Getting approved for disability benefits for degenerative joint disease (DJD) is a multi-step process. The first step is proving that your medical condition is severe enough to satisfy the Social Security Administration (SSA). The SSA uses the Blue Book, also called the Listing of Impairments, to evaluate medical conditions for the purpose of disability benefits.
What are the Blue Book requirements for Degenerative Joint Disease?
DJD is also called degenerative arthritis or osteoarthritis. DJD is addressed in two areas in the Blue Book:
- Major dysfunction of a joint; and
- Disorders of the spine.
Although DJD can cause pain, stiffness, and decreased range of motion in the joint, these clinical findings are not enough to convince the SSA that your condition is serious enough to prevent you from working. Your complaints of pain will likely be dismissed if you cannot back them up with objective medical evidence.
Your medical evidence must describe the severity of your condition. Your x-rays or MRIs must show such visible physical changes as the narrowing of joint spaces, destruction of bone or cartilage, or fusion of the joint. Your records may show instability of your joint, permanent joint shortening, or partial or incomplete dislocation.
The medical imaging evidence should also be supported by clinical findings by your doctor. For DJD, this can include decreased strength and decreased range of motion.
The most common areas for DJD are the lower back, neck, knees, hips, shoulders, and hands. If your DJD is in your spine, you must have a diagnosis of nerve root compression, arachnoiditis, or spinal stenosis in order to qualify for Social Security Disability Insurance (SSDI) under the Blue Book criteria.
The physical changes, along with the pain, stiffness, and decreased range of motion of your joints must make it quite challenging for you to work to qualify for disability benefits. Your DJD must be either:
- So severe in at least one of your hips, knees, or ankles that you cannot walk or stand effectively; or
- Involve both of your arms to the extent that it prevents you from being able to perform fine or gross movements effectively.
You should be seen regularly by a medical doctor (M.D.) or an osteopathic doctor (D.O.), in order for the SSA to take your claim seriously. The SSA does not accept your condition as serious if you are only undergoing chiropractic treatment.
What if I do not qualify under the Blue Book criteria for DJD?
The Blue Book does not contain every medical condition that could possibly render a person unable to work. For this reason, the SSA allows you to qualify medically if you can prove that you have a medical condition that is of “equal severity” to a condition that is listed in the Blue Book. This condition must be shown with objective, accepted medical diagnostics and other testing. You must also show that your condition is serious enough to prevent you from being employed.
What if I do not have a condition the SSA considers severe enough for disability benefits?
Do not despair. If you have a legitimate medical condition that has progressed to the point that it causes you to be unable to work, this can qualify you medically with the SSA. Some people have multiple medical conditions, any one of which might qualify them for disability benefits. The test is whether it is reasonable that your medical condition causes you to be unable to maintain employment and support yourself. This is a subjective standard, as long as it is reasonable for your medical status to prevent you from working.
Is my medical condition enough to get me disability benefits?
By itself, no medical condition is enough to get you disability benefits, because there are non-medical requirements as well. If, despite your medical condition, you somehow manage to earn more than $1,170 a month—$1,950 for legally blind persons—you will not be considered disabled. At that point, you are considered capable of substantial gainful activity (SGA).
In addition to the earnings limit, you must have accumulated enough work credits in order to qualify for an award of SSDI benefits. Work credits are earned by working at a job that pays into the Social Security system. For every three-month period that you work enough, you will earn work credits. Until you have accumulated enough work credits, you will not be eligible for SSDI benefits, because SSDI is an insurance program.
The number of work credits you need will depend upon your age at the time you became disabled. Younger workers need fewer work credits and older workers, who have had more time to accumulate work credits, are required to have more work credits.
I am disabled but I do not have enough work credits. What can I do?
There is a safety net for people who are disabled but have not accumulated enough work credits to qualify for SSDI benefits. If you have low income and few assets, you might qualify for Supplemental Security Income (SSI). Although both SSDI and SSI programs are administered by the SSA, they are considered separate and receive their funding from completely different sources. Both programs, however, use the Blue Book to evaluate medical conditions. You must meet the Blue Book medical qualifications in order to receive SSI benefits.
Qualifying for disability for DJD is a difficult and challenging process. Most people are denied benefits the first time they apply. After fighting through the appeals process, however, many people are awarded Social Security Disability benefits. The Social Security Disability attorneys at the Disability Advantage Group will help you through every stage of the process. We will handle your disability claim and we will not give up until you get the benefits you deserve. Call us today at 865-566-0800 for a free consultation.