Getting Disability for Raynaud's Disease

Raynaud’s disease is a condition where the arteries that supply blood to the skin become narrowed, limiting blood circulation to certain body parts (most commonly the fingers, toes, nose, and ears). The disease causes episodic spasms (called vasospastic attacks) in response to stress or cold temperatures that can last anywhere from seconds to hours. During a Raynaud’s attack, the affected body parts usually feel numb and cold, and the skin color can appear white or blue. As circulation returns, they may turn red and throb, tingle, or swell.

Over time, Raynaud’s can cause these arteries to swell, further limiting blood flow and potentially making it difficult to perform many job-related tasks such as walking, standing, or using your hands. When symptoms of Raynaud's keep you from working full-time for at least one year, you may qualify for Social Security disability benefits (SSDI or SSI). Before you file for benefits, however, it's a good idea to learn some basics about how Social Security evaluates Raynaud's disease and what medical records you'll need to provide in order to be considered disabled.

When is Raynaud's Disease a Disability?

The Social Security Administration (SSA) can award disability benefits if you have a medically determinable impairment that prevents you from earning at or above the substantial gainful activity level for twelve months or longer. For many people, Raynaud’s disease is a painful but intermittent inconvenience that is unlikely to interfere with their ability to work. But complications of Raynaud’s can result in itchy skin ulcers that form as a reaction to cold temperatures,  infected body parts, and gangrene due to a lack of blood flow. In extreme cases, the blood flow becomes permanently blocked, causing deformities and usually requiring amputation.  When symptoms from Raynaud's are severe enough to meet the requirements of a listed impairment or cause functional limitations that rule out all jobs, you might be eligible for Social Security disability benefits.

Qualifying for Disability Benefits With Raynaud’s Disease

Raynaud's disease isn't one of the listed impairments that the are considered automatically disabling, but symptoms of the disorder can result in a medical-vocational allowance when they prevent you from performing any jobs in the national economy. Before you can be found medically disabled, you’ll need to show that you meet the non-medical criteria for at least one of the agency’s disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

SSDI is based on your work history and how much money you paid into the Social Security program by way of payroll taxes. SSI is a needs-based program with strict income and asset limits. Some people might qualify for both SSDI and SSI, known as concurrent benefits. When you first apply for disability benefits, your file will be sent to your state’s Disability Determination Services (DDS) office to determine whether you financially qualify for SSDI, SSI, or both. If you can legally receive at least one type of benefit, a claims examiner will then decide whether you’re medically disabled.

Getting Disability for Secondary Raynaud's by Meeting a Listed Impairment

If you have "secondary Raynaud’s" that is caused by another medical condition, you may be able to get disability by meeting the listing for the underlying disorder. For example, you may meet listing 14.04 for systemic sclerosis (scleroderma) if you have both a scleroderma diagnosis and Raynaud’s with one of the following:

• gangrene (death of body tissue) in at least two of your arms or legs, or
• inadequate blood supply to your toes or fingers that cause ulcerations resulting in your inability to walk or hold objects without help.

You may also meet the requirements of listing 14.09 for inflammatory arthritis if your Raynaud's is a byproduct of a joint disorder. (For more information, see our article on getting disability for arthritis.) 

Getting Disability by Showing That You Can’t Work

Even if you don't have a disorder that meets a disability listing, you can still qualify for benefits if you can show that your Raynaud's symptoms result in a residual functional capacity (RFC) that rules out all full-time work. Your RFC is a set of functional limitations on what you can and can’t do in a work setting. For example, if you have ulcerations on your fingers from Raynaud's, you may not be able to lift, carry, grasp, push, or pull items. 

Social Security uses your RFC by comparing it with the demands of your past jobs and seeing if you could return to that type of work. If you can’t, the agency will then decide whether other jobs exist that you could do, considering factors such as your age, education, and work experience. For most people younger than 50, this means determining whether you could do a simple sit-down job, but people 50 years of age and older may have an easier time qualifying under a special set of rules known as the medical-vocational grid.

Getting disability benefits based solely on Raynaud’s disease isn’t very common. But many disability applicants with Raynaud’s also have related connective tissue or circulatory system disorders (such as peripheral vascular disease) that also interfere with their ability to work. Social Security is required to consider all your impairments combined when determining whether you’re disabled, so make sure you let the agency know about every condition you’re being treated for.

Medical Evidence Required to Prove Disability Due to Raynaud’s Disease

The most useful source of medical information are the progress notes from your doctors that document your medical treatment for Raynaud's. In order to have the best chance of qualifying for disability, your medical file should contain a few specific things, including:

• a diagnosis of primary or secondary Raynaud’s disease, preferably by a rheumatologist
• medical records that show you’ve gotten regular treatment (at least several times per year)
• a list of what treatments you tried and how well they worked
• your doctors’ observations about how you look and feel during a visit, as well as the results of physical examinations
• intake and discharge forms from any hospitalizations, and
• a medical source statement about your limitations.

Because Raynaud’s disease (sometimes called white finger or dead finger) is usually diagnosed based on a patient’s self-reporting of their symptoms,  most doctors will perform tests to rule out other conditions. These tests should be included in your medical records, even if they don't show any abnormality.  

Mild cases of Raynaud’s normally respond to self-treatment—such as keeping your extremities warm—to reduce the frequency and severity of attacks. More advanced cases sometimes require prescribed medications to help open blood vessels. In the most severe Raynaud’s disease cases, doctors may recommend nerve blocks or surgery. Let the SSA know about any admission and discharge records you have from those procedures. 

Keep in mind that Social Security is most concerned with how your Raynaud's limits your ability to perform normal everyday activities. You may be asked to conduct an interview over the phone or go to a consultative examination.You may also want to submit third-party statements from friends, family, or former employers that can help the SSA understand more about your Raynaud’s and how it has an impact on your ability to function.

How to File for Social Security Disability Benefits

Social Security has several easy ways to apply for disability benefits:

• File online at www.ssa.gov.
• Call 888-772-1213, between 8 a.m. and 7 p.m., Monday through Friday, to speak with a representative. People who are deaf or hard of hearing can call the TTY number at 800-325-0778.
• Make an in-person appointment at your local Social Security field office.

No matter how you choose to apply, you’ll need to have certain information on hand at the time that you complete the disability application, including contact information for your medical providers and dates for all medical treatment you’ve obtained.

What If My Application is Denied?

Few disability applicants are awarded benefits on their first try, but you can appeal a denial. You’ll need to first request reconsideration of your application before you can ask for a hearing with an administrative law judge. Most people who are awarded disability don’t get approved until after a hearing with a judge, a process that can take about a year (or more, in some cases.)

You aren’t required to get legal assistance during any part of the disability determination process, but it can be a good idea. An experienced lawyer can help you gather the evidence you need to show that you’re disabled and can handle communications with Social Security so that you don’t miss any important appeal deadlines. Disability attorneys work on contingency (meaning they get paid only if you win) and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.