The Arthritis Foundation defines rheumatoid arthritis (RA) as a joint disease caused by the immune system attacking the joints.
It is therefore considered an autoimmune disorder like lupus or multiple sclerosis. In rheumatoid arthritis, the immune system attacks the synovium, a tissue that lines the inside of the joints and produces a lubricating fluid that helps the joints move easily and smoothly.
RA causes the synovium to become inflamed, and that inflammation causes the joints to become swollen and painful.
If rheumatoid arthritis goes untreated, it can eventually damage both the bones and cartilage in a joint. The affected joint gradually becomes deformed and loses its mobility – and the damage is irreversible.
Since such damage can occur shortly after the onset of rheumatoid arthritis, doctors strongly recommend both early diagnosis and aggressive treatment.
In a video produced by the Mayo Clinic, Dr. Eric Matteson, a rheumatologist, provides an overview of the disease, in which he describes the known causes and risk factors.
For example, about 75 percent of patients are women, and most patients develop RA between the ages of 40 to 60. Dr. Matteson also describes the Mayo Clinic’s research on treatments, particularly the use of stem cells.
What are the symptoms?
Rheumatoid arthritis most commonly develops in the hands, wrists, elbows, feet, ankles and, knees. It is usually symmetrical, which means if one elbow is affected, the other will also be affected.
Rheumatoid arthritis can affect other systems like the respiratory or cardiovascular system and is, therefore, also described as a systemic disease.
During the early stages of rheumatoid arthritis, the patient may not see swelling or redness in their joints at first, but they will experience pain and tenderness.
According to the Arthritis Foundation, rheumatoid arthritis also shows the following traits:
- It affects small joints, like those in the hands or feet
- It affects the same joints on both sides of the body
- It affects more than one joint
- Morning stiffness lasts for over half an hour
- The swelling, pain, stiffness or tenderness lasts for at least six weeks
The patient may also experience fatigue, a low-grade fever and/or loss of appetite. The symptoms can come and go.
During a flare-up, the patient’s symptoms will be particularly severe, and a flare-up can last anywhere from a few days to several months.
As mentioned earlier, rheumatoid arthritis can affect other parts of the body and cause symptoms like any of the following:
- Inflammation of blood vessels that can damage the skin, nerves or other organs
- Inflammation and scarring in the lungs that causes breathing difficulties
- Rheumatoid nodules or bumps under the skin
- Dryness in the mouth coupled with irritated or infected gums
- Reddened, dry or and/or painful accompanied by impaired vision and photosensitivity
How is rheumatoid arthritis diagnosed?
Rheumatoid arthritis can be difficult to diagnose, for its symptoms, especially in the early stages, can mimic those of other diseases. There is also no one test that can identify it.
According to WebMD, a doctor who suspects a patient has rheumatoid arthritis will take the following steps during an examination.
They will start by taking the patient’s personal and family history. Rheumatoid arthritis can run in families, so if a close relative has it, the patient is also likely to have the disease.
The doctor will then perform a physical exam during which they examine the patient’s joints for pain and range of motion.
The doctor will order several blood tests. Since rheumatoid arthritis is caused by a malfunctioning immune system, the doctor will look for certain antibodies in the patient’s blood.
The doctor will also check the patient’s red blood cell (RBC) count, for anemia is also a common symptom of rheumatoid arthritis.
The doctor may also check the patient’s c-creative proteins and erythrocyte sedimentation rate. Both of these tests measure inflammation, and the results are higher in a patient with rheumatoid arthritis.
The doctor may also order imaging tests like X-rays or MRIs to take a look at the patient’s joints and check for joint damage. While such tests don’t really diagnose rheumatoid arthritis, they can help the doctor find any joint problems early on.
Is rheumatoid arthritis considered a disability?
Rheumatoid arthritis can be disabling. The Social Security Administration (SSA) maintains a Blue Book that lists various disabling conditions.
The Blue Book, which is more formally called “Disability Evaluation Under Social Security,” describes the criteria a given condition must meet in order to be considered a disability.
The Blue Book is divided into two sections: One describes conditions that affect adults, and the other describes those that affect children.
The conditions are then categorized by type: neurological disorders, cancer, cardiovascular disorders, and so forth.
Rheumatoid arthritis falls under “immune system disorders.” That category is further subdivided, and one of the categories is “inflammatory arthritis.”
Inflammatory arthritis describes autoimmune disorders that affect the joints and includes both psoriatic arthritis and rheumatoid arthritis.
Such conditions are considered disabling if they cause deformity and constant inflammation, and if any of the following are true:
- Arthritis affects at least one weight-bearing joint like a knee and at least one peripheral joint like a shoulder or elbow
- Arthritis affects at least one peripheral joint and at least two organs or systems and causes persistent symptoms like fatigue or weight loss
- Arthritis affects the spine, so the patient can’t bend or move at all
- Arthritis affects the spine, thus limiting the patient’s mobility to some degree, and also affects at least two other organs or systems
- The patient suffers repeated flare-ups that affect at least two organs or systems to such an extent that they can not function
The Blue Book defines “major dysfunction” of a joint in the following way:
- The patient can’t walk or move effectively due to arthritis in their hip, knee and/or ankle
- The patient can’t perform tasks due to arthritis in their shoulder, elbow or hand
What is Residual Functional Capacity?
