In this guide, you will learn how to win Social Security Disability for post-traumatic knee arthritis. If you’re experiencing joint pain or post-traumatic knee arthritis, you’re entitled to file a disability claim with the Social Security Administration (SSA). However, to qualify for benefits and win your case, you must meet all SSA medical requirements to show proof of arthritis and have enough work credits built up through your employment history.
Can You Get Social Security Disability or SSI for Arthritis?
To learn how to win Social Security Disability for post-traumatic knee arthritis, you must first understand some key factors related to arthritis pain and disability.
Understanding Joint Pain and Arthritis
Joint pain and stiffness are common health problems among people as they age. According to the Arthritis Foundation, about 53 million adults and 300,000 children in America suffer from some type of inflammatory joint condition. While there are more than 100 different types of arthritis, the common symptoms present in all of them is joint stiffness, tenderness, swelling, and pain around the site of the affected body area.
Joint pain can vary significantly from person to person, and usually progresses as a person ages. Some people may experience mild discomfort that does not impact their daily activities. Other people experience severe or debilitating pain that restricts even the most simple physical tasks or activities, including performing their daily work duties. Common types of arthritis include:
- Ankylosing Spondylitis
- Gout
- Juvenile Arthritis
- Osteoarthritis
- Psoriatic Arthritis
- Rheumatoid Arthritis
Is Arthritis Considered a Disability?
Joint pain and stiffness that leads to arthritis can result from many causes, including infection and inflammation within the body, physical injury to a body part, aging, and certain types of cancer. Depending on the severity of the condition, arthritis may be considered a disability that warrants payment of Social Security Disability Insurance (SSDI) benefits.
If you suffer from joint pain or arthritis that impacts your ability to perform your normal job duties, you may qualify for SSDI benefits. When basic motor skills such as kneeling, sitting or standing, walking, and lifting objects are impaired, you may not be able to hold down a job, even on a part-time basis. If you are approaching retirement age, you may qualify for SSDI benefits, even if you are deemed capable by the Social Security Administration (SSA) for only light sedentary work.
Depending on the type of arthritis you have and how it impacts your job skills, you may be deemed capable of heavy, medium, light, or sedentary work. If you’re suffering from joint pain or arthritis, a Social Security Disability lawyer can guide you through the SSA process of filing for disability benefits and oversee your case for best results. Since long-term disabilities can create claim complications, it’s important to understand how long term disability lawyers can maximize your benefits.
How Joint Pain Can Qualify Under a Blue Book Listing
SSA uses a Blue Book that puts joint pain and arthritis conditions into specific categories. The Blue Book outlines the conditions that qualify for disability benefits, as well as how someone experiencing those conditions can qualify for SSDI benefits. Before filing for SSDI benefits, applicants need to understand what the Blue Book is and how it can influence the application process.
The Social Security Administration has recently updated its listing for joint dysfunction and given it a new number: listing 1.18. The new listing addresses chronic joint pain or stiffness, instability or immobility of affected joints, and impairment-related physical limitation of musculoskeletal function for a continuous period of at least 12 months.
To meet the listing, a joint in one of the extremities must cause chronic joint pain or stiffness in one or multiple joints. The joint stiffness and pain must be associated with an abnormality in a joint that causes problems with motion or stability. The SSA Blue Book has a big impact on claims for post-traumatic knee arthritis.
For your medical condition to qualify under a Blue Book Listing, your medical records must show evidence of an anatomical abnormality in one of the two following ways: 1) medical imaging such as an x-ray, ultrasound, or MRI must show evidence of ankylosis (narrowing of joint space) or destruction of bone, or 2) abnormality found on a physical exam such as partial dislocation of a joint, tightening of a joint, or joint stiffness caused by a fused bone or adhesion.
In addition, your medical records must show one of three limitations: 1) you must use a cane, crutches, a walker, or a wheelchair that requires both hands, or 2) you can not use one hand, and the other hand is needed to operate limitation devices, or 3) you can not use either hand or arm to start, sustain, or complete work.
