How You Are Assessed
Youll be assessed by an independent healthcare professional to help the DWP work out the level of help you need.
Face-to-face assessments have been suspended since March 17 and continue to be replaced by telephone and paper-based assessments – we have a full guide on how to prepare for assessments here.
Tip #: Receive An Rfc Test From Your Physician
RFC tests are also important to demonstrate how your osteoarthritis affects your day-to-day life. These tests measure your functioning capacity in a variety of areas to help the SSA better understand how capable you are of taking care of yourself. Lower scores on RFC tests indicate an inability to function at normal levels, which can help applicants to receive disability benefits.
Osteoarthritis And Long Term Disability Insurance Claims
Patients with osteoarthritis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their osteoarthritis may qualify for long term disability benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
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Documenting Your Disability Due To Osteoarthritis Is Essential
The insurance company will base its decision on information obtained from your medical providers and upon any information you provide during the application and/or appeal process. The following will help you understand the kind of information your long-term disability insurance company needs to evaluate your LTD claim based on osteoarthritis.
If you find that your osteoarthritis limits your ability to work, you should work closely with your doctor to document your condition. In order to qualify for long term disability benefits, you will need sufficient evidence detailing how your condition prevents you from working or performing daily tasks that you otherwise would be able to do.
What Kinds Of Arthritis Qualify You For Disability Benefits
There are more than 100 different types of arthritis and related conditions, and it is the leading cause of disability in America. According to the Arthritis Foundation, more than 50 million adults and 300,000 children have a form of arthritis.
Arthritis, an informal way of referring to joint pain or joint disease, is generally caused by obesity, old age, fractures in the bones, or bacterial and viral infections. The most common types of arthritis include:
- Degenerative arthritis: when the cartilage cushioning bones begins to wear away.
- Inflammatory arthritis: when the immune system goes array and attacks healthy joint with uncontrolled inflammation .
- Infectious arthritis: when a virus or fungus enters the joint and triggers inflammation.
- Metabolic arthritis: a buildup of uric acid in the bodys joint, resulting in gout.
Unfortunately, any type of arthritis can limit your ability to perform everyday activities due to the swelling and pain of the joints, but the Social Security Administration views them all differently.
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Residual Functional Capacity Analysis
The SSA also looks at how your arthritis is preventing you from carrying out daily activities that would be required in a work environment. Actions such as your ability to stand and walk for long periods, lift heavy objects, bend, or kneel are assessed by the SSA from your medical records and RFC form. Read more in our story How to File for Residual Functional Capacity.
What Can I Do
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Pip Test Scoring Criteria
The PIP scoring criteria awards points for a statement which applies to you for each activity
The DWP will decide which statement best fits your situation most of the time. You will get a set amount of points ranging from 0 -12 points for each activity.
The total number of points you get for each group of activities will decide whether you are entitled to PIP, and how much money you will receive.
To get the standard rate daily living component, you need to score 8 to 11 points in total for the daily living activities. You need 12 points to get the enhanced rate.
To get the standard rate mobility component, you need to score 8 to 11 points in total for the mobility activities. You need 12 points to get the enhanced rate.
A Diagnosis Of Osteoarthritis Doesnt Automatically Qualify You For Disability
A fact that complicates the answer to the question of is osteoarthritis a disability? is that a diagnosis of osteoarthritis doesnt automatically qualify you for disability benefits. Like many other diseases, the insurance company does not consider osteoarthritis a disability unless it interferes with your ability to participate in normal activities or prevents you from performing the basic tasks associated with your work. Here are a few symptoms that may indicate youre eligible for long-term disability benefits.
- Inability to lift more than 10 pounds
- Difficulty grasping or picking up small objects
- Pain when sitting or standing for long periods of time
- Difficulty walking upstairs
In order to diagnose osteoarthritis, your doctor will take your personal and family histories. A physical examination will include checking your joints for tenderness, redness, swelling, and range of motion. There are a number of clinical tests that will also help your doctor make an accurate diagnosis.
- X-rays dont show cartilage, but it will show cartilage loss based on the space between your joints
- MRI tests will produce images of bones and cartilage
- Joint aspiration, in which fluid is extracted from a joint and analyzed
- Blood tests
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Evidence Needed Related To Your Osteoarthritis
The first type of medical evidence that the Blue Book directly requests is a complete medical history of your osteoarthritis. You should be able to provide the following evidence. Records from your physician should include your presenting symptoms, the progression of your disease, as well as the results of a full physical examination. The physical examination notes should include:
- An explanation of any weight-bearing joints involved, such as the hip, knee, or ankle, and how it affects your ambulation and mobility.
