Social Security Disability for Osteoarthritis

How To Apply For Social Security Disability For Osteoarthritis

Social Security Disability Insurance (SSDI) is a government-run program funded by social security taxes for individuals who, due to medical, psychological, or mental health issues, are unable to get or keep gainful employment. Any person with a sufficient history of Social Security payroll tax payments who is considered to be disabled by the SSA (Social Security Administration) may be eligible for disability benefits.

Disability for Osteoarthritis

You may qualify for Social Security disability insurance (SSDI) benefits if osteoarthritis has affected your ability to work.

Osteoarthritis (OA) is a degenerative joint disease caused by the gradual loss of cartilage. This debilitating condition worsens over time, often causing partial or full disability. The progressive degeneration of Osteoarthritis is classified into 4 stages from Stage 0 with no joint damage to Stage 4 with the most severe and advanced form of Osteoarthritis. It is further classified into primary and secondary osteoarthritis.

Primary osteoarthritis is most often caused by stress placed on weight-bearing or weakened joints with symptoms of pain and discomfort. Secondary osteoarthritis symptoms normally stem from a separate condition caused by injury or other diseases such as inflammation.

The symptoms of pain and joint stiffness caused by osteoarthritis may prevent you from carrying out your work, which means that you may be eligible to receive Social Security Disability benefits. Osteoarthritis can be very painful as it attacks the joints and limits the ability of a person to function normally. Osteoarthritis is a comorbid condition as it is both expensive to treat and can cause disability to the extent that a person is unable to work. About one-third of expenditure for osteoarthritis is spent on medications and about half of the direct costs of the disease are contributed to hospitalization.

Unfortunately, getting a disability claim approved can be difficult. A Social Security disability advocate can help you through this challenging process. Having an advocate to represent you maximizes your chances for success, even if your claim has already been denied.

How Does Osteoarthritis Affect My Ability to Work?

Over time, repetitive movements and bearing weight places stress on the joints. When the joints weaken, they begin to deteriorate and develop OA symptoms, including pain and stiffness. Osteoarthritis can also develop due to prior injuries or inflammation.

No matter what caused your OA, worsening symptoms can interfere with your ability to work.

If you can’t work, or if you can no longer perform your regular job duties, you could even lose your job.

What Is Social Security Disability Insurance (SSDI)?

Social Security disability insurance (SSDI) is a government-run program funded by social security taxes. This program is designed for individuals who, due to medical, psychological, or mental health issues, are unable to get or keep gainful employment.

Any person with a sufficient history of Social Security payroll tax payments may qualify if he or she is considered to be disabled by the SSA (Social Security Administration).

Do I Qualify for Social Security Disability Benefits?

In order to apply for SSDI benefits certain provisions must be met including:

  • The condition has rendered you incapable off working for at least 12 months
  • Possess a sufficient history of work credits

Generally, you need a total of 40 credits to quality, 20 of which must have been earned during the ten-year period before the disability started. You can earn a maximum of four credits in a year as long as you meet minimum earning amounts for each credit ($1,410 per credit in 2020).

For example, if a person has worked for at least five of the past ten years and met the minimum earning requirements during each of those years, they should meet the technical qualifications required for eligibility. Certain exceptions do exist for younger applicants who may be allowed to qualify based on the work records of their parents.

Is Osteoarthritis a Disability Under Social Security?

The effects of osteoarthritis can be considered a disability by the SSA.

The SSA maintains a listing of all qualified disability conditions, commonly referred to as the Blue Book. If the Blue Book lists a disease or disorder by name, this typically helps facilitate the disability application and approval system. The bad news is that this publication does not specifically name osteoarthritis as a listed condition. Fortunately, the Blue Book does have a category for musculoskeletal impairments and, specifically, joint dysfunction.

Qualifying for Disability Under the Listing for Joint Dysfunction

To get your osteoarthritis disability claim approved, you must apply under the listing of “Major Dysfunction of a Joint(s).” This category encompasses any condition that leads to joint dysfunction, as OA does.

The Blue Book criteria for joint dysfunction include:

  • Gross anatomical deformity,
  • Chronic joint pain,
  • Joint stiffness,
  • Limited range of motion, and
  • Instability.

