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Social Security Disability Benefits For Osteoarthritis
I have been diagnosed with osteoarthritis. Can I apply for Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?
If you have received a diagnosis of osteoarthritis, you have the foundation for a Social Security disability claim. However, the main focus will be on the symptoms you experience from osteoarthritis and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week.
As the most common form of arthritis in the world, osteoarthritis is almost expected as we age. It occurs when the cartilage (cushioning tissue) that protects the ends of our bones wear out over time. This wearing out can happen at any joint of the body, but the most commonly affected are the hands, hips, knees, and spine.
Symptoms of osteoarthritis slowly worsen as time passes. These signs include joint pain, tenderness, and/or stiffness; loss of flexibility; grating sensation at the joints; and bone spurs, which are hard lumps on the bones around affected joints. Even though there are ways to manage these symptoms, the main disorder unfortunately cannot be cured.
Is Osteoporosis Considered a Disability?
When osteoarthritis worsens, it can be disabling. The Social Security Administration (SSA) uses a 5-step process to decide if you are disabled.
Step 1. Do you work with a gainful activity?
The SSA first considers your work activity. If you are engaged in Substantial Gainful Activity (SGA) you will not be found disabled. The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found as disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your osteoarthritis and any other physical or mental conditions are considered.
Step 2. Does your condition qualify as “severe”?
To be considered disabled, your medical condition must significantly limit your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.
By SSA standards, being disabled entails that you have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits. If your condition is that severe, SSA goes to Step 3.
Step 3. Does your osteoarthritis match a Listing?
The Social Security Administration maintains a list of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them. The Adult Listing for osteoarthritis can be found here.
If you do not have an impairment that meets or equals one of the listings or the duration requirement is not met, SSA determines what you’re capable of doing despite your impairments – your Residual Functional Capacity (RFC) – and will proceed to Step 4.
RFC is a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments. In short, it is an evaluation of your capacity for full-time work.
Step 4. Can you still do any of the work you’ve done in the past fifteen (15) years?
At this step, the SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity (SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, SSA goes on to Step 5.
Here at Step 4, you have the “burden of proof”, which means you must present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.
Some types of objective medical evidence that can support a claim for disability based upon osteoarthritis include:
- General clinical records
- Documentation of medically prescribed treatment and response
- Imaging results (MRI, CT scan, or x-ray)
- Clinical notes of specialists
In terms of specialists’ opinions, these are doctors and professionals who specialize in treating osteoarthritis:
- Rheumatologists – top specialists in arthritis and other joint problems.
- Orthopedists – specialists in bone or joint damage.
- Physical therapists or Occupational therapists – trained non-doctor professionals who help you restore your movements and function.
Bear in mind that if you are only treating with your family doctor or primary care doctor for your osteoarthritis, the SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).
Step 5. Are you able to do other work?
At Step 5, the “burden of proof” shifts to SSA. If you cannot do your past relevant work, SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, SSA will determine you are not disabled. If you cannot do other work, SSA will find you disabled.
Are you older than 50? If so, there are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.
Osteoarthritis is so common that people tend to forget how much suffering it can bring. But you likely know how this condition can greatly restrict your capacity to work and live your life. Don’t be discouraged from claiming the assistance you may deserve.
Contact Gillette Law Group
For your best chance of receiving disability benefits, contact us at the Gillette Law Group. We are on your side, and we can help you pursue a highly effective disability application – just as we have successfully served numerous applicants like you over the years. Whether you are claiming for the first time or appealing a previously-denied claim, we can help you get approved by the SSA.
Your consultation with us is free, so talk to us today at (855) 873-2604.