- An explanation of any peripheral joints involved, such as the shoulder, elbow, wrist, and hand, and how it affects your fine and gross motor movements.
- Any visible deformity to your joints such as subluxation, contractures, bony or fibrous ankyloses, or any instability of your joints.
As osteoarthritis is not specifically listed as a condition in and of itself, it is vital that your physician document the following:
You Can Still Qualify For Social Security Disability If Your Osteoarthritis Doesnt Meet The Blue Book Standards
If you do not meet the criteria for either of the blue book categories described above, you might still qualify for Social Security disability. You will need to prove that your osteoarthritis causes you to have reduced functional capacity that is equal in severity to one of the blue book standards and that makes you unable to work. The Social Security Administration will consider your physical limitations and determine the type of work you are capable of doing, if any.
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Hand Oa Symptoms And Treatment
People with hand osteoarthritis can usually be identified by the presence of enlarged joints in their hands and crooked fingers. Hand OA generally occurs in three main spots in the hand: at the base of the thumb in the joints closest to the finger tips or middle joints of the fingers. Symptoms that are associated with hand OA include:
- stiffness
- limited use of fingers, and
- bony growths on the bones.
Individuals who have OA at the base of their thumb often have a deep aching at the base of their thumb and have difficulty grasping objects or making pinching motions. Thumb OA affects individual’s abilities to do a lot of fine motor skills, including turning keys, opening lids, and writing.
Treatment for hand OA can include pain medication, wearing splints or braces during certain activities, physical therapy, and steroid injections. If individuals have extremely severe symptoms, they can have their bones fused together or have a joint replaced. Bone fusion significantly limits movement in the fingers, while joint replacement may increase functionality in the fingers.
Social Security Disability For Osteoarthritis In Detroit
When you perform your job diligently for years, any career can strain your body over time. This may cause damage to your bones and jointsand lead to osteoarthritis.
Having osteoarthritis means you lose cartilage in your joints. This can make it difficult to work, or even move around.
If youre unable to work due to this condition, you may be able to receive Social Security disability benefits to ease the financial burden you face.
Disability benefits provide monthly checks and eligibility for Medicare health care coverage. But theyre hard to win. Most people get their first applications denied.
An experienced lawyer can guide you successfully through the process.
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You May Need A Disability Lawyer
You have much to gain from winning an SSDI benefits claim. Osteoarthritis is a long term disability, so being awarded an SSDI benefit gives you the financial support you need for years to come. Unfortunately, it is never easy winning a benefit of this type, so you should consider consulting with an SSDI benefit attorney who will use his or her experience and knowledge to work on your behalf to get the benefits you need that help you lead a more normal life.
Can I Get Social Security Disability For My Osteoarthritis Of The Knee
Yes, you can. There are two ways to get Social Security Disability for your osteoarthritis of the knee. The first way is to show that you meet Social Securitys specific listing on osteoarthritis of the knee and the second way is to show that due to your physical restrictions there are no jobs available in the US economy which you would be able to do on a full time basis. I will discuss both methods of getting disability benefits for your osteoarthritis of the knee below. However, its worth noting that youre more likely to win your case by showing there are no jobs available than by meeting a listing because the requirements of listings are often so exact that most people do not meet them.
Method 1 Listing: The listing for osteoarthritis of the knee is located in the section on major dysfunction of a joint at listing 1.02. This listing is extremely specific and requires:
Gross anatomical deformity and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint, and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint. With:
A. Involvement of one major peripheral weight-bearing joint , resulting in inability to ambulate effectively.
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What Are The Symptoms Of Arthritis
Symptoms of arthritis include pain and stiffness in your joints, inflammation around the joints and limited joint movement. There are many different types of arthritis, each with different symptoms.
Its normal to experience aches and pains, especially if youve carried out strenuous activity. But if your symptoms are unexplained, dont go away within a few days or if they are impacting your day-to-day life, you should visit your doctor.
Qualifying For Your Oa Back Problems
If you have osteoarthritis in the vertebrae of the spine, you are not alone. This is a very common area of the body to have OA. Under certain specific condition, a person with OA of the spine can be approved for disability. Having one of the following conditions will qualify you for disability for osteoarthritis:
- Limited motion of the spine from the compression of the spinal nerve.
- Difficulty in walking because of narrowing of the spinal canal in the lower back region.
- The need to frequently change positions or posture more than once every two hours due to inflammation of the arachnoid membrane.
