In accordance with the Facilities for Illness Management, osteoarthritis impacts 21.2% of adults within the U.S. Osteoarthritis is the commonest kind of arthritis and the main trigger of labor incapacity. Greater than half of U.S. adults with arthritis are of working age, and although some instances of osteoarthritis will not be extreme, the situation can restrict the kind of work a person does or forestall them from working in any respect.

If you’re affected by the results of osteoarthritis and have been denied incapacity don’t surrender, virtually 70% are denied initially! Simply name 512-454-4000 for a free, no obligation session to study what your choices are.

Most osteoarthritis is the results of put on and tear on the joints that develops when cartilage in joints steadily deteriorates.

Although it happens most regularly within the palms, knees, hips and backbone, osteoarthritis can have an effect on any joint. Signs develop steadily and turn out to be worse over time as ache and discomfort turn out to be extra intense.

Along with ache, signs embody:

•   Swelling round a joint;
•   Tenderness when stress is utilized to a joint;
•   Stiffness in joints;
•   Lack of flexibility and lowered vary of movement;
•   A grating sensation when a joint strikes; and
•   Bone spurs – additional bits of bone that kind round a joint

These signs could cause you to overlook work and jeopardize your means to take care of employment.

Osteoarthritis can’t be reversed, however therapies can scale back ache and improve mobility.

Medical doctors regularly prescribe a mix of medicines and life-style modifications that features over-the-counter medicines to alleviate ache, corticosteroids by injection or orally, bodily remedy, train, and weight administration. Demonstrating that you’re following your physician’s remedy plan is a vital a part of qualifying for incapacity advantages.

Can I Qualify for Social Safety Incapacity if I’ve Osteoarthritis?

You probably have Osteoarthritis and can’t keep employment, you could be eligible for incapacity advantages, however to qualify you have to to fulfill each the monetary and medical necessities set forth by the SSA.

1.   Monetary Necessities:

Earlier than you’re eligible for Social Safety incapacity advantages, it’s essential to fulfill some fundamental monetary necessities.

You have to: 1) have a incapacity that has lasted or is anticipated to final 12 months; and a pair of) it’s essential to have labored in a job the place you paid Social Safety taxes lengthy sufficient and just lately sufficient; and three) it’s essential to not earn greater than Substantial Gainful Exercise (SGA), which is $1,550 monthly in 2024 for nonblind candidates and $2,590 monthly for blind candidates. For those who earn greater than the SGA quantity, your declare can be denied, and when you have not labored sufficient just lately to earn the required quantity of labor credit, Social Safety will deny your declare.

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2.   Medical Necessities:

Because the ache and stiffness attributable to osteoarthritis worsens, it could actually severely restrict a person’s means to stroll, use their palms and arms, and even sit at a pc for an extended time period.

In some instances, a hip or knee substitute could also be required. However regardless that it may be disabling, osteoarthritis isn’t listed as a separate impairment in Social Safety’s Blue Guide, a handbook which lists impairments Social Safety considers disabling and should mechanically qualify for advantages. Nevertheless, when you have extreme hassle strolling or utilizing your fingers, you could not have the ability to carry out sedentary work or jobs that require even a short while of standing or strolling.

The Blue Guide has a couple of listings underneath which Social Safety evaluates osteoarthritis; and you’ve got the most effective likelihood for approval in case your situation matches one of many following impairments:

Bear in mind that there are very particular standards for every impairment.

To satisfy the necessities of an inventory for spinal issues (1.15 or 1.16), it’s essential to have a prognosis of osteoarthritis in your backbone and:

•    Narrowing of the spinal canal within the decrease again affecting nerve roots and making it extraordinarily troublesome to stroll or use your palms; or
•   Compression of a spinal nerve root limiting the movement or your backbone and making it troublesome to stroll or use your palms.

To qualify underneath listings for joint dysfunction (1.18), it’s essential to present medical proof of one of many following:

•    An apparent deformity in a joint, evidenced by medical imaging comparable to an x-ray or MRI; or
•   Destruction of bone; or
•   Joint house narrowing; or
•   Fused joints or bones (ankylosis).

AND

•    You have to have a historical past of joint ache, stiffness, instability and lowered vary of movement; and
•   Documentation of the necessity to use a walker, two canes or two crutches, or a wheelchair or scooter that requires each palms; or
•   You’re unable to make use of one hand on account of osteoarthritis and want to make use of the opposite to function a one-handed wheelchair, cane, crutch or different system; or
•   You’re unable to make use of both arm or hand for work.

