations

As mentioned above, while SSA does have a Blue Book Listing for rheumatoid (inflammatory) arthritis, SSA will likely need a residual functional capacity (RFC) evaluation from your doctor as well. This can be a simple statement or report that details your own RA symptoms and the limitations they have on your ability to function every day.

You will want to work closely with your doctor so that s/he understands the everyday limitations you have as a result of your RA.

Not all rheumatologists can complete a full RFC evaluation. In that case, it can be helpful for her or him to indicate your limitations and the cause of those limitations. The limitations do not have to be stated in a letter separate from your chart. If your provider is able to write your limitations in your chart, even that can be helpful to SSA.

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Can I Get SSI for Rheumatoid Arthritis

Rheumatoid arthritis may make it difficult for you to perform certain activities, including hold a pen or pencil for long periods of time or type on a keyboard for an extended period. You may also have difficulty with walking, standing, bending, and squatting. Your RA may also make it difficult for you to lift items over a certain weight or reach over your head at all.

You may be on certain medications for your rheumatoid arthritis that make it difficult for you to function, including making you dizzy, drowsy, or fatigued.

To qualify for SSI benefits for rheumatoid arthritis, your rheumatoid arthritis must keep you from working and has already lasted (or is expected to last) at least one year or result in death.

In 2023, the highest federal SSI payment is $914 per month for a single person and $1,371 per month for a couple. Certain states have an increased maximum payment for individuals and couples as they supplement the federal SSI amount, including California, Michigan, New Jersey, and Montana.

In most states, individuals who qualify for SSI benefits will also receive Medicaid health benefits, which can help pay health care expenses.

If you are applying for Supplemental Security Income (SSI) benefits for rheumatoid arthritis, you must have below the income and asset thresholds to qualify for benefits. SSI is a federal program that provides monthly payments to millions of people who have limited income and few resources.

To qualify for SSI benefits as a single person, you must have less than $2,000 in assets. If you are married, you both must have less than $3,000 in combined assets.

SSI divides income into two categories: earned and unearned. Earned income includes any wages, net earnings from self-employment, royalties and honoraria, and money from sheltered workshops. In 2022, a person must have less than $861 per month in unearned income to qualify for SSI, while a couple must have less than $1,281 per month in unearned income to receive SSI. For earned income, an individual can earn up to $1,350 per month (maximum substantial gainful activity amount) and still receive SSI, while a couple can earn up to $2,607 per month and still receive SSI benefits.

If you live in a state that adds money to the federal payment, you may be able to receive SSI even if you have greater income. SSI payments can be reduced based on other income coming into your household, including situations where your bills are paid by someone else.

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Can I Get SSDI for Rheumatoid Arthritis

If you are applying for Social Security Disability Insurance (SSDI) benefits for rheumatoid arthritis, you must have worked in jobs and paid into Social Security for a certain amount of time. Work credits are calculated based on how old you are, how long you have worked, and how much money you have earned. You can earn up to four work credits per year for every year you worked.

The amount of money needed to earn one work credit changes annually. For 2022, you can earn one credit for every $1,510 you earn in wages or self-employment income. Once you have earned $6,040, you have earned your four credits for the year.

The number of work credits you need to qualify for disability benefits depends on when your disability begins. Normally, you will need 40 credits, 20 of which were earned in the prior ten years (ending with the year your disability begins). Therefore, we usually say you will need to have worked five of the last ten years to qualify for SSDI benefits.

If you can meet both the medical requirements and work requirements outlined by SSA, you can be found disabled for rheumatoid arthritis and receive Social Security disability benefits.

Social Security only pays benefits for total disability, no benefits are payable for partial or short-term disability. You must be totally disabled and unable to work for at least one year to qualify for Social Security disability benefits.

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Can I Get Disability for RA

The Social Security Administration (SSA) uses the Blue Book of Listings to understand the way a condition impacts your ability to function and work. SSA evaluates rheumatoid arthritis under Listing 14.09, Inflammatory arthritis. SSA understands that the spectrum of inflammatory arthritis includes a wide variety of disorders, each with a different cause, course, and outcome. Therefore, each condition is evaluated a bit differently.

Generally, when SSA evaluates a claim for rheumatoid arthritis, the agency will need to see certain clinical features and serologic findings as described in the most recent edition of the Primer on Rheumatic Diseases, published by the Arthritis Foundation.

To be found disabled under Listing 14.09, there are several different potential avenues, two of which can apply to rheumatoid arthritis. Under Listings 14.09A(1), a finding of disability can be directed if there is medical evidence of persistent inflammation or persistent deformity of one or more major peripheral joints in a lower extremity with either a medical need for a walker, bilateral canes, bilateral crutches, or a wheeled/seated mobility device involving the use of both hands or an inability to use one upper extremity to independently initiate, sustain, and complete work-related activities and a documented medical need for a one-handed hand-held assistive device or a wheeled/seated mobility device involving the use of one hand.

Under Listing 14.09A(2), a finding of disabled can be directed if there is medical evidence of persistent inflammation or persistent deformity of one or more major peripheral joints in each upper extremity and medical documentation of the inability to use both upper extremities to independently initiate, sustain, and complete work-related activities involving fine and gross motor movements.

Under Listing 14.09B, disability can be established through medical evidence of inflammation or deformity in one or more major joints with the involvement of two or more organs/body systems (with at least one involved to at least a moderate level of severity) and at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).

Under Listing 14.09D, disability can be established by medical evidence of repeated manifestations of inflammatory arthritis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level: limitation of activities of daily living; limitation in maintaining social functioning; or limitation in the ability to complete tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

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Can I Get Disability for Rheumatoid Arthritis

In some cases, if you do not meet one of the Blue Book listings, SSA will be able to find disability for rheumatoid arthritis if your residual functional capacity (RFC) eliminates all jobs in the national economy.

The RFC is important to a rheumatoid arthritis disability case because it shows the maximum amount of work you are able to perform. If you have a supportive doctor who believes you are disabled due to your RA, s/he can help your disability claim by indicating why you are disabled and unable to work.

It isn’t enough for your rheumatologist to say you are disabled and unable to work. SSA is the one that ultimately decides whether your condition prevents you from working in any capacity. SSA reviews your file to determine whether your condition would allow you to perform a different job, your same job, or if you are entirely unable to work.

While your doctor should never try to inflate or exaggerate your rheumatoid arthritis symptoms, if s/he can describe how you are actually doing and what limitations you actually have, that can be helpful for your disability case.

Make sure you talk with your doctor either before you apply for Social Security disability benefits, or shortly after, so s/he can keep notes that will help her or him fill out the RFC form promptly.