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Disability Benefits and Inflammatory Arthritis

According to the CDC, 23% of all adults in the United States have arthritis. It is the leading cause of disability preventing Americans from working. Inflammatory arthritis is a group of diseases characterized by inflammatory of the joints and often other tissues (Arthritis Foundation). These include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, systemic lupus, and others.

For individuals suffering from some form of inflammatory arthritis, there are two routes to being approved for disability benefits. The most common method of proving disability is establishing through medical evidence and testimony that you are unable to perform your past work or other work due to your symptoms. In an inflammatory arthritis case, this would generally involve testifying about your physical limitations and how your ability to work and perform daily living activities is impacted.

However, you can be approved for benefits based merely on your medical records if your records demonstrate the following:

A. Persistent inflammation or persistent deformity of:

1. One or more major peripheral weight-bearing joints resulting in the inability to ambulate effectively; or

2. One or more major peripheral joints in each upper extremity resulting in the inability to perform fine and gross movements effectively.

OR

B. Inflammation or deformity in one or more major peripheral joints with:

1. Involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity; and

2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).

OR

C. Ankylosing spondylitis or other spondyloarthropathies, with:

1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45° or more of flexion from the vertical position (zero degrees); or

2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 30° or more of flexion (but less than 45°) measured from the vertical position (zero degrees), and involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity.

OR

D. Repeated manifestations of inflammatory arthritis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:

1. Limitation of activities of daily living.

2. Limitation in maintaining social functioning.

3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

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