Get Social Security Disability & SSI Benefits: Osteoarthritis

Winning Your Osteoarthritis & Degenerative Joint Disease Case

Video

How Social Security Reviews Osteoarthritis & Degenerative Joint Disease

Osteoarthritis (also called degenerative joint disease) is an extremely common medical condition, and therefore, it is an extremely common Social Security disability claim. It is the deterioration of cartilage. It is often referred to as "wear and tear" arthritis. Between the bones (and spinal vertebrae) you have cartilage that acts as a fibrous cushion allowing your bones to move and function. When the cartilage deteriorates, the bones rub against one another causing joint swelling, stiffness, pain, numbness, and reduced and slowed range of motion. Ultimately, you are limited in the use of your joint. Osteoarthritis can affect any joint in the body, and in severe cases, it affects the joint lining, ligaments, and even the bone itself.

In your osteoarthritis Social Security & SSI disability case, your medical records will serve as the prime source of your condition. A diagnosis will need to be based on objective imaging - x-ray, CT scan or MRI; and MRI is the best. Imaging is necessary to meet an osteoarthritis-related listing. Disability is consistent with "marked" or worse imaging findings.

Social Security will highly concerned with your treatment. Osteoarthritis is an unfortunate medical condition as there is no cure, and treatment is highly limited because the medical and scientific communities have not been able to develop artificial cartilage. Therefore, treatment is usually anti-inflammatories, pain medications, braces, and reduced use of the joint. Relief from corticosteroids and injections are usually short-lived. Physical therapy is usually ineffective. Stem cell therapy in America has been highly restricted, and therefore, stem cell injections are still experimental. Surgeries are rare and usually limited to a joint replacement (hips and knees being the most common) or an artificial disk replacement (lumbar spine being the most common).

Social Security will also be highly concerned about clinical evaluations of you done by your doctor; these essentially address how seriously your osteoarthritis affects you. Your doctor will evaluate your -

1. Strength,
2. Muscle atrophy,
3. Range of motion,
4. Sensation,
5. Reflexes, and
6. Straight-leg raising (if the lumbar spine is involved).

If your doctor notes in your medical records that your clinical evaluations are normal or near-normal which is common, and such findings and inaccurate, you need to speak to your doctor.

Social Security & SSI Osteoarthritis Listing

There is no specific Social Security listing for osteoarthritis. However, osteoarthritis is directly relevant to three listings that can be applicable in an osteoarthritis case:

1. Major dysfunction of a joint - Adult Listing 1.02 and Child Listing 1.02,
2. Reconstructive surgery or surgical arthrodesis of a major weight-bearing joint - Adult Listing 1.03 and Child Listing 1.03, and
3. Disorders of the spine - Adult Listing 1.04 and Child Listing 1.04.

A Success Story - Important Additional Testimony

Mr. Christensen was a character. He lived in St. Louis, MO. when we started his case, and he moved to Kansas City, KS. at the time his hearing was held.

He suffered from osteoarthritis that resulted in lumbar degenerative disk disease. This combination of impairments was the basis of his disability. His primary symptom was back pain. He was also overweight with a body mass index (BMI) of 40-45.

His hearing was held in Kansas City, KS. A St. Louis administrative law judge (ALJ) held his hearing and appeared by video. Mr. Christensen and counsel appeared in Kansas City, KS. The St. Louis ALJ had been the original ALJ assigned to the case, and he remained the ALJ even though Mr. Christensen moved.

He was 51 as of his alleged onset date (AOD) of disability. His past work was as a certified nurse assistant (CNA). He did not have work skills that would transfer to other work. The main physical requirement of his past work was standing and walking. Hence, because of his age (over 50), as long as Mr. Christensen could show he could not stand and walk throughout the workday (limited to Sedentary Physical Exertion), he would win his case.

Mr. Christensen had significant difficulty being on his feet. He spent most of his life in a recliner. The reclined position best alleviated his back pain. Not only was standing and walking a problem, but even sitting upright caused significant back pain. Moreover, he could not lay flat; he slept is his recliner.

The lumbar MRI showed moderate abnormalities. It was not strong evidence of a severe back condition, so it was important to get extra evidence submitted in his case. Counsel obtained residual functional capacity (RFC) forms, pictures, and testimony from his wife.

Counsel asked Mr. Christensen's treating St. Louis primary care doctor to address a RFC assessment form; he declined. Mr. Christensen's treating nurse practitioner did fill out a RFC form. Similarly, Mr. Christensen's treating Kansas City doctor declined to fill out a RFC form, but the doctor's nurse practitioner did. A RFC from a doctor is best, but two nurse practitioner statements wasn't bad.

Counsel asked Mr. Christensen to take pictures of his recliner and his living room. Mr. Christensen and his wife had turned their living room into his bedroom.

Mr. Christensen was not a good witness. He was too tough for his own good. He had difficulty admitting his physical disabilities.

Counsel asked Mr. Christensen's wife to testify. Mrs. Christensen was a high school teacher, a straight-shooter, and a helpful witness. She testified that Mr. Christensen used a cane, had difficulty driving, going to the store, doing housework, and performing necessary hygiene (he used a shower chair). She testified he could not handle the stairs in their house and could no longer use the upstairs master bedroom or bathroom. She testified he lived on the main floor; he could no longer walk the dogs, watch the young grandkids alone, or do any yard work. She also testified they sold their fishing boat since he was no longer able to use it.

The (ALJ) did not seem to be impressed with the nurse practitioners's RFC statements. The pictures helped, but it was Mrs. Christensen's testimony that made the difference. Mr. Christensen won his case. He received monthly benefits, 24 months of back pay, an earnings freeze which allowed him a higher Social Security retirement amount, and entitlement to Medicare.

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