SSDI Benefits Could Help Those With Arthritis

Does Your Arthritis Qualify You For Social Security Disability Benefits?

If you have arthritis, you may qualify for Social Security Disability Insurance (SSDI). To find out if you qualify, review your condition under the Social Security Administration’s (SSA) five-step sequential evaluation process:

1. Are you working? The SSA defines work as the ability to engage in substantial gainful activity (SGA). If you are working and earning more than SGA, your benefits will be denied. To qualify, your condition must prevent you from working for at least 12 continuous months.

2. Your condition must be severe enough to limit significantly your ability to perform basic work activities like:

• 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 work situations.
• Dealing with changes in a routine work setting.

The cost of treating arthritis depends on the medication used. Disease-modifying anti-rheumatic drugs (DMARDs) typically cost between $1,500 and $2,000 each year, while biologics cost $1,300 to $3,000 per month. It’s not uncommon for RA patients to pay up to $30,000 every year for medication. Although your health insurance may cover part of the costs, you may have to pay out of pocket as much as 30% of the cost of your drugs.*

*Source: WebMD.com.

3. Does your arthritis meet or equal a medical listing? Arthritis is listed under Musculoskeletal Disorders (Listing 1.00) and Immune System Disorders (Listing 14.0), and has several specific medical listings or categories.

Osteoarthritis
With degenerative arthritis (osteoarthritis), you satisfy the requirements if you have significant:

• Limitations using your arms/hands.
• Issues standing and walking.
• Back or neck issues with persistent sensory, reflex and motor loss.

Inflammatory Arthritis
If you have inflammatory arthritis (such as rheumatoid arthritis), to satisfy Listing 14.09, you must have:

• Persistent swelling.
• Pain.
• Joint limitation (hip, knee, ankle, shoulder, elbow, or wrist and hands).

If your arthritis doesn’t satisfy a medical listing, the SSA continues to the next two steps to review how your limitations and symptoms affect your ability to work.

4. Can you perform work you’ve done in the past? If you can, benefits are denied. If you cannot, the process proceeds to the last step.

5. Are you capable of performing other work? SSA will review vocational factors (age, education, work experience), to determine what other work, if any, you can do. At this step, the SSA enlists medical-vocational rules. If SSA finds there is other work you can perform, benefits are denied. If SSA finds you do not have transferable skills to do any other work, benefits are awarded.