Qualifying for Disability Benefits (SSDI) with Arthritis in Pennsylvania

On an annual basis, the SSA (Social Security Administration) spends hundreds of billions of dollars on social security programs, including disability benefits.  According to the SSA’s own statistics, in 2013 alone, the Social Security Administration spent a staggering $816 billion on benefits on nearly 58 million Americans.  Among them, 8.9 million disabled workers collectively received $10 billion, with an average monthly payment of $1,129 in benefits.
Unfortunately, being approved to receive disability benefits is a challenging task, because the SSA imposes numerous and highly specific requirements on disabled Americans who wish to qualify. Among these requirements, one, in particular, stands out as the most basic and fundamental of all: being classified as disabled to begin with.  Even if your doctor says you are disabled, the SSA may disagree.

In order to help the residents of Pennsylvania and New Jersey determine whether they have a chance to qualify for benefits, our experienced social security disability attorneys explore which conditions count as a disability according to SSA standards.  In this edition, we answer the question: can I qualify for benefits with arthritis?

Arthritis Statistics

Arthritis is a health condition which affects the musculoskeletal system, especially the joints (e.g. knees, fingers, shoulders, hips, elbows).  The word arthritis comes from the Greek arthron, or joint, and the Latin itis, or inflammation.  Together: inflammation of the joints.  This inflammation can cause symptoms such as:

  • Bone Spurs
  • Pain/Tenderness
  • Reduced Flexibility
  • Reduced Mobility
  • Stiffness
  • Swelling

Arthritis is one of the most prevalent medical conditions in the United States.  According to the Centers for Disease Control and Prevention (CDC):

  • 52.5 million Americans — 16.7% of the U.S. population — have some form of arthritis.
  • 49.7% of all Americans aged 65 and older have arthritis.
  • 294,000 children have arthritis.
  • Estimates say that by 2030, 67 million Americans aged 18 or older will have arthritis.

The CDC reports that in 2007 in Pennsylvania:

  • 3,045,000 adults have arthritis — about 23.9% of the total Pennsylvania population.
  • 1,240,000 adult arthritis sufferers are male.
  • 1,805,000 adult arthritis sufferers are female.

The CDC reports that in 2009 in New Jersey:

  • 1,428,000 adults have arthritis — about 16.1% of the total New Jersey population.
  • 533,000 adult arthritis sufferers are male.
  • 895,000 adult arthritis sufferers are female.

But arthritis is not a blanket condition.  Instead, there are several subcategories of arthritis, some the most common being:

  • Rheumatoid Arthritis
  • Inflammatory Arthritis
  • Osteoarthritis

Arthritis is often comorbid with additional health conditions, such as diabetes, heart disease, obesity, and high blood pressure.

Arthritis and Disability Benefits in Pennsylvania

The SSA maintains an official Listing of Impairments for both adults and children.  Together, these two lists cover the various health conditions which the SSA considers eligible to qualify as a disability.
Under Section 14.09 of the SSA’s Adult Listing of Impairments, inflammatory arthritis is a covered condition.  The SSA considers all of the following inflammatory arthritis-related disorders to be potentially eligible for disability benefits:

  • Ankylosing Spondylitis
  • Behçet’s Disease
  • Gout
  • Inflammatory Bowel Disease
  • Lyme Disease
  • Pseudogout
  • Psoriatic Arthritis
  • Reiter’s Syndrome
  • Rheumatoid Arthritis
  • Sjögren’s Syndrome
  • Whipple’s Disease

How the Social Security Administration Defines Arthritis

Under Section 1.00 of the Musculoskeletal System List, the SSA states that:

“Regardless of the cause(s) of a musculoskeletal impairment, functional loss for purposes of these listings is defined as the inability to ambulate effectively on a sustained basis for any reason, including pain associated with the underlying musculoskeletal impairment, or the inability to perform fine and gross movements effectively on a sustained basis for any reason, including pain associated with the underlying musculoskeletal impairment.”

This could include osteoarthritis, rheumatoid arthritis, and inflammatory arthritis.
However, simply having an arthritic condition is not enough by itself.  Once it has been established through extensive medical documentation that you have a given condition, the SSA will then evaluate that condition’s severity.  If your condition is not severe enough to hinder your ability to work at either your old job or in some new capacity, you may not be able to qualify for disability benefits. Your arthritis must be severe enough to prevent you from earning an income.
The Listing of Impairments discusses how the SSA determines whether or not a given condition, such as arthritis, is classified as “severe.”  For example, in Section 14.00D the SSA states that:

“…the criterion is satisfied with persistent inflammation or deformity in one major peripheral weight-bearing joint resulting in the inability to ambulate effectively…”

In other words, if joint inflammation in your hips, knees, ankles, or feet is persistently inflamed to the point where you cannot walk or move around with ease, your arthritis may be considered disabling enough to qualify for benefits.
In another example of what constitutes “severe” arthritis, the SSA cites:

“…one major peripheral joint in each upper extremity resulting in the inability to perform fine and gross movements effectively…”

This means that if inflammation in a shoulder, hand, or elbow joint in each arm interferes with your basic (“gross”) and complex (“fine”) motor skills, you may be considered eligible to receive monthly disability benefits for your arthritis.
Finally, it’s important to know that your condition must have lasted or be expected to last for a minimum of 12 months.

Our Pennsylvania Social Security Disability Attorneys Can Help You

If you are interested in learning more about how you may qualify for benefits with arthritis, the disability attorneys at Young, Marr & Associates are here to help.  We have over 25 years of experience representing thousands of residents of Pennsylvania and have obtained millions of dollars in benefits for our clients.  Call (215) 701-6519 in Pennsylvania, or contact our Philadelphia social security disability lawyers online for your free consultation.

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