You might also be eligible for incapacity advantages when you have had reconstructive surgical procedure of a significant weight bearing joint comparable to a hip or a knee (See Part 1.17), however it’s essential to have the ability to present:

•    Documentation of reconstructive surgical procedure or fusion; and
•   Proof that you simply expertise excessive problem shifting that has lasted, or is anticipated to final 12 months; and
•   Proof that you simply want a walker, 2 canes or two crutches or a wheelchair or scooter requiring each palms.

Social Safety evaluates your declare primarily based in your medical proof which incorporates medical doctors’ notes, hospital data and laboratory exams.

Social Safety may also request an unbiased examination by a health care provider of Social Safety’s selecting. Be ready to submit:

•    detailed bodily examination studies, together with descriptions of orthopedic or neurologic issues;
•   imaging and diagnostic exams comparable to x-rays and MRIs displaying proof of bodily abnormalities;
•   medical doctors’ notes describing your subjective signs, such because the frequency and severity of your ache and/or incapability to carry out actions of day by day residing like cooking, cleansing, and procuring;
•   studies from surgical procedures;
•   documented want for an assistive system, comparable to a cane or walker;
•   medicines and unwanted effects; and
•   historical past of bodily remedy and some other therapies tried and what the outcomes had been.

Focus on your situation along with your medical suppliers and ensure they describe your limitations and signs of their notes intimately.

Social Safety will examine your physician’s notes with what you say in your utility. You have to to show that you’re following your physician’s remedy plan, and regardless of that your medical situation nonetheless prevents you from working full-time.

Moreover, it’s vital to maintain monitor of your work absences.

As soon as Social Safety determines your limitations attributable to your situation, they are going to have a vocational knowledgeable assess whether or not an individual with those self same limitations is employable. In case your situation or the remedy rendered for that situation causes you to be absent frequently two or extra days a month or be “off-task” 15% or extra of the workday, most vocational specialists will discover you unemployable.

In case your osteoarthritis doesn’t match a listed impairment, you should still qualify for SSDI primarily based in your limitations.

Social Safety will conduct a Residual Practical Capability evaluation to judge how your incapacity impacts your means to carry out your previous job or if there may be some other job you’ll be able to carry out, bearing in mind whether or not or not you’ll be able to drive, your age, and stage of training. For instance, when you have problem strolling on uneven surfaces, climbing stairs, or bending, you could be restricted to sedentary jobs. You probably have osteoarthritis in your shoulders, arms, or palms, you could be restricted from work that requires lifting, reaching, typing, writing, or grabbing. If Social Safety decides you can not do your previous job or don’t have the talents to carry out a brand new job, you could be authorized for a Medical-Vocational Allowance.

If you’re 55 or older or have one other medical situation you could get approval.

Social Safety follows a algorithm to find out when the company expects an applicant to study a brand new job.

Candidates who’re 55 or older usually fall underneath a grid rule, which implies they don’t seem to be anticipated to study a brand new job. For instance, a 55-year-old applicant with no transferable abilities is likely to be discovered disabled. For those who can’t return to your previous job, and also you don’t have the talents to study a brand new one, Social Safety will doubtless grant you incapacity advantages.

You might also be eligible for Social Safety Incapacity advantages when you have one other medical situation, comparable to weight problems.

If you’re chubby, Social Safety should contemplate how additional weight along with osteoarthritis limits your performance and causes extra ache than an individual who has arthritis alone. One dysfunction alone might not meet the factors of an impairment as said in Social Safety’s Blue Guide, however when you have a couple of medical situation, Social Safety should contemplate how these well being points mixed restrict your means to carry a job and carry out needed day by day duties.

Do you have to file a declare?

For those who consider that you simply meet Social Safety’s medical and monetary necessities, you must apply for advantages.

If you’re nonetheless not sure or wish to speak to somebody, please contact us at 512-454-400. We’re all the time able to take your name and talk about your choices with you freed from cost. We’re comfortable to assist of us similar to you discover the most effective resolution for his or her private scenario.

How do I file for Social Safety Incapacity advantages?

After getting determined to file a declare, you may take step one and apply for Social Safety Incapacity advantages in individual at your native Social Safety Administration workplace, on-line, or over the telephone.

After your utility is submitted, Social Safety will ship your file to the state’s Incapacity Willpower Providers workplace (DDS). A claims examiner will request and assessment your medical data and should name you for an interview or further paperwork. When the claims examiner has sufficient info, Social Safety will decide and notify you by mail. Usually, this takes three to 4 months, however might take longer. Don’t be discouraged in case your preliminary utility is denied – most are – and you’ll have the chance to enchantment.

