Rheumatoid Arthritis and Social Security Disability Benefits
When I was diagnosed with RA at the age of 25, I was right in the middle of law school and had not yet started my career. However, many people struggle with RA in the prime of their working years, and despite advanced treatments and laws to protect us in the workplace, not everyone with RA is able to continue working. This can be frustrating and disheartening, and can be made more so by the bureaucratic confusion surrounding the process of applying for disability benefits. Although I have no personal experience with this issue, I do have the hard-won research skills and ability to read code that comes with graduating from law school! And while I can’t offer any legal advice, I hope that this article can help explain some of the mystery behind applying for Social Security disability benefits.
Social Security Disability Programs
The Social Security Administration is the branch of the United States government that provides disability benefits to individuals who are out of work for at least a year due to long-term disability. If you have been diagnosed with rheumatoid arthritis (RA) and subsequently have been unable to continue working, there are two types of benefits for which you may qualify. While both of these programs require you to prove the extent of your disability, the other aspects of qualifying for each program differ greatly.
The first program is Social Security Disability Insurance (SSDI). To qualify for SSDI benefits, you must have earned enough work credits during your recent work history. In most cases this means you must have worked for five of the past ten years. However, if you are not old enough to have a ten-year work history, you must have worked half of the time that you have been able to work since the age of 18. For example, if you are 24 years old you will be expected to have worked three of the past six years in order to qualify.
If you do not have enough work credits to qualify for SSDI benefits, you may still be able to qualify for the second program, which is called Supplemental Security Income (SSI). SSI is a needs-based program for low-income families. In addition to meeting the disability criteria, you must also meet certain income and asset restrictions. As of 2013, in order to qualify for SSI benefits you must earn no more than $710 per month as an individual or $1,066 per month as a couple. You must also have less than $2,000 in assets as an individual or $3,000 in assets as a couple.
Qualifying for Social Security Disability With RA
The Social Security Administration has a publication called the Blue Book that lists all of the medical conditions that may qualify an individual for disability benefits, along with the criteria that must be met. The easiest way to qualify for either of the above programs is to submit medical documentation to prove that your RA meets the criteria listed in the Blue Book.
RA can be found in Section 14.09 of the Blue Book, under the heading “Inflammatory Arthritis.” In addition to providing proof of your diagnosis, the Blue Book requires you to be able to prove at least one of the following: (1) You suffer from persistent inflammation or deformity in one of your major weight-bearing joints, which results in the inability to move freely. (2) Your condition affects both of your arms and prevents you from performing everyday tasks. (3) Other organs are involved, causing at least two of the following symptoms: severe fatigue, fever, malaise, and/or involuntary weight loss. And/or (4) you suffer from repeated rheumatoid arthritis flare-ups with at least two of the following symptoms that cause limitations in your daily living activities: fever, fatigue, unexplained weight loss.
Applying for Social Security Disability Benefits
In order to apply for Social Security disability benefits, you can visit your local Social Security office in person or you can apply online. If you can provide medical evidence to show that your RA meets the requirements listed in Section 14.09 of the Blue Book, you will be much more likely to be approved for benefits during the initial stage of the application process. After you submit your application, you should expect a decision from the Social Security Administration within three to six months. If you are approved, your award letter will tell you when you can expect to begin receiving benefits.
Appealing a Denied Claim
If the Social Security Administration denies your original application, you may want to pursue a disability appeal. To do so you must file your appeal within 60 days of the date of your denial letter. At this point you should also consider retaining the services of a Social Security attorney, who can help you through each stage of the appeal process including your disability hearing. At the hearing your chances of receiving benefits will be greater than at any other point in the appeals process and statistics have shown that applicants with legal representation are more likely to be awarded benefits than those who try to represent themselves.
After the past 2+ years, how do you feel about telehealth appointments to manage your RA?