Joint pain, mobility problems, and other symptoms of rheumatoid arthritis (RA) can affect your daily life and make full- or part-time work challenging. When people with RA can no longer work, many in the United States seek Social Security disability benefits. Disability benefits help replace lost income when people with RA have to leave their jobs.
Many people with RA work for decades before applying for disability benefits. One myRAteam member wrote, “I have decided after 30 years of medication and pain and trying to keep working, I can’t take it anymore. I am applying for disability.”
You’re not alone if you share these sentiments. The Centers for Disease Control and Prevention (CDC) found that 19 percent of those who qualified for disability benefits between 2011 and 2013 reported “arthritis/rheumatism” as their main problem.
Leaving a job or considering leaving because of a disability can cause significant financial stress. “I worry about the future financially, as we still have mortgage payments and [I have an] inability to work in the future,” a myRAteam member commented.
The process of applying for a disability claim can feel intimidating, especially if you are newly diagnosed with RA. Knowing ahead of time what is needed to get Social Security disability benefits can help. Here’s what the Social Security Administration (SSA) uses to determine disability and how to go through the application process to receive benefits.
There are two federal disability programs in the United States, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both share one requirement: The person who receives the funds has to have a disability that affects their ability to work. However, the programs differ in other ways.
Social Security Disability Insurance gives disability benefits to those who have previously worked for a required time period in the recent past. SSDI benefits are funded through payroll taxes. If you are approved, you can receive benefits starting six months after you become disabled. If you have been disabled for at least a year, you can get back payments of disability benefits from that year. You will be eligible for Medicare 24 months after your SSDI benefits began.
Supplemental Security Income gives disability benefits to those who have not worked for the required time period and have limited funds. If you are approved, you can receive benefits in the next month. You may also be eligible for back payments of SSI if you became disabled before your SSI approval.
In most states, SSI eligibility qualifies you for Medicaid. In some states, you have to apply for Medicaid separately from SSI to receive it. Almost all states provide additional benefit supplements for SSI recipients, and many of these states have their own eligibility rules.
SSI also has an asset cap. If an individual has more than $2,000 of assets or a couple has more than $3,000 of assets, they stop being eligible. The SSA has a list of SSI resources considered to be assets.
It’s possible to get both SSDI and SSI if you have very limited funds and also have a work history.
There are several criteria used to determine whether someone qualifies as disabled and is determined eligible to receive Social Security benefits. The following criteria will be evaluated when you apply for Social Security disability benefits:
There’s a lot of paperwork needed to apply for disability benefits for RA. The Social Security Administration provides a checklist of the necessary information. Here is a basic rundown of what you might need to provide for a disability application.
If you haven’t been denied in the past 60 days and aren’t currently getting any benefits, you can apply for SSDI online. If you have never been married, you were born in the United States, and you are between the ages of 18 and 65, you can apply for SSI online. If you don’t meet those criteria, you can still apply at a local Social Security office or over the phone.
On average, it takes three to five months to process an application for disability benefits. However, some members have heard back sooner. “My case only took 23 days for an answer,” one myRAteam member shared.
Most people are not approved the first time they apply. An average of 21 percent of those who applied for disability benefits between 2010 and 2019 were approved on their first attempt, according to the SSA’s 2020 statistical report on the SSDI program. You can still receive benefits even if you’re denied the first time.
If your application for benefits was denied, you have the option to appeal the decision. To make an appeal, you must apply for reconsideration. Someone who did not evaluate your case the first time will conduct a second case evaluation. Between 2010 and 2019, about 2 percent of those whose applications weren’t approved the first time were approved from an appeal.
The second step to appealing is a hearing by an administrative law judge. These judges are trained in disability laws and will hear all of the evidence in your disability case. You may have a lawyer or a disability attorney represent you at this hearing. A myRAteam member recommended this: “Make sure you have an attorney who specializes only in disability.” Some law firms even specialize in disability hearings.
If your appeal is denied, you can ask the Appeals Council to look at your case and make a decision on it. About 8 percent of successful Social Security disability claims between 2010 and 2019 were approved at the hearing or Appeals Council level. If you are denied at this level, the only remaining option is a federal court hearing.
For further information about filing Social Security disability claims or making appeals, Social Security disability attorneys or disability lawyers are a good source of legal advice.
If you cannot get approved for disability benefits in the United States, you may qualify for short-term benefits under the Family and Medical Leave Act (FMLA). This act is best known for providing up to 12 weeks of leave to care for an ailing family member or to bond with a newborn or newly adopted child. However, people with serious medical conditions like some autoimmune diseases can also get benefits through this program.
If you qualify for this benefit, you can get up to 12 weeks of unpaid leave in a given year. Although you will not get paid, your job will be protected so you have the option to go back to work if your health improves. In addition, you will retain your medical insurance coverage as if you had not taken leave.
Some states may have additional laws that offer paid leave, partially paid leave, or other options under this broader act. These laws often change or get updated, so it’s up to you to make sure you’re applying for a program that will work for you.
To apply for FMLA leave, you will need to fill out an application form as well as forms to certify your medical condition. Your employer is allowed to use a qualified representative to clarify or authenticate the information on your certification form, although they may not do so. They may also request a second and, if necessary, a third opinion. Your employer is responsible for all costs associated with hiring representatives and getting additional opinions, and you are eligible for leave while these evaluations are ongoing.
If you’d like to research more about disability benefits in countries outside of the United States, check out these resources, listed by country:
When you join myRAteam, you gain a community of more than 197,000 people who understand what it's like to live with rheumatoid arthritis. Members offer support and advice on a range of topics, including applying for disability benefits.
Have you applied for disability benefits for your RA? Are you looking to apply and need advice on getting approved? Comment below or start a conversation on myRAteam.