Arthritis is a leading cause of Social Security Disability and Long Term Disability Insurance Claims. The Social Security Administration and disability insurance companies demands specific proof of disability before they will grant benefits for disabling diseases such as arthritis.
Despite new drug treatments, arthritis is still a major disabling condition. The disease eats away at cartilage, tissue and bone leaving its victims with unrelenting pain in their fingers and joints.
The Social Security Administration (SSA) regulations view some forms of arthritis as orthopedic impairments, and some as autoimmune disorders. Osteoarthritis is evaluated as an orthopedic impairment by lab tests and effect on soft tissue, bones and joints. Other forms of arthritis such as the connective tissue, psoriatic and rheumatic forms of the illness (lupus, sclerosis and scleroderma) are evaluated under the autoimmune regulations.
Any case requires more than just simple findings of reduction in mobility and reports of pain. The physical findings must be supported by appropriate lab tests or a biopsy. The Autoimmune regulations were recently revised to take into account updated treatment modalities.
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An examination by a rheumatologist is optimal, but may not always be practical. Unfortunately, the SSA rarely will send a claimant out for a consultative examination with a board-certified expert. X-rays are routinely done, but x-rays do not show soft tissue and cartilage damage and may not show bone deterioration.
Recent regulatory changes recognize the superior forms of evidence that can be provided by MRI’s and CAT scans. The Social Security Administration says that these are “quite expensive and we will not routinely purchase them.” Applicants fortunate enough to have treating physicians who will order these tests are in a better position to win claims.
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Showing functional limitation is an essential part of proving a case. Along with detailed medical records, it is helpful to have clear statements from doctors and witnesses about limitations in use of hands, use of arms or legs, and ability to sit, stand and walk. It is particularly important to note fine motor skill problems, such as inability to write or hold a pen or coffee cup.
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If repetitive motion increases pain, this should be noted. There is a huge difference in being able to lift something once and being able to lift throughout a day. If a person must lie down and rest for extended periods, it is important to have this noted in the medical records and letters of observation. Also, the combined effect of arthritis and obesity should be considered where appropriate.
Social security disability law asks whether a person is able to do full-time work on a predictable, consistent and productive basis. Ability to work on a hit-or-miss basis is not enough. Our office will work with you to be certain all the evidence is prepared and presented in the best possible way to win your client’s case. Marc Whitehead & Associates represents disabled claimants in their Social Security Disability, Long Term Disability Insurance and Veterans Disability Claims. To learn more, please read our free Social Security Disability E-book, and visit our website at disabilitydenials.com.
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