Is Degenerative Arthritis An Eligible Social Security Disability?

by Jul 4, 2018Disability Benefits

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If you have degenerative arthritis, also known as degenerative joint disease (DJD) and osteoarthritis, you might qualify for benefits through one of Social Security’s two disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

Degenerative arthritis can affect any joint—though it most often appears in the neck, hips, knees, lower back, and hands—and if severe enough, it can prevent you from working and earning a living. The condition, which can be brought on by both genetic and lifestyle factors, causes pain, stiffness, reduced mobility, and restricted joint motion.

Any of these symptoms can limit your functional capacity, which makes degenerative arthritis an eligible Social Security disability.

How to Get Disability Benefits for Degenerative Arthritis

If your degenerative arthritis is severe enough to keep you from working and earning a living, you might be able to get Social Security disability for your condition. SSDI and SSI provide monthly compensation and often make you eligible for government health care benefits through either Medicare or Medicaid. There are two ways you can qualify for Social Security disability for degenerative arthritis.

One, you can prove to the SSA that you meet the criteria of a “Blue Book” listing. Or, two, you can complete a Residual Functional Capacity (RFC) test showing that your condition limits you the same way a Blue Book condition would.

Blue Book Listings for Degenerative Arthritis

The Blue Book is a list of conditions that qualify for Social Security disability. Under each condition is a list of qualifying criteria. If your diagnosis meets all the criteria for that condition, you are eligible for disability based on the Blue Book listing.

Although the Blue Book has no specific listing for degenerative arthritis, it does have two listings under which you might be able to qualify: major dysfunction of a joint (listing 1.02) and disorders of the spine (listing 1.04). The criteria for getting benefits under the listing for major dysfunction of a joint are as follows:

  • The joint must have a physical abnormality (e.g., subluxation, instability).
  • You must present MRI evidence of joint narrowing, joint fusion, or bone or cartilage destruction.
  • The condition must cause you to have restricted mobility and chronic stiffness.
  • You must prove that you have difficulty walking or using your hands.

To receive benefits for a spine disorder under listing 1.04, you must meet at least one of the following criteria:

  • Spinal stenosis
  • Arachnoiditis
  • Nerve root compression

Most recipients of Social Security disability do not qualify based on a Blue Book condition, as the SSA is very strict when holding an applicant’s condition up against the required criteria. If you do not meet the Blue Book criteria, you can apply with a Residual Functional Capacity (RFC) test.

The Residual Functional Capacity (RFC) Test

The Residual Functional Capacity (RFC) test offers another way to get benefits if you do not meet the requirements for a Blue Book listing. This test, as its name indicates, measures your residual functional capacity, which is a fancy way of describing the amount of functionality you still have in spite of your condition.

Functionality refers to your ability to carry out work duties as well as daily living activities, such as:

  • Eating
  • Bathing
  • Dressing
  • Toileting

The RFC test, then, lets the SSA know what kinds of activities you can and cannot perform. The SSA uses these results to decide whether it believes you are capable of working or not.

To have an RFC test completed, you must visit either your own doctor or one appointed by the SSA. The doctor will perform a physical exam, run tests, ask you questions, and do whatever else they deem necessary to obtain an objective measurement of your functional capacity. Once the test is complete, we submit the results to the SSA, along with any supporting evidence—for example, lab test results, or a personal statement from your physician.

What if Social Security Denies My Disability Application for Degenerative Arthritis?

If the SSA denies your application, you can appeal its decision. A Social Security disability lawyer can help you with this process. Our firm has had a lot of success working with clients who were turned down in the past and helping them get approved the second time around.

Call 865-566-0800 to Schedule a Free Case Evaluation With a Social Security Disability Lawyer

A Social Security disability attorney from the Disability Advantage Group, can evaluate your case and let you know if your degenerative arthritis is an eligible Social Security disability. We offer a free consultation and case evaluation. To schedule your appointment, call our office at 865-566-0800.