There are 4 steps to the Social Safety enchantment course of:

1.   File a Request for Reconsideration with the Social Safety Administration to utterly assessment the case.
2.   For those who don’t agree with SSA’s response to your Request for Reconsideration, you may request a listening to earlier than an Administrative Legislation Choose (ALJ). ALJs are attorneys who work for the Social Safety Administration; they assessment SSDI instances and both uphold or overturn choices to disclaim SSDI advantages. If you’re not represented by an legal professional at this level, now’s the time to acquire authorized counsel. This can be a important level within the course of and can increase your likelihood for achievement. You actually don’t have to rent us, however you must significantly contemplate hiring some advocate that can assist you at this level. Your advantages are within the steadiness and having somebody by your aspect who understands the factors the SSA seeks for approval could make all of the distinction.
3.   If an ALJ doesn’t grant your declare, you may request that the Appeals Council assessment your case.
4.   Federal Court docket assessment. The ultimate step within the enchantment course of is submitting go well with in U.S. District Court docket.

What is going to occur in courtroom – >

Do I want a incapacity legal professional for SSDI?

You probably have osteoarthritis and can’t work, you could be eligible for Social Safety Incapacity advantages, however qualifying is difficult and most preliminary functions are denied.

You could actually file a declare by yourself, however proof reveals that your probabilities for approval are elevated considerably when you have authorized illustration. At every potential stage of the method, from the preliminary utility stage to the reconsideration stage and the ALJ listening to stage, an legal professional can help you in finishing the detailed kinds and questionnaires required by Social Safety, gathering and submitting related medical proof, and making ready questionnaires to your medical doctors. On the ALJ listening to part an legal professional is not going to solely proceed to guarantee that the proof is full, however put together you for questioning by the ALJ, put together an argument in your behalf and query any medical doctors or vocational specialists chosen by the ALJ to testify on the listening to. On the Appeals Council and federal courtroom stage, a lawyer can current authorized arguments to point out your case was wrongfully denied. Charges charged by incapacity attorneys are regulated by federal legislation and are often 25% of incapacity backpay you’re owed. There aren’t any out-of-pocket prices, and in case you don’t win your case, you gained’t be charged something.

What if I don’t qualify for SSDI?

For those who haven’t labored lengthy sufficient to earn sufficient work credit, or in case you earn an excessive amount of earnings, you could be eligible for incapacity advantages via one other Social Safety program, comparable to Supplemental Safety Revenue (SSI), or from a long-term incapacity insurance coverage plan via your employer or a privately bought coverage.

SSI is a program that pays month-to-month advantages to individuals with restricted earnings and sources who’re disabled, blind, or age 65 or older. SSI relies on earnings as an alternative of labor credit, and is financed by basic funds of the U.S. Treasury. You’ll be able to test eligibility necessities and start the applying for SSI on-line or by calling Social Safety at 1-800-772-1213. Along with SSDI and SSI advantages, you might be able to get monetary help from a privately bought long-term incapacity coverage or a coverage via your employer.

I’ve long-term incapacity insurance coverage – ought to I file a declare?

Sure – you must file a declare as quickly as you turn out to be disabled.

Lengthy-term incapacity insurance coverage (LTD) protects your earnings if you’re unable to work on account of sickness or harm and is bought as a part of a bunch employment plan or privately via an insurance coverage firm. Insurance policies pay between 50-60% of your wage and advantages proceed till you come back to work or for the variety of years said within the coverage. Nevertheless, don’t stop your job earlier than you file a declare as a result of LTD protection is nice solely so long as you’re employed, and you should definitely test your coverage’s definition of “disabled” as every coverage will state the definition of “disabled” which is in use. Additionally, remember that long-term incapacity insurance coverage firms can require a claimant to additionally apply for SSDI.

Do I want a incapacity legal professional for a long-term incapacity insurance coverage declare?

It doesn’t matter when you have a long-term incapacity insurance coverage coverage bought via a personal insurance coverage dealer or a bunch coverage bought along with your employer; submitting a declare for long-term insurance coverage is a fancy course of.

The wording of LTD insurance policies will be complicated and the legal guidelines and laws which have an effect on the 2 sorts of LTD insurance coverage differ in procedures for submitting claims and appeals. An skilled LTD legal professional with thorough data of ERISA legal guidelines and laws will keep away from errors and improve your likelihood of success. Once more, you don’t have to rent us, however you must significantly get assist at this level. An legal professional will act in your behalf, finishing your utility and submitting your declare in a well timed method. They’ll additionally negotiate a settlement or file an enchantment for you. If it turns into essential to file go well with, an LTD legal professional can put together your case towards an insurer. Most LTD attorneys deal with instances on a contingency foundation and cost roughly 25%-40% of a claimant’s late advantages. You don’t pay an legal professional’s payment except the legal professional wins your case.