Residual Functional Capacity or RFC describes a patient’s ability to perform various tasks in spite of a disability. It concentrates on those tasks related to a job.
If a patient’s arthritis doesn’t meet the criteria listed in the Blue Book, they may still get benefits if they can prove that they are unable to work.
A person evaluating a patient’s RFC may consider any of the following:
- Can the patient concentrate on their work?
- How long can they stand, sit, walk, kneel, or push?
- Can the patient handle or reach for large objects?
- Can the patient understand, remember and carry out job-related tasks?
Some treatments may actually decrease a patient’s RFC. For example, some medications may impair the patient’s ability to concentrate on paperwork or the computer.
Similarly, the patient may have conditions caused by their arthritis, like depression or sleep disturbances, that impair their ability to work.
The RFC will be used to determine if the patient can perform sedentary, light, medium or heavy work. It will also indicate if the patient can still perform the type of work they have done in the past.
How does somebody get disability benefits?
A patient may apply for disability through either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Both have offices that people can visit in person. A patient applying through SSDI can also apply online.
They should answer every single question; leaving blank spaces will either prolong the application processor result in a denial.
In addition to their disability, the applicant will have to answer questions about their work history, finances, and education.
The applicant should provide as many and as extensive medical records as possible. Disability applications for arthritis should include at least some of the following:
- Imaging tests like X-rays or MRIs
- Laboratory blood tests
- Physical exams, with an emphasis on mobility evaluations
- Descriptions of treatments
- Other lab work is done for inflammatory arthritis
The applicant should ask their doctor for help to ensure they use the appropriate terminology. If the patient’s condition doesn’t meet the Blue Book criteria, both they and their doctor will have to fill out RFC forms. Again, they need to be thorough and use the correct terms.
The applicant should also get a Social Security advocate or lawyer to help them. The advocate or lawyer can help the applicant through the entire process. Successfully getting benefits is rarely straightforward, and people often need help along the way.
The advocate or lawyer can help with both the initial filing and any necessary appeals in the case of a denial. People who have a lawyer or advocate helping them are more likely to get their benefits.
Does age make a difference?
Yes. In a nutshell, the older an applicant is, the better their chances of getting disability benefits. According to the Disability Benefits Center Website, the SSA divides people into the following age categories:
- 18 to 44 – Young individuals
- 45 to 49 – Younger individuals
- 50 to 54 – Approaching advanced age
- 55 to 60 – Advanced age
- 60 to 65 – Approaching retirement age
Applicants for disability are most likely to get benefits if they are at least 55 years old. People that age have a harder time finding work than do younger people even when they don’t have a disability. An older person with a disability will have a very difficult time finding work, and the SSA knows that.
What are grid rules?
The grid rules, which are more formally known as “medical-vocational guidelines” examine the patient’s age, education and work history.
They are called the grid rules because they are displayed in a table with five columns that look like a grid. The grid rules use the age categories listed above.
Education levels consist of the following:
- Marginal to none
- High school graduate or more – does not provide direct entry into skilled work
- High school graduate or more – does provide direct entry into skilled work
Work experience has three categories:
- Unskilled or none
- Semi-skilled or skilled skills not transferable
- Semi-skilled or skilled, skills transferable
“Transferable” refers to how well the applicant’s skills can be transplanted from one workplace to another.
An airplane mechanic is very skilled, but those skills won’t help them if they try to get a job that doesn’t involve maintaining or repairing planes. Their skills are thus “nontransferable.”
A secretary, on the other hand, has transferable skills, for many types of employers have offices that need people who can handle paperwork.
The grid rules are most beneficial to people with limited education and job skills, for the SSA believes that people with more education and skills will have an easier time finding work.
The SSA also consider the physical demands of a given job. It divides jobs into five categories: sedentary, light, medium, heavy and very heavy. The last two are the most physically demanding, and people of capable of such work are not considered disabled.
A sedentary job is the least physically demanding: The employee must be able to sit for at least six hours during an eight -hour workday, and they might occasionally have to lift something that weighs up to ten pounds.
Light work requires the employee to be able to stand and/or walk for six hours during an eight-hour workday. They will frequently have to lift objects that weigh ten pounds and occasionally lift objects that weigh up to twenty pounds.
Medium work has the same mobility requirements as does light work. The employee also has to be able to frequently lift objects that weigh 25 pounds and occasionally lift objects that weigh up to 50 pounds.
As might be guessed, an applicant who is unable to perform even sedentary work is far more likely to be considered disabled than an applicant who can perform light or medium work.
In his video, the Social Security lawyer, Johnathan C. Ginsberg, discusses how the grid rules can help applicants who are over 50 and have limited education, skills and/or work experience.
arthritis is technically considered a disability, but the SSA will want proof that the applicant’s condition is severe enough to prevent them from working.
The applicant should, therefore, work with their doctor and advocate or lawyer to provide such proof. If the SSA still denies their claim, they may appeal that decision.