Get Social Security Disability & SSI: Ankylosing Spondylitis

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Social Security's Take On Ankylosing Spondylitis

Ankylosing spondylitis (a type of spondyloarthropathy) is a form of arthritis that primarily affects the spine (mainly the lower spine) or the sacroiliac joints (joints that connect the spine to the pelvis). Ankylosing means stiffening of a joint. Spondylitis means vertebrae. Ankylosing spondylitis causes inflammation of the joints which erodes the surrounding tissues. In severe cases, ankylosing spondylitis fuses the vertebrae and/or the sacroiliac joints. The cause is not known, and there is no cure.

Social Security will need to see the basis for your diagnosis - an x-ray or MRI (an MRI is by far better). Blood test may be performed to determine if there are inflammatory markers (an objective measurement of inflammation). In rare circumstances, genetic testing may be done as 90% of patients have a specific gene called HLA-B27. This gene is not the cause of the condition, but it is a genetic marker of the disease - it is an indication you have an auto-immune disease (the body attacks itself).

Social Security will also need to see common symptoms of ankylosing spondylitis which usually include the following:

1. Pain,
2. Stiffness,
3. Reduced range of motion,
4. Weakness and muscle atrophy, and
5. General fatigue.

In severe cases, ankylosing spondylitis causes a curvature of the spine (kyphosis). This occurs because the spine has become less flexible, and it causes the spine to bend forward. In extremely rare cases, the eyes, heart, and lungs are affected.

Social Security will also need to see your medical records to determine your medical treatment which is usually limited to pain suppression - pain medications, anti-inflammatories, physical therapy, and a TENS machine. Sometimes, back or hip surgery is appropriate. Physical therapy and a TENS unit is usually ineffective in significantly severe cases because it does not correct the condition, but both can be helpful post-surgery. TENS units are best for nerve pain, and they can be effective if a nerve or nerve root is impinged. The most common surgeries are as follows:

1. Laminectomy (relieves pressure on the spinal cord caused by encroaching spinal vertebrae),
2. Fusion (fuse damaged vertebrae), and
3. Osteotomy (straightens the spine).

Back surgeries are discussed in more detail here - Back & Neck Surgeries And How They Affect Your SSDI/SSI Social Security Disability Case.

In any disability case, ankylosing spondylitis inlcuded, Social Security will find your condition more severe the more treatment you receive. The most significant factors in determining the severity of your condition is your MRI findings and whether you have been prescribed a surgery.

Ankylosing Spondylitis Social Security & SSI Listing

At Step 3, Adult Listing 14.09C and Child Listing 114.09C both require one of the following:

1. Spine fusion with limited flexion demonstrated at 45 degrees or more; or
2. Spine fusion with limited flexion demonstrated between 30 and 45 degrees and two or more body parts are affected.

Satisfying the listing is difficult. First, a diagnosis of ankylosing spondylitis is uncommon as the signs and symptoms are often the same as many other types of spine impairments. As well, a specific diagnosis is often determined by doctors to be unnecessary to any treatment regimen as treatment for ankylosisng spondylitis is generally the same for many other types of spine impairments. Hence, a obtaining the diagnosis itself is a frequent challenge in satisfying the listing. Second, radiologists and doctors often do not assess the degree of limited flexion as it is not necessary to diagnose or treat the condition. Hence, MRI findings do not contain this necessary aspect of data that is required to satisfy the listing. If either of the two aforementioned issues exists in your case, you must ask you doctor to 1) specifically assess them in your medical records or 2) write a separate statement that each aspect of the listing is satisfied.

Helpful Resource

1. Ankylosing-Spondylitis Video - Spine-Health