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Getting Disability Benefits for Rheumatoid Arthritis

Posted on September 09, 2020

Article written by
Annie Keller

Joint pain, mobility problems, and other symptoms of rheumatoid arthritis (RA) can 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 rheumatoid arthritis 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 my disability.”

You’re not alone if you share these sentiments. The Centers for Disease Control and Prevention 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 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. 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.

Types of Disability Benefits in the United States

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 are different 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 became disabled. If you have been disabled for at least a year, you can get back payments of disability benefits from that year. You are eligible for Medicare 24 months after your SSDI benefits began.

Supplemental Security Income gives disability benefits to those who have not worked 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 Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands, you have to apply for Medicaid separately from SSI to receive it, but the qualifying criteria are the same. Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, Oklahoma, and Virginia all use different criteria to determine who is eligible for Medicaid, even if you already receive SSI.

Almost all states provide additional benefit supplements for SSI recipients; but Arizona, Mississippi, North Dakota, and West Virginia do not. Many of the states that offer an SSI supplement have their own eligibility rules.

SSI has an asset cap. If an individual has more than $2,000 of assets or a couple has more than $3,000 of assets, you stop being eligible. The Social Security Administration 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.

What Is the Definition of Disability?

There are several criteria used to determine whether someone is considered disabled enough to be eligible for benefits. The following criteria will be evaluated when you apply for Social Security disability benefits:

  • If you are making at least $1,260 a month, you are mostly likely not eligible for disability benefits. (If you are making some money but less than that amount, you may still be eligible. The amount of benefits you receive may be reduced.)
  • You cannot do the basic tasks most jobs require. These include standing, walking, lifting, sitting, and memory tasks. In addition, you must not have been able to do these tasks for at least 12 months.
  • You have a diagnosed disability. The Social Security Administration provides a list of conditions that are considered so disabling that they prevent working. Rheumatoid arthritis is one of the conditions included under the category of inflammatory arthritis. You can still be eligible for benefits even if your specific condition isn’t listed.
  • You are unable to do the type of work you did previously. (If you’re applying for SSI, it’s not necessary to have a work history, so this isn’t always applied.)
  • You must be unable to do any other form of sustainable work. Your diagnosis, age, medical history, and education will be examined, as well as any other work history or skills that might be applied to work.

Applying for Disability Benefits

There’s a lot of paperwork needed to apply for disability benefits for rheumatoid arthritis. The Social Security Administration provides a checklist of necessary information. Here’s a basic rundown of what you might need to provide for a disability application.

Information About Yourself and Your Family

  • Your full legal name, date of birth, and Social Security number
  • The full names and dates of birth of current or previous spouses, and dates of marriage, divorce, or death
  • The full names and birth dates of your children
  • Bank account information

Medical Evidence About Your Condition

  • The name and contact information for your rheumatologist and other health care providers who can discuss your medical condition
  • A complete list of present and past medications, and a list of any medical tests you have had for RA (such as X-rays, blood tests, and MRI scans)
  • A description of how RA symptoms impact your ability to do tasks like shopping, cooking, cleaning, and other activities of daily living

Total Work History

  • Earnings from the past year
  • Contact information for your current employers or any you have worked for in the past two years
  • A complete work history from the last 15 years, including any jobs from before you became disabled
  • Whether you are getting or intend to get any form of workers’ compensation
  • Any military service, branch and dates

Documents

  • Birth certificate
  • Social Security card
  • Proof of U.S. citizenship
  • W-2 or other tax forms from the previous year
  • Any medical records or test results about your condition that you currently possess
  • Proof of any workers’ compensation you have received

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.

Perseverance When Filing for Disability Benefits

On average, it takes three to five months to process an application for disability benefits. This delay can cause financial stress for members of myRAteam. One member said, “Hoping I’m not living in a cardboard box before hearing a favorable decision.” Some members 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 22 percent of those who applied for disability benefits between 2008 and 2017 were approved on their first attempt. You can still receive benefits even if you’re denied the first time. The next step is to appeal the decision. This is a simple process: you apply for reconsideration and your case will be evaluated by someone who did not take part in the first evaluation. Between 2008 and 2017, about 2 percent of those whose applications weren’t approved the first time were approved during reconsideration.

There is a second step to appealing, a hearing by an administrative law judge. These judges are trained in disability laws and will hear all the evidence in your disability case. You may have a lawyer 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 you are denied at this level, you can ask the Appeals Council to look at your case and make a decision on it. About 9 percent of successful SSDI claims between 2008 and 2017 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.

It can be stressful to wait for disability benefits to be approved. Members of myRAteam offer advice on how to cope with the wait and tips on getting approved.

  • “Most people get turned down one or two times. This doesn't mean you are OK, just that you have to keep trying. At this point, get a disability attorney. Yes, it makes a difference.”
  • “Look on the disability site for Social Security for RA; there are a lot of videos. You can learn what exactly the doctor is looking for.”
  • “It does help to have a lot of your medical history to back up your claim.”
  • “Remember RA is sometimes invisible, so you can be disabled and look OK.”
  • “You have to be prepared for a long fight, but don't give up.”
  • “Be prepared for a denial a couple times, but stick with it, and if a hearing is necessary, go for it!”

While the process can be long, many myRAteam members are eventually successful. “The good news is my Social Security benefits were approved,” a member shared. “Five years of struggling. It's such a relief.”

When you join myRAteam, you gain a community of more than 132,000 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.

Here are some recent conversations about RA and disability benefits.

Here is a question-and-answer thread about disability benefits:

Have you applied for disability benefits for your RA? Looking to apply and need advice on getting approved? Comment below or start a conversation on myRAteam.

References

  1. Disability Benefits — Social Security Administration
  2. Supplemental Security Income (SSI) — Social Security Administration
  3. Understanding SSI — SSI Eligibility — Social Security Administration
  4. How You Qualify | Disability Benefits — Social Security Administration
  5. Part III — Listing of Impairments (Overview) — Social Security Administration
  6. 14.00 — Immune-Adult — Social Security Administration
  7. Adult Disability Starter Kit — Social Security Administration
  8. Who is eligible for Supplemental Security Income (SSI)? — AARP
  9. SSI VS SSDI: What They Are & How They Differ — Benefits Access Blog — National Council On Aging
  10. Annual Statistical Report on the Social Security Disability Insurance Program, 2018 — Outcomes of Applications for Disability Benefits — Social Security Administration
  11. Federal Court Review Process — Social Security Administration
  12. Appeals Council Review Process in OARO — Social Security Administration
  13. Social Security Administration's Hearing Process, OHO — Social Security Administration
  14. Arthritis-Related Disabilities and Limitations — Centers for Disease Control and Prevention

Annie specializes in writing about medicine, medical devices, and biotech. Learn more about her here.

A myRAteam Member said:

Don’t get upset my dear. We in the team know what you’re going through.Our family is not experiencing the burning pain we’re having. So take care of… read more

posted 4 days ago

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