Proving Arthritis-Based Disability

The Arthritis Foundation estimates that up to 2.1 million Americans are affected by rheumatoid arthritis. The incidence is higher after age 50, and it can affect the whole body. It lurks in the hands, skin, heart, lungs and joint linings, leading to long-term joint damage and chronic pain.

For a Social Security disability claim, the clinical findings are of utmost importance. An examination by a rheumatologist is optimal, but may not always be available. The Social Security regulations require more than simple findings of reduction in mobility, range of motion and reports of pain. Such findings have to be supported by laboratory tests, including either antinuclear antibody (ANA) tests, a positive serologic test, an elevated sedimentation rate or a biopsy showing changes in synovial membrane.
Social Security will usually not provide any definitive tests in its consultative examinations. A claimant with arthritis is often sent for evaluation to doctors who are not rheumatologists. X-rays may be done by Social Security doctors, but x-rays do not show cartilage damage and may not clearly show bone deterioration caused by arthritis.

The severity of rheumatoid arthritis can be proven by statements from doctors and other observers about functional limitations. It is important to have clear statements about limitations on use of hands, arms or legs, and ability to sit, stand and walk.

If repetitive motion will exacerbate the pain and the underlying condition, this should be noted. There is a big difference in being able to lift something once and being able to lift it multiple times during a day.

It can be especially important to clarify the good day/bad day differences. For example, if during most days a person must periodically lie down and rest for extended periods, it is important to document this. It would preclude most competitive employment.

Social Security law asks whether a person is able to do full-time work. If the claimant cannot perform on a predictable, consistent and productive basis, it is likely that disability can be established. Ability to work on a hit-or-miss basis is not enough.