Applying On The Basis of Osteoarthritis, or Simply Arthritis
How the Social Security Administration views Osteoarthritis
Social Security evaluates the affects of osteoarthritis in the muscloskeletal category of impairments in the Disability Evaluation Under Social Security disability handbook.
Under subsections 1.03 "Arthritis of a major weight-bearing joint (due to any cause)" and 1.04 "Arthritis of one major joint in each of the upper extremities (due to any cause)". Listing 1.03 deals with arthritis of major weight bearing joint (hips, knees, ankles) due to any cause (osteoarthritis, rheumatoid, or other types of arthritis). To meet or equal this listing an individual must have a history of constant joint pain and stiffness with evidence of significant limitation of motion or abnormal motion upon physical examination of the affected joint, along with the criteria described in A or B of the listing.
A. States that an individual must have major anatomical malformation of the hip or knee that can be evidenced by a x ray that shows significant bony destruction or severe joint space narrowing and an extreme limitation of the ability to walk or stand;
B. States that an individual meet or equals this listing if they have had an unsuccessful reconstructive surgery or athrodesis (bone fusion through bond grafts, synthetic bone grafts, metal implants to hold bones together for bone to grow, or other fusion methods) of a major weight bearing joint that did not or is not expected to be weight bearing within twelve months of onset (when an individual had to stop performing substantial gainful work activity).
Listing 1.04 deals with arthritis of the upper extremities (shoulders, elbows, wrist and hand) due to any cause. To meet or equal this listing an individual must have continual joint pain and stiffness, extreme limitation of the upper extremity joint or joints that is corroborated by a current physical evaluation. Along with joint pain, stiffness, and marked limitation of motion, there must be x-ray evidence of severe bony destruction or significant narrowing of joint space in the affected joint or joints.
To meet or equal this listing individuals with upper extremity joint arthritis must have either:
A. The range of motion in both arms at the shoulders (scapular motion as well) must be have restricted to less than 90 degrees with regard to forward flexion and abduction (elevation); or
B. There must be total anatomical deformity, enlargement, or effusion (fluid build up around the joint) of the affected joints. Total anatomical deformities might include contracture, fibrous ankylosis, joint instability, or ulnar deviation.
Social Security disability based upon arthritis can be approved on the basis of a meet or equal the listing, if the disabled individual meets the criteria listed. However, this does not mean there is no way for an individual with significant problems with arthritis cannot be approved for disability if they do not meet or equal the listing criteria.
Social Security disability is based upon residual functional capacity rather than specific medical conditions; consequently if an individual's residual functional capacity is so limited by arthritis that-- A). They are unable to perform any of their past substantial work activity (types of work not specific places of employment) that was performed more than three months at a earning capacity that is above the monthly SGA amount in the past fifteen years
and
B). Their limitations preclude other types of work
Then they may be approved for disability benefits through a medical vocational allowance. Medical vocational determinations take an individuals age, education, past work history, medical condition, and residual functional capacity into account. As a result, many disabled individuals who do not meet or equal impairment listings are able to when their disability benefits.
Information about the condition itself
Osteoarthritis is the most common type of arthritis; in fact about twenty seven million Americans suffer from the painful disease. Osteoarthritis generally affects the hands, feet, spine, and weight bearing joints (hips and knees). And it accounts for about one forth of all primary care visits and half of the NSAID use in the United States. These numbers will continue to rise do to our aging population. Studies indicates that eighty percent of all Americans will have radiologic evidence of osteoarthritis by the age of sixty-five and of those about sixty percent will be symptomatic. Symptoms of osteoarthritis might include joint pain, stiffness, crepetus, tenderness, or inflammation. Osteoarthritis pain increases with activity making walking, standing, bending or even sitting difficult.
Osteoarthritis is often referred to as a "wear and tear" arthritis because it seems to affect older individuals more often. However, this moniker is a bit of a misnomer. Osteoarthritis is a disease process that takes longer to develop so it appears to be the result of the wear and tear an individual experiences over a lifetime when it is in fact caused by many factors that may or may not include age and "wear and tear". Naturally there seems to be a correlation with age and joint usage, but there are in fact several causes for osteoarthritis.
For example, osteoarthritis can be caused by trauma, hereditary disposition (some studies indicate that as many as sixty percent of all osteoarthritis cases have a hereditary component), mechanical stress to joints, or possibly allergies, fungi, or infections. Many medical professionals believe that all osteoarthritis can be attributed to mechanical stressors that might include congenital misalignment of the joints, pathogens, injury or trauma to joints, being obese or overweight, peripheral nerve impairment, or even sudden uncoordinated movements can cause osteoarthritis.
There are two types of osteoarthritis primary and secondary. Primary osteoarthritis is a chronic degenerative disease that is associated with aging but not caused by aging. As a person gets older, their cartilage loses some of its water content making it less resilient, thereby rendering it less protective of the joints. Once the cartilage is damaged, joints begin to rub together and this can cause degenerative changes. The area around the joint cap can become inflamed due to the breakdown products released by cartilage into the joint lining or synovial space. Bone changes (bone spurs and bony destruction) often cause inflammation can be debilitating and painful.
Secondary osteoarthritis is caused by other factors but the anatomic and functional manifestations as well as development and consequences are the same as primary osteoarthritis. Secondary causes of osteoarthritis might include diabetes, gout, costochondritis, hormonal disorders, congenital disorders, obesity, injuries, Lyme's disease, or even pregnancy.
There are no laboratory tests to diagnose osteoarthritis; consequently most diagnoses of osteoarthritis are based upon clinical examination and imaging techniques. Generally, a simple x ray of the affected area can confirm a diagnosis of osteoarthritis.
Treatment of osteoarthritis generally consists of life style changes, exercise, manual therapy, and medications or other methods of alleviating pain. Life style changes such as weigh loss, moderate exercise, rest, and assistance devices (walker, cane, brace) provide benefit not matter what the location or severity of the osteoarthritis. Medication can also be used to alleviate the pain of osteoarthritis. Generally treatment consists of NSAIDs such as ibuprofen and naproxen or drugs such as acetaminophen. For more severe cases, corticosteriods, steroid injections, or even surgical replacement of joints can be considered in the most severe cases.
