Arthritis and Social Security Disability Insurance
Here is an explanation of Social Security's five-step process to determine if an arthritis patient qualifies for SSDI:
1. Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $940 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
2. Conclude the arthritis disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
3. Ask if the arthritis disability meets or equals a medical listing. Arthritis is considered under the musculoskeletal body system and has several specific medical listings or categories. To satisfy the listing criteria, a person with inflammatory arthritis (such as rheumatoid arthritis) must have:
- persistent swelling.
- pain.
- limitation of joints (hip, knee, ankle, shoulder, elbow, or wrist and hands).
People who have degenerative arthritis (osteoarthritis) satisfy the requirements if they have:
- significant limitations using their arms/hands.
- a significant problem standing and walking.
Those who have significant back or neck problems due to degenerative arthritis must have persistent sensory, reflex and motor loss.
However, if a person’s arthritis disability does not satisfy a medical listing, the SSA continues to the next two steps to see whether the person might still qualify for disability benefits. At the next two steps, the SSA looks primarily at how the actual limitations and symptoms imposed by arthritis affect a person’s ability to perform work. Thus, at Steps 4 and 5, Social Security looks more specifically at the work-related impact of arthritis.
4. Explore the ability of an individual to perform work they have done in the past despite their arthritis. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine arthritis disability, the SSA enlists medical-vocational rules, which vary according to age.
For example, if a person is:
Under age 50 and, as a result of the symptoms of arthritis, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires 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.
Age 50 or older and, due to the disability, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.
Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.
Over age 60 and, due to the disability, unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.
Any age and, because of arthritis, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.
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