Medical record and medical limitation requirements shown above must occur within a consecutive 4-month period to receive SSDI benefits. For instance, you can not have an x-ray or MRI from one year ago that shows an abnormal joint condition and the current need for a walker or wheelchair 6 months later. However, the Social Security Administration has recently changed its consecutive 4-month requirement period to a 1-year requirement period during the COVID-19 pandemic.
Qualifying Based on Residual Functional Capacity
The Social Security Administration has strict regulations for the approval of SSDI benefits. They want to make sure that SSDI claims are paid appropriately based on a person’s level of impairment, and they want to prevent fraudulent claims. Because of SSA Blue Book listing qualifications and strict SSA regulations, many SSDI claims are denied.
It’s estimated that about 90% of people who qualify for SSDI disability based on some type of joint problem or musculoskeletal problem do not meet the Blue Book listing for that impairment. In addition, many medical diagnoses that are associated with joint pain or arthritis are not explicitly listed in the SSA Blue Book. There are no listings for the following joint-related problems:
- Bursitis
- Chronic fatigue syndrome
- Degenerative joint disease
- Fibromyalgia
- Gout
- Hip problems
If you suffer from any of these conditions, you will be required to provide SSA with medical reports that contain specific notes from your physician on how your joint problems limit your functional abilities for your job.
Most SSDI claims are based on how a claimant’s medical condition impacts his or her ability to work. The Social Security Administration has special disability claims examiners, as well as administrative law judges, who oversee disability hearings. These examiners and judges look for detailed medical reports that show the claimant’s specific limitations for performing work duties. If adequate limitations are not found, SSA may deem the claimant fit for work duties and deny the SSDI claim for benefits.
When joint and arthritis conditions do not meet requirements in the SSA Blue Book, SSA may determine your impairment and work limitations based on Residual Functional Capacity (RFC). The RFC measures your ability to work and perform job duties after assessing your physical or mental impairments caused by your condition. If your assessment permits some type of work, you may “ask how much can you earn and still keep your Social Security Disability?” If you’re disabled, you may be able to perform part-time work and still keep your SSDI benefits. Average SSDI benefits range from $800 to $1,800 per month, with the maximum payment for 2022 set at $3,345 per month.
In some cases, you may be eligible for SSI and SSDI benefits at the same time. This occurs if you develop a disability at a young age, have an insufficient work history, or have a low income. Since SSI and SSDI use the same disability assessment process, you should ask a disability lawyer, “can I collect SSDI and SSI simultaneously?” This is usually a big benefit for people who don’t have adequate work credits or who have a low income because collecting SSDI and SSI benefits at the same time will increase their monthly benefit payments.
How to Win Social Security Disability for Post-Traumatic Knee Arthritis
Knee arthritis typically occurs when the cushioning cartilage in the knee joint wears down. When this happens, the result is a stiff knee joint that causes pain with certain movements like walking, running, jumping, climbing or any other movement that puts pressure on the knee. The most common type of knee arthritis is osteoarthritis, the gradual, age-related degeneration of cartilage. However, autoimmune conditions, as well as physical trauma, can also lead to damaged knee joints.
In most cases, the cartilage damage associated with post-traumatic knee arthritis is irreversible. While surgical and non-surgical procedures and treatments can often reduce pain, increase joint flexibility, and improve movement, post-traumatic knee arthritis often results in major lifestyle changes due to mobility problems.
The most common types of knee arthritis that result in SSDI claims are osteoarthritis of the knee, rheumatoid arthritis of the knee, and post-traumatic knee arthritis. When filing for SSDI benefits for these conditions, a Social Security Disability attorney can help you figure out how to fill out your application for disability insurance benefits. The attorney can file your claim in a timely manner, gather essential medical records to support your claim, oversee the SSA determination process, provide evidence and guidance in SSA hearings, and file an appeal if your claim is denied.
SSA disability cases often involve complex issues that take time to investigate. After an initial disability claim is filed, the standard processing time with SSA is 90 to 120 days. If SSA is having trouble getting your medical records, the processing time will take longer. To avoid unnecessary delays and get faster SSDI benefit payments, it’s important to have an attorney who knows how to win Social Security Disability for post-traumatic knee arthritis.