Getting Disability Benefits for Hand Osteoarthritis

Hand osteoarthritis (OA) happens when the connective tissue that protects your joints (called cartilage) wears down where two finger bones meet, often causing stiffness, swelling, and visibly enlarged or crooked joints.  OA is commonly known as degenerative arthritis because it causes a progressive decline in bone cartilage, and hands are one of the most common parts of the body for people to develop OA.

Many people with osteoarthritis experience minimal discomfort, but if your hand OA makes it painful or impossible to grip, type, or perform other fine motor tasks, you may qualify for Social Security disability benefits. (Age plays a major role here, since osteoarthritis usually develops over time, and applicants older than 50 have an easier time getting approved than younger applicants do.) You can increase your chances of winning your case by familiarizing yourself with some of the basic legal principles that dictate when the Social Security Administration (SSA) can consider you disabled.

When Can I Get Disability Benefits for Hand Osteoarthritis?

You may be eligible for Social Security disability if you’re unable to work full-time for longer than twelve months due to your hand OA. Social Security offers two types of benefits available: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Eligibility for SSDI is based on your work history and how much you contributed to the program in payroll taxes while you were working, while SSI is needs-based and available to anybody below a certain income and asset level.

While the financial eligibility requirements for both programs are different, the definition of “disabled” is the same for both. Social Security will considers you disabled if you meet a listed impairment (“medically disabled”) or you’re unable to work any job full-time (“vocationally disabled”). Listed impairments are conditions found in Social Security’s “Blue Book” of medical disorders. If you have certain evidence in your medical record, the SSA can find you disabled automatically without having to further determine whether you can do any work. 

Getting Disability for Hand Osteoarthritis by Meeting Listing 1.18

The Blue Book doesn’t have a specific listing for hand OA. But if you have osteoarthritis at the base of your thumb and it affects the joint between your wrist and hands on both hands, you may qualify for benefits under Listing 1.18, Abnormality of a major joint in any extremity. In order to meet this listing, you’ll need to provide medical documentation of the following:

• chronic joint pain or stiffness in your hand or hands
• abnormal motion, instability, or immobility of the affected joints
• physical examination or imaging showing that there is an "anatomical abnormality" like joint space narrowing, and
• an inability to use both hands to effectively perform fine and gross movements, such as preparing a simple meal, using utensils, or picking up a piece of paper.

Because the listing requires you to be very limited in your ability to use your hands, meeting listing 1.18 can be very challenging. However, you can still qualify for disability benefits even if you don't meet listing 1.18 if you can show that you’re unable to work at any job.

Getting Disability by Showing You Can't Work With Hand Osteoarthritis

You can qualify for disability benefits if limitations from your hand osteoarthritis result in a residual functional capacity (RFC) that rules out your past and all other work. Your RFC is a set of restrictions that reflect Social Security’s opinion about the most you’re capable of doing in a work setting. For example, a typical RFC for people with hand osteoarthritis will likely involve restrictions on how long you can use your hands to do tasks such as typing or holding objects (“manipulative limitations”). The worse your symptoms are, the more manipulative limitations you’ll have. Here’s an example comparing two applicants with osteoarthritis in their hands:

Once Social Security has assessed your RFC, the agency will compare your current limitations with the demands of your past work to see if you could return to that kind of job. If you can't, Social Security will then need to determine whether you are capable of doing any other types of work, given your age, education, and experience. People who are at least 50 years old—the age when osteoarthritis is most likely to develop—might not be expected to learn a new job if they don't have the job skills to make a career switch under the medical-vocational grid rules.

People younger than 50, however, are expected to change their line of work, so they generally need to show that they can’t do even the easiest, sit-down jobs in order to get disability. But keep in mind that most sedentary jobs require a near-constant amount of fine motor skills (such as typing, filing, or writing), so if you have very significant manipulative limitations, the SSA will usually rule out that kind of work for you.

Medical Records You'll Need to Get Disability Based on Hand Osteoarthritis

Social Security will generally want to see medical imaging showing the extent of your hand OA as well as progress notes from doctors documenting your ongoing treatment for the osteoarthritis. Ideally, your medical records should include most, if not all, of the following information:

• objective imaging (X-rays, MRIs, or CT scans) showing the presence of osteoarthritis
• physical examination of your hands establishing common symptoms such as stiffness, swelling, pain, or bony growths
• reduced range of motion in your hands, fingers, and wrist
• clinical notes from your physician containing their observations of your condition
• any prescribed pain medication, including side effects
• physical therapy records
• use of a splint or brace, and 
• other treatment modalities, such as steroid injections or surgical intervention (like a bone fusion).

Certain environmental conditions, such as exposure to cold, heat, or humidity, can make symptoms of OA worse. Make sure to let your doctor know if you experience any “flare-ups” of this nature so that the doctor can record your experience in the progress notes. Social Security can use that to justify putting restrictions in your RFC against working outside or in cold warehouses, further reducing the number of jobs you'd be expected to perform.

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 Happens 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.