Psoriatic arthritis and Disability: Essential Facts to Understand
Qualifying for Disability Benefits with Psoriatic Arthritis in the U.S.
For those with psoriatic arthritis (PsA) who find their condition severely limiting their ability to work, financial assistance may be available through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) in the United States.
Qualifying Criteria
To qualify for disability benefits, a person with PsA must provide strong, ongoing medical records from treating doctors that document the severity of symptoms, treatments, and their impact on the ability to work. This includes frequent visits, physical exams, lab results, imaging, and doctors’ statements or letters describing functional impairments.
The impairment must be severe enough to prevent any substantial gainful employment for at least 12 months, or be terminal. The Social Security Administration (SSA) evaluates disability claims through a five-step evaluation process.
SSA's Five-Step Evaluation Process
- Is the applicant working?
- Is the condition severe?
- Does the condition meet or equal a listed impairment? PsA may be evaluated under listings for inflammatory arthritis or musculoskeletal disorders if documented severity meets criteria.
- Can the applicant perform past work?
- Can the applicant perform other work based on residual functional capacity?
Meeting or equaling a listing significantly improves chances of approval.
Application Process
Application for SSDI or SSI is done through the Social Security Administration (SSA). Submit thorough medical evidence from rheumatologists or treating doctors showing diagnosis and functional limitations of PsA. The SSA may also request a consultative examination to assess physical function.
Processing can take months; if denied, appeals are possible. Appeals can be taken to reconsideration, hearings before an Administrative Law Judge, Appeals Council, and Federal Court if necessary.
Additional Notes
For veterans, VA benefits may be awarded if PsA or related joint pain is service-connected, based on impairment ratings related to functional loss. Long-term disability insurance claims may also be an option if coverage applies, but claimants must confirm their policy covers PsA or related arthritis.
People with PsA may have high rates of unemployment, absenteeism, and reduced work productivity due to physical and psychosocial effects.
- Social Security Disability benefits can be crucial for those with Alzheimer's, arthritis, chronic-kidney-disease, type-2-diabetes, and respiratory-conditions, among other chronic-diseases, who find their condition limiting their work capacity.
- In the evaluation process, entities like psoriasis, skin-conditions, and eye-health are considered under listings for inflammatory arthritis or musculoskeletal disorders if the severity meets criteria.
- It's important to note that mental-health issues can also impact one's ability to work and may need to be addressed in the documentation of the impact of medical-conditions.
- Regular fitness-and-exercise, along with suitable therapies-and-treatments, can help manage PsA symptoms, thereby improving one's ability to work.
- Approximately, people with PsA face high rates of unemployment, absenteeism, and reduced work productivity due to physical and psychosocial effects, which can impact workplace-wellness.
- Medicare can provide coverage for the medical treatment and management of PsA and other qualifying conditions after a certain age or under specific circumstances.
- Veterans who have PsA or related joint pain as a result of their service may be eligible for VA benefits based on impairment ratings related to functional loss.
- Long-term disability insurance can be an option if coverage applies, but it's essential to confirm that the policy covers PsA or related arthritis.
- For those diagnosed with PsA, it's crucial to maintain thorough medical records to support disability benefit claims or other applications.
- The application process for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) involves submitting comprehensive medical evidence from rheumatologists or treating doctors, and the SSA may request a consultative examination to assess physical function.
- Processing of SSDI or SSI applications can take several months; if denied, appeals can be made through reconsideration, hearings before an Administrative Law Judge, Appeals Council, and Federal Court if necessary.
