Rheumatoid arthritis is a chronic inflammatory disorder that affects a person’s joints. The disease can also damage a variety of other body systems, such as the skin, eyes, lungs, heart and blood vessels. Rheumatoid arthritis is an autoimmune disorder and occurs when a person’s immune system attacks the membranes surrounding his or her joints, causing them to inflame. Unlike osteoarthritis which is damage caused by general wear of the joint, rheumatoid arthritis impacts the lining in the joints and causes painful swelling that may result in bone erosion and joint deformity over time.
Early in the disease process, rheumatoid arthritis usually affects smaller joints such as the joints in a person’s fingers, hands, toes and feet. As the disease process progresses, larger joints such as the writs, knees, ankles, elbows, hips and shoulders become affected. Generally, symptoms occur on both sides of the body. Common joint related symptoms include tender, warm swollen joints and joint stiffness that may be worse in the mornings or after periods of inactivity. Fatigue, fever, and loss of appetite are also common symptoms individuals with rheumatoid arthritis experience. Rheumatoid nodules can also develop. These nodules are firm lumps under the skin. The disease can progress and a person’s joints can become permanently deformed over time. Symptoms from this disease vary in severity and longevity. Flares can occur when an individual has periods of relative remission but suffers from periods of increased disease activity and symptoms. Flares can last for days or months.
To qualify for Social Security Disability, an individual who suffers from rheumatoid arthritis may meet the medical requirements of the Listing of Impairment 14.09 titled “Inflammatory Arthritis.” According to the listing, a person may be found disabled if there is evidence of persistent inflammation or persistent deformity in his or her lower extremities which causes severe difficulties ambulating, such as the need to use two canes, two crutches, a walker, or a wheelchair. Social Security also lists the inability to walk at a reasonable pace on rough or uneven surfaces and the inability to use public transportation as other examples of the inability to ambulate effectively. The listing can also be met if an individual’s rheumatoid arthritis affects his or her upper extremities and results in an extreme loss of function, such as the inability to prepare a simple meal and feed oneself, the inability to take care of personal hygiene or the inability to sort and handle papers or files. A person can also meet the requirements of the listing if he or she has inflammation or permanent deformity in one or more major joints and involvement of at least two or more organs or body systems accompanied by at least two symptoms of severe fatigue, fever, malaise, and/or involuntary weight loss. Alternatively the listing is met if the individual has ankylosing spondylitis or another spondyloarthropathy with fixation of the spine of at least forty-five degrees or with fixation of the spine of at least thirty degrees with moderate involvement of two or more body systems. Lastly, the listing can be met if a person suffers from repeated manifestations of inflammatory arthritis and has at least two symptoms of fatigue, fever, malaise or involuntary weight loss and the person has marked or severe difficulties in at least two of the following: activities of daily living, social functions, or ability to complete tasks in a timely manner due to deficiencies in concentration, persistence or pace.
Alternatively, if the requirements of the listings are not met, Social Security will determine a person’s capacity to work by evaluating the extent and the severity of his or her symptoms. Rheumatoid arthritis may affect a person’s legs, ankles, knees and feet making it difficult of him or her to stand and/or walk. For individuals whose rheumatoid arthritis affects his or her hands, wrists, and/or fingers, Social Security will likely find the person has limits on how much he or she can write, type, handles small and large objects. Documented symptoms of malaise and fatigue may prove a person is limited in his or her ability to engage in strenuous activities or physical exertion.
Social Security will rely on an individual’s medical records when determining whether a listing is met, and if not, what work restrictions that person has. Generally, a rheumatologist specializes in and treats patients with rheumatoid arthritis and seeking treatment from a specialist is important to prove disability. Additionally, it is imperative that a person’s medical records include the diagnosis of rheumatoid arthritis, blood tests indicating that the diagnosis is likely, physical examinations that reveal inflammatory arthritic abnormalities and documentation of the frequency and severity the individual’s symptoms.