If your OA affects your legs, the condition must impair a weight-bearing joint and interfere with your ability to walk. The weight-bearing joints of the lower extremities are:

  • Ankle,
  • Knee, and
  • Hip.

If you have osteoarthritis in your upper body, the condition must affect one or more of the following:

  • Shoulder,
  • Elbow,
  • Wrist, or
  • Hand.

To qualify for benefits, your condition must also impair your ability to perform fine or gross hand movements.

What Evidence Do You Need to Support Your Osteoarthritis Disability Claim?

To support an SSDI claim under the joint dysfunction category, you must provide imaging tests that reflect one of more of the following conditions:

  • Joint narrowing,
  • Bony destruction, or
  • Abnormal stiffening or immobility (ankylosis).

Unfortunately, the fact that you suffer from osteoarthritis is not enough to get your claim approved. To effectively document your SSDI claim, you must demonstrate how your OA-related disability prevents you from working. Typically, this information comes from a medical examination called a residual functional capacity (RFC) assessment. 

Can I Qualify for Disability Based on Reduced Functional Capacity?

According to the World Health Organization (WHO), osteoarthritis is the most common cause of disability for older adults. However, this chronic disease can affect individuals of all ages. For working adults, OA can interfere with your ability to perform your job.

The U.S. Centers for Disease Control (CDC) reports that osteoarthritis disability prevents 8 million U.S. residents from working to some degree. Some people with OA can’t work at all. Many more can work to some degree but can no longer perform some portion of their previous job duties.

If you have lost the ability to work, even partially, your reduced functional capacity can qualify as a disability.

How to Apply for Osteoarthritis Social Security Disability

To apply for Social Security disability for osteoarthritis, you can visit a local SSA office in person. Alternatively, you can schedule a phone interview to process your application or you can fill out the necessary forms online.

Some of the information you will need to complete the process includes:

  • Information for all doctors, hospitals, and clinics where you have sought medical treatment;
  • Names and dosages of all your current medications;
  • Names and birth dates of your spouse and minor children, if applicable;
  • Names and addresses of current and past employers;
  • Copies of your federal tax return and most recent W-2s;
  • Medical testing records and lab results; and
  • A timeline for when your disability first affected your ability to work.

You might have to provide other information as well, depending on the records you have in your possession. You must take care, however, because any errors in the application process can lead to a denial of your claim.

You do have another option for applying for SSDI. You can trust an experienced attorney or disability advocate to assist you.

How a Disability Advocate Can Help You Get SSDI Benefits for Osteoarthritis

Applying for disability benefits can be a confusing and daunting process. Because of all the possible complexities involved, it can be difficult to negotiate this process. The best way to ensure a successful outcome is to have the right legal representation.

A disability advocate can help you present your case in an appropriate manner to the SSA to ensure that it receives the consideration it deserves.

Based on SSA data, the disability claims approval rate is only 22% for initial claims. In other words SSA denies approximately 78% of initial claims. In most cases, the denials occur due to incorrect, missing, or insufficient information. The overall award rate is only 28.8%, which means your chances of winning an appeal are also marginal, at best.

You can hire a lawyer to assist you, and improve your chances of getting an approval. First, however, consider using the services of a Social Security disability advocate from GAR Disability Advocates. Our fees are set by the SSA but we only get paid when we get your benefits approved. SSA deducts our fee in advance, so you never have to pay out-of-pocket for our assistance. 

Free SSDI Case Evaluation from GAR Disability Advocates

Here at GAR Disability Advocates, we are a team of highly trained and experienced legal professionals who assist clients with qualifying for disability benefits. 

We provide compassionate assistance for clients who cannot work and who rely on getting their benefits to survive. We take this frustrating and complex process and make it simple for you, increasing your chance of getting an approval and maximizing your benefits payout. We can help you with your initial claim or at any step in the appeals process. Best of all, you pay nothing until we get your benefits claim approved.

Contact us now for your free SSDI benefits case evaluation.

Need Help Getting Your Disability Claim Approved?

If you or a loved one need help getting your disability claim approved, contact a GAR Disability Advocate today for a free consultation.

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