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What Would You Like To Do
- Inflammation of the arachnoid membrane that protects spinal cord nerves
- Spinal canal narrowing and nerve compression
These kinds of conditions come with many technical terms that are difficult for anyone outside the medical and legal professions to understand.
Thats one reason why its a good idea to speak with a Social Security disability attorney when seeking benefits.
A legal professional could also help you qualify for benefits under another category of disability: joint dysfunction.
To qualify for Social Security disability benefits for joint dysfunction, you must have a joint deformity in at least one knee, ankle or hip.
You could also qualify if each of your arms suffers from a joint deformity in the shoulder, hand, wrist or elbow. These deformities must make it difficult for you to perform daily tasks.
And, as always, youll need medical evidence to back up your claim.
You may also develop osteoarthritis due to kidney failure. The SSA recognizes the dangers of kidney disease, allowing you to receive benefits in this situation.
If you have kidney failure, winning disability benefits could be particularly helpful for you because many osteoarthritis medications cannot be taken when you have kidney problems, limiting your ability to treat your osteoarthritis.
Blue Book To Assess Impairments
SSA has prepared a list of impairments and gathered them in the Blue Book, for their disability examiners as a reference guide. This detailed list provides quick guidance for a review by the examiner to assess if your particular set of limitations is so severe that your work history, age, and education do not have to be considered in a disability determination. Each diagnosis listed must be accompanied by certain findings for the diagnosis to meet the listing and allow approval based on the listing.
SSA recognizes inflammatory arthritis could qualify as a disabling disease if it is accompanied by the following findings.
- Deformity or swelling of an ankle, knee, or hip joint with:
- At least two of the following symptoms: fever, loss of weight, fatigue, or a general feeling of discomfort
- At least two organs or systems affected with one being moderately involved
Spondyloarthropathies or Ankylosing Spondylitis .
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Qualifying For Disability Based On Reduced Functional Capacity
If you have osteoarthritis but you don’t meet the criteria under any of the listings discussed above, the Social Security Administration will look at your “residual functional capacity,” or “RFC.” Your RFC assessment is used by the SSA to determine what kind of work you are still capable of doing despite the limitations from your arthritis.
Lower extremity arthritis. If your arthritis affects your legs or your spine, you will probably be limited in walking on uneven surfaces, climbing, or squatting. In this case, your RFC assessment may limit you to no more than sedentary work. Sedentary work is mostly sit-down work — work where you don’t need to lift more than ten pounds at a time and the work is done mostly seated. However, up to two hours a day of walking or standing may be required for sedentary work, so if you have severe enough trouble with walking because of your arthritis, you may not be able to perform even sedentary work.
Upper extremity arthritis. If you have osteoarthritis in your shoulders, arms, or hands, your RFC assessment may limit the work you can do that involves lifting, reaching, typing, writing, or grabbing. This would make it difficult to do many jobs, even sedentary jobs.
If you can’t do even sedentary work, the SSA should find you disabled. For more information, see our article on proving you can’t do a full range of sedentary work.
Definition Of Disability For Inflammatory Arthritis
Under most LTD policies, an individual is considered disabled if he or she is: unable to perform the material duties of his or her own occupation for the first two years of the policy and unable to perform the duties of just about any occupation after the first two years of the policy. The definition of disability is specific to each individual policy, so you must review your own LTD policy to determine how the term disability or totally disabled is defined for you.
Your provider will then determine whether your Osteoarthritis is severe enough to keep you from performing activities commonly required for working. These activities include:
- Sitting or standing
Based on your limitations, you may be deemed capable of heavy, medium, light, or sedentary work.
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What Benefits I Can Claim If I Have Osteoarthritis
List of evidence you should provide to get social security disability benefits:
According to Social Security Administration, you have to complete medical history related to osteoarthritis to avail of the disability benefits. You have to provide a few of the important evidence. Moreover, records from your doctors should include your existing symptoms, the progression of your osteoarthritis, and the results of your complete examination. Notes of your physical examination should essentially include-
- A detailed explanation of any of the involved weight-bearing joints, like the ankle, knee, hip and the way it affects ones mobility and ambulation
- A detailed explanation of your involved peripheral joints, like your elbows, shoulders, hands, wrists and the way they affect your gross and fine motor related movements
- Any visible type of joints deformity, like contractures, subluxation, fibrous or bony ankylosis or any type of instability in the joints.
Along with this, osteoarthritis does not categories itself as a disability condition, your doctor needs to provide the following important documents-
If you underwent any surgery related to osteoarthritis, like joint replacement, your orthopedic surgeon should provide the necessary surgical records. Also, the surgeon has to provide necessary documents to prove that surgery was essential to treat your weight-bearing joint.