October 7, 2010

Qualifying for Social Security Disability Benefits based on Arthritis

Arthritis is one of the leading causes of disability. Indiana disability claimants suffering from arthritis may qualify for Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) if the claimant meets the criteria set by the Social Security Administration (SSA).  Indianapolis Social Security Disability Attorney Scott Lewis is experienced in representing claimants with various types of arthritis.  Many Indiana residents suffer from arthritis and are unable to work due to their condition.

How does a person suffering from arthritis qualify for Social Security disability benefits?

As all disabling conditions, the SSA uses a 5 step sequential evaluation process to determine if a disability claimant will receive SSDI or SSI benefits based on arthritis. In Step 1 of the evaluation process, the SSA wants to know if the claimant is working.  In this step, the SSA simply determines if an individual is “working.”  If so, the claimant must prove that they are earning less than the monthly Substantial Gainful Activity (SGA) set by the SSA.  Earning more than the monthly SGA amount is enough for the SSA to deny the disability claimant’s SSDI or SSI application.

In the next step of the evaluation process, Step 2, the SSA will ask if the claimant’s arthritis is severe.  The impairment must be severe enough to significantly limit the claimant’s ability to perform basic work activity. In addition, the arthritis must last, or be expected to last, for a continuous period of not less than 12 months.  It’s the claimant’s responsibility to prove that the disabling condition such as arthritis is severe enough that his or her ability to perform basic work activities are limited and will last a minimum of 12 months.

If a disability claimant suffering from arthritis can pass Steps 1 & 2 of the evaluation process, the SSA will continue to Step 3 of the evaluation process.  In Step 3, the SSA will decide if the claimant’s arthritis meets or equals the criteria of the SSA’s Listing of Impairments. The SSA’s Listing of Impairments is simply the SSA’s breakdown of the disabling conditions and the criteria for each of the conditions.

Arthritis is considered under Section 1.00 Musculoskeletal Body System, in the SSA’s medical listings.  To satisfy the listing criteria, a person with inflammatory arthritis (such as rheumatoid arthritis) must have persistent swelling, pain and limitation of joints such as the hips, elbows, wrist & hands, knees, ankles, and shoulders.  Other disability claimant’s who have degenerative arthritis (osteoarthritis) may satisfy the criteria of the listing if they have significant limitations using their arms and/or hands or have a significant problem standing and walking. Disability claimants with degenerative arthritis who have significant back or neck problems must have persistent reflex, sensory, and motor loss to meet the listed criteria.

Don’t be discouraged if you are a disability claimant that does not meet the listing of impairments criteria for arthritis because the SSA will continue Steps 4 & 5 of the disability evaluation process.  As the evaluation process continues to Step 4, the SSA will look at how the actual limitation and symptoms of the claimant’s arthritis affects his/her ability to perform work.  Therefore, the SSA looks more directly how the disabling condition impacts the claimant’s ability to work.  In this step, the SSA will determine if the claimant is able to perform work that he/she has done in the past with the claimant’s claimed disability.  If the SSA determines that the disability claimant is able to perform past work despite of their disability, in most cases, the disability claim is denied.  On the other hand, if the person cannot perform past work with their disability, then the evaluation process continues to Step five.

In the final step of the evaluation process, the SSA will review the claimant’s personal information such as:

  • age
  • education
  • work experience
  • physical condition
  • mental condition

To determine disability, the SSA enlists vocational rules, which may vary according to age. For example, a disability claimant with arthritis under the age of 50 who is able to prove that they are unable to perform sedentary work, the SSA may approve this claimant’s claim. For claimants who are 50 years old or older with arthritis, who are limited to performing sedentary work but have no work-related skills that allow him to do so, the SSA may reach an approval for the claimant’s SSDI or SSI claim.   The SSA defines sedentary work as the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.  Claimants with arthritis that are over age 60 who are unable to perform any of the jobs he/she has performed in the last 15 years, the SSA will likely decide that the claimant is disabled.  Again, the SSA carefully considers the above criteria in order to determine disability.

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