Arthritis can debilitate you. Pain, achiness and stiffness in your affected joints may prevent you from even getting out of bed in the morning. If your arthritis has progressed to the point that it has stopped you from working, you need to apply for Social Security Disability benefits as soon as possible.
Attorney Kimberly Bishop, of The Bishop Law Firm, is a NC Board Certified Social Security Disability Lawyer in Raleigh, NC who has practiced disability since 2009 in North Carolina. In addition, Chasity Everett, EDPNA, also represents disability clients for the firm and has worked with disabled clients since 2002.
If you are looking for a Social Security Disability Lawyer in NC, give us a call today for a free case review, 919-615-3095 or you can start your free case review online now.
Types of Arthritis
There are two main types of arthritis: osteoarthritis (most common) and rheumatoid arthritis. Psoriatic and Gout are also types of arthritis.
Osteoarthritis
Osteoarthritis (wear and tear) occurs when the cushioning at the end of your bones deteriorates. If you injure a joint, you can later in life develop osteoarthritis in that area. In addition to old injuries, you can develop osteoarthritis simply by aging.
In my clients with osteoarthritis, they describe chronic pain with altered joint function. Activity aggravates the pain especially if the arthritis is in a weight bearing joint.
Osteoarthritis can be detected by imaging (x-ray and MRI), joint fluid analysis and certain (limited to ruling out other diagnosis) blood tests.
Pain medication, physical therapy, a tens unit and injections are all treatment options. My clients frequently say that the effectiveness of these treatments often wane the longer they are applied.
Rheumatoid Arthritis
Rheumatoid arthritis (inflammatory arthritis) happens when your body attacks itself (auto immune disorder). It can affect joints and bones but also internal organs and body systems.
RA usually starts small by affecting smaller joints first (fingers and toes). Chronic pain and even bone deformity are symptoms. The medications used to help with RA can have their own set of disabling side effects (Also read our post on Rheumatoid Arthritis).
Gout
Gout involves a buildup of crystals (uric acid) in one specific area causing tenderness, swelling and pain. A gout attack can happen suddenly and leave a patient unable to walk or use their arm (big toes and elbows are frequent sites of gout attack).
In my clients with gout, they are usually on a daily preventative and take a different medication for sudden attacks. The frequency of gout attacks can rule out work for those with severe symptoms.
Psoriatic Arthritis
Psoriasis is a skin disorder which causes itchy, scaly rashes. Not everyone with psoriasis will develop Psoriatic Arthritis, but for those that do, it can start at the same time as your psoriasis symptoms or years later. Joint pain, stiffness and swelling are the symptoms of psoriatic arthritis, adding itchy scaly rashes to that can make life difficult.
Controlling inflammation is the goal for Psoriatic Arthritis treatment. As with most drugs to control inflammation, there can be side affects and those alone may eliminate a person’s ability to work.
Social Security Disability Benefits
Social Security (generally) offers two types of benefits for the disabled:
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general).
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2023, SSI is $914.00 per month for an individual and $1,371 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
You must be found disabled by SSA before you are entitled to either benefit. The Social Security Administration uses a Five Step Sequential Evaluation to determine if you are disabled:
- Step 1 – Are You Working? The Social Security Administration defines work as “Substantial Gainful Activity” (SGA). SGA is roughly defined as work from earnings that average more than $1,470 (2023) a month. If you are making that amount you generally will not qualify for disability.
- Step 2 – Is Your Condition “Severe”? Severity is key when it comes to what qualifies as a disability. Severe is defined by the Social Security Administration as: your condition must interfere with basic work-related activities for your claim to be considered.
- Step 3 – Is Your Condition on the List of Disabling Conditions? The Listings are very hard to meet in most cases and not always interpreted as a common reading would suggest. If you meet a listing you are gravely ill. The listings are found here.
- Step 4 – Can You Do the Work You Did Previously? The Social Security Administration will look at your past work and determine if it was sedentary, light, medium, or heavy. They also will evaluate the skill level: unskilled, semi-skilled and skilled. For instance, an attorney would be sedentary skilled work. The Dictionary of Occupational Titles is found here.
- Step 5 – Can You Do Any Other Type of Work? If the Social Security Administration finds that you cannot do what you used to do, they then look to see if you can do anything else. This is where the “grids” come into play. The grids are the Medical-Vocational Guidelines. The grids are only for exertional impairments. Non-exertional impairments are not considered by the grids. If you are found to be capable of any other work, you will be found not disabled. Read The Grids and Your Social Security Disability Case.
Disability for Arthritis
The first step in attaining disability benefits for arthritis is to seek medical treatment to find out which type of arthritis you have and begin appropriate medical treatment.
If you are unable to work due to your arthritis, your next step will be to file a claim online or at your local SSA office for disability benefits.
SSA will apply the above Five Step Sequential Evaluation at every level of the disability process.
As with most conditions in the SSA world, severity is more important than the name of your impairment.
Receiving the appropriate medical treatment for your type of arthritis and still being unable to work due to the severity of your symptoms gives you your best chance of attaining disability benefits.
The Social Security Administration can evaluate arthritis under listing 14.09 Inflammatory Arthritis.
A. Persistent inflammation or persistent deformity of:
1. One or more major peripheral joints in a lower extremity (see 14.00C8) and medical documentation of at least one of the following:
- A documented medical need (see 14.00C6) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i)); or
- An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7), and a documented medical need (see 14.00C6) for a one-handed, hand-held assistive device (see 1.00C6d) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii)); or
2. One or more major peripheral joints in each upper extremity (see 14.00C8) and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7).
OR
B. Inflammation or deformity in one or more major joints of an upper or a lower extremity (see 14.00C8) with:
1. Involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity; and
2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
OR
C. Ankylosing spondylitis or other spondyloarthropathies, with:
1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45° or more of flexion from the vertical position (zero degrees); or
2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 30° or more of flexion (but less than 45°) measured from the vertical position (zero degrees), and involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity.
OR
D. Repeated manifestations of inflammatory arthritis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:
1. Limitation of activities of daily living.
2. Limitation in maintaining social functioning.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
In addition to Listing 14.09, SSA can use Listing 1.00 Musculoskeletal Disorders or the Grid Rules to find a claimant disabled.
Also read Social Security Disability Conditions
As we have written before, the Listings are often difficult to meet and 14.09 is no exception. Your ability to work will be affected long before you meet this Listing.
You may still be able to use your arms and legs, but it hurts terribly to do so. When one day of use requires 7 days of recovery, work is not an option.
I advise clients not to worry about meeting this or any other listing. If you are following your doctor’s advice but still are unable to work because of your arthritis, apply for Social Security Disability Benefits as soon as possible and appeal all denials.
Your best statistical chance of being approved for Social Security Disability is before a Social Security Administrative Law Judge but you have to file and then appeal twice to get to that level.
The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Winston Salem, Garner, Greensboro, Greenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095.
Also read NC Social Security Disability Lawyer