Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent joint pain, swelling, and stiffness. It can also affect a number of bodily systems, including the skin, heart, lungs, nerves, and eyes.
Disability Requirements for Arthritis
Rheumatoid arthritis may be considered a disability, depending on the symptoms and their severity. Symptoms must be sufficiently severe so that they significantly limit a person’s ability to do basic work such as lifting, standing, walking, and remembering.
- Patients who have RA may be eligible for disability insurance from the Social Security Administration (SSA) if they can demonstrate they are unable to perform any type of work on a consistent basis because of their condition. Patients must also have been employed long enough to have a certain number of Social Security work credits in order to qualify.
- The Social Security Administration has specific standards patients must meet to qualify for disability insurance and documentation from a doctor must be provided to prove a person is no longer able to work.
- The SSA disability listing for rheumatoid arthritis falls under autoimmune disorders listing-level severity 14.09A and 14.09C1, in which there is the presence of an impairment-related physical limitation of functioning. Listing-level severity in 14.09B, 14.09C2, and 14.09D refers to inflammatory arthritis that involves various combinations of complications (such as inflammation or deformity, extra-articular features, repeated manifestations, and constitutional symptoms or signs) of one or more major joints in an upper or lower extremity (14.00C8) or other joints.
Applying for Disability
- People who have rheumatoid arthritis can apply for SSA disability in person at a local Social Security office, on the phone (800-772-1213), or online at ssa.gov/benefits/disability
- Part of the application process involves documentation from a doctor that includes blood work, results of clinical exams, X-rays, MRIs, a history of medications and therapies and the results, a medical history that shows how the RA has progressed over time, and any other information to support the case for getting Social Security disability.
- Applications for disability are often rejected the first time they are submitted. Working with an attorney or disability advocate may help patients navigate the process and improve the chances of being approved for payments.
What Are Symptoms of Rheumatoid Arthritis?
Symptoms of rheumatoid arthritis usually start gradually, often before joint pain or stiffness is present, and may include:
- Muscle pain
- Numbness and tingling in the hands
- Low-grade fever
- Weight loss
- Feeling unwell (malaise)
Rheumatoid arthritis usually affects the same joints on both sides of the body (symmetrical). Joint pain and stiffness usually begin in the small joints, such as at the base of the fingers, the middle of the fingers, and the base of the toes, or may occur in a single, large joint, such as the knee or shoulder, or it may shift from one joint to another
As RA progresses, joint pain and inflammation become more prominent and symptoms include:
- Joint pain and stiffness that may affect the:
- May result in carpal tunnel syndrome, which causes weakness, tingling, and numbness in the hand and fingers
- Finger deformities/bent fingers
- Wrist: difficulty bending the wrist backward
- Elbow: swelling may result in numbness or tingling in the fingers
- Shoulder: pain and limited motion
- Hips: difficulty walking
- Knee: difficulty bending the knee and “Baker's cyst” (a fluid-filled cyst in the space at the back of the knee)
- Foot: joint tenderness at the base of the toes may result in standing and walking with weight on the heels. The top of the foot may be swollen and red, and the heel may be painful.
- Ankle: nerve damage that can lead to numbness and tingling in the foot
- Neck: pain and stiffness, difficulty bending the neck and turning the head
- Cricoarytenoid joint: inflammation of a joint near the windpipe that can cause hoarseness and difficulty breathing
- Other symptoms of rheumatoid arthritis may include:
- Decreased bone density
- Muscle weakness
- Skin problems: rheumatoid nodules (painless lumps that appear beneath the skin)
- Eye problems: redness, pain, and vision problems
- Lung disease: shortness of breath and a dry cough
- Pericarditis: inflammation of the tissue around the heart that can cause chest pain and difficulty breathing
- Vasculitis: inflammation of blood vessels
- Sjögren's syndrome: causes dry eyes and dry mouth
How Is Rheumatoid Arthritis Diagnosed?
The diagnosis of rheumatoid arthritis involves a combination of clinical, laboratory, and imaging tests. A patient’s medical records can be used to help make the case for a patient to receive Social Security Administration disability payments.
Laboratory studies used to diagnose rheumatoid arthritis include:
- Complete blood count
- Erythrocyte sedimentation rate
- Rheumatoid factor assay
- C-reactive protein level
- Antinuclear antibody assay
- Anti-cyclic citrullinated peptide and anti−mutated citrullinated vimentin assays
Imaging studies used to diagnose rheumatoid arthritis include:
- X-rays (first choice): Hands, wrists, knees, feet, elbows, shoulders, hips, cervical spine, and other joints as indicated
- Magnetic resonance imaging (MRI)
- Ultrasound of joints
Joint aspiration and analysis of synovial fluid may be indicated, including:
- Assessment of overall appearance
- Gram stain
- Cell count
What Is the Treatment for Rheumatoid Arthritis?
Medications used to treat rheumatoid arthritis include:
- Nonbiologic disease-modifying antirheumatic drugs (DMARDS)
- Biologic tumor necrosis factor (TNF)–inhibiting DMARDs
- Biologic non-TNF DMARDs
Other drugs used to treat rheumatoid arthritis include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Pain relievers (analgesics)
- Topical skin products
Surgical treatments for rheumatoid arthritis include:
- Tendon realignment
- Reconstructive surgery or arthroplasty
Other therapies for rheumatoid arthritis include: