Individuals seeking financial assistance for their disability from the Social Security Administration (SSA) may be familiar with the “Blue Book.” Officially titled “Disability Evaluation under Social Security,” the Blue Book describes various health conditions considered severe enough to prevent an individual from working.
The Blue Book, which gets its name from the original color of the manual, is now only available online. Healthcare professionals, patients, attorneys, and SSA employees often reference the Blue Book when attempting to establish whether or not an individual would be deemed disabled under the SSA rules.
How the Blue Book Can Help You Medically Qualify for Disability with Osteoarthritis
Arthritis is the leading cause of disability in the United States. An estimated 31 million people living with osteoarthritis in the United States. However, only the more advanced cases are considered for a Social Security disability award.
If an individual’s impairment is included in the Blue Book and they can provide the medical evidence required, they are said to “meet the listing.” Meeting a Blue Book listing is the most straight-forward way to begin receiving disability payments. While there is not one specific listing in the Blue Book for osteoarthritis, there are a few sections that would likely apply to those with osteoarthritis.
The musculoskeletal section of the Blue Book, section 1.02, addresses major dysfunctions of a joint. This section states that joint dysfunction is characterized by gross anatomical deformity, as well as chronic joint pain and stiffness that cause limitations in movement of the joint. One of the following two criteria must also be present to meet the listing:
A. Involvement of one major peripheral weight-bearing joint (such as the hip, knee or ankle), resulting in the inability to ambulate effectively.
OR
B. Involvement of one major peripheral joint in each upper extremity (such as the shoulder, elbow, or wrist-hand), resulting in the inability to perform fine and gross movements effectively
If an individual’s osteoarthritis has resulted in the need for joint replacement surgery, he or she might qualify under section 1.03, reconstructive surgery or surgical arthrodesis of a major weight-bearing joint. While most total joint operations are successful, if an individual is unable to return to effective ambulation within 12 months of their surgery date disability will be considered. If a year after surgery, a person is unable to walk a sufficient distance without a walker, two canes or crutches, or assistance from another person, they would likely meet the listing in section 1.03.
Additionally, if an individual has spine difficulties as a result of osteoarthritis, it might be possible to meet a listing in section 1.04, disorders of the spine.
What Evidence Do I Need to Win My Osteoarthritis Claim?
In addition to listing the various conditions that might qualify someone for disability benefits, the Blue Book also includes the medical evidence required to earn a disability award.
Perhaps the most essential medical evidence needed to support an osteoarthritis claim is a detailed physical exam. As a person’s physical condition with osteoarthritis can change over time, it is preferable to have a longitudinal record of ongoing observations by a doctor.
According to the SSA, the physical examination must include a detailed description of the rheumatological, orthopedic, neurological, and other findings appropriate to the specific impairment being evaluated. The physician should document observations and abnormal findings, such as the straight-leg raise test. Other important medical evidence includes descriptions of the joint such as range of motion, the condition of the musculature, any circulatory deficits, and sensory or reflex changes.
Additional helpful medical evidence includes medical imaging such as x-rays, CT scans, or MRIs. X-ray images showing joint space narrowing, bony destruction, or fusion of the affected joint are particularly helpful. Surgical reports and blood work may also be relevant.
Finally, the SSA will want to know what type of treatment has been received, as well as the response to that treatment. For example, if you are taking pain medication or anti-inflammatory drugs for your osteoarthritis, the SSA will want to know the dose, timing, and how well you respond to the treatment.
Can a Lawyer Help Me Win My Claim for Osteoarthritis?
Winning a disability case for osteoarthritis can be challenging, given that so many people are affected by the generally mild disease. An experienced Social Security lawyer will be able to guide you through the application process, ensuring that you have all of the appropriate medical documentation in order.
A disability lawyer is skilled at pulling all of the facts of your case together to paint a compelling picture to the SSA, thus improving your chances of winning your osteoarthritis claim. Fill out the Free Case Evaluation on this page to be connected with a lawyer to review your case!
