Joint pain, chronic pain, stiffness, and other symptoms of psoriatic arthritis (PsA) can make working impossible. Fortunately, people in the United States living with this condition can seek Social Security disability benefits to replace the income lost from having to leave their jobs.
“My mom is on disability due to the disfigurement of her hands caused by psoriatic arthritis,” one MyPsoriasisTeam member said.
The process of applying for a disability claim can feel intimidating. Facing the appeals process if you aren’t approved can be all the more daunting.
“Even with arthritis, I only received a grant to modify my workplace for a motorized scooter and special chairs, plus modifications to my car,” wrote a MyPsoriasisTeam member. “It wasn’t enough to be registered disabled, even though I couldn’t cut my food, open cans, write, put underwear/socks on, etc.”
Understanding these processes in advance can make applying easier, including what the U.S. Social Security Administration (SSA) considers when determining eligibility for disability and what information you’ll need to provide.
There are two federal disability programs in the United States, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). To qualify for either program, you must have a disability that stops you from doing your current job or any other form of gainful employment.
SSDI provides benefits to people with a recent full-time work history. The funds are drawn from payroll taxes. If you are approved for SSDI, you can receive benefits six months after the date your disability began. You are eligible for Medicare 24 months after you start receiving SSDI.
SSI offers disability benefits to low-income individuals, regardless of work history. If you’re approved, you can receive benefits in the next month. Additionally, you may be eligible for back payments if you became disabled before your SSI was approved.
In most states, SSI eligibility qualifies you for Medicaid. In Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands, you have to apply for Medicaid separately from SSI, but the criteria are the same for both. Eligibility criteria for SSI recipients varies across states.
Almost every state provides an SSI supplement, with the exception of Arizona, Arkansas, Mississippi, North Dakota, Tennessee, and West Virginia. The eligibility rules for supplements vary by state.
There is an asset cap to receiving Supplemental Security Income: $2,000 in assets for individuals or $3,000 for couples. The Social Security Administration has a list of which assets (“resources”) are considered. Your primary residence, household belongings, and one personal vehicle are not counted among these assets.
It’s possible to get both SSDI and SSI if you have very limited funds and have a work history.
The SSA evaluates several factors when determining whether someone’s disability makes them eligible for benefits. Criteria for eligibility include the following:
In addition, you must be unable to perform any work you’ve done previously. A work history is not a prerequisite for receiving SSI. In short, you must be unable to engage in what the SSA calls “substantial gainful activity.” The Social Security Administration will consider your diagnosis, age, medical history, education, and work history, as well as any other marketable skills.
People with psoriatic arthritis face considerable paperwork when applying for disability benefits. The Social Security Administration offers a checklist of necessary application information. If you need assistance with your application, you might consider enlisting assistance from a trusted friend, relative, or a knowledgeable professional about the process.
“Contact the National Psoriasis Foundation and they will assist you in filing,” one MyPsoriasisTeam member recommended.
Below is a summary of what you’ll need to provide.
Members of MyPsoriasisTeam shared suggestions regarding gathering medical evidence. “Make sure your health providers are keeping good documentation of your treatment and how it affects you,” one member advised.
Another MyPsoriasisTeam member found that X-rays alone were insufficient to prove a disability: “The tests for rheumatoid arthritis don’t show much damage, so I’ve got to argue about their tests and misinterpreting the results.”
You can apply for SSDI online if you aren’t currently receiving benefits and if you haven’t been denied in the past 60 days. You may use this approach if you were born in the United States, have never been married, and are between 18 and 65. If you don’t meet any of those criteria, you can still apply at a local Social Security office or over the phone.
Processing an application for disability benefits usually takes three to five months. Getting approved can take even longer.
Most people are not approved the first time they apply, but MyPsoriasisTeam members recommend persistence. “When applying for disability, don't get too upset if you get denied the first few times. Most people I know had to apply three or even four times before getting approved,” one member shared.
Around 30 percent of those who applied for disability benefits between 2012 and 2021 were approved on their first attempt, according to the SSA. You can appeal the decision if your application is denied. The first step is reconsideration, when your case will be evaluated by someone who did not take part in the first evaluation. About 2 percent of applications that weren’t approved the first time were approved during reconsideration from 2012 through 2021, per the SSA.
If necessary, you have the option of filing a second appeal, which includes a hearing by an administrative law judge trained in disability laws. You may have a disability attorney represent you at this hearing. Some law firms specialize in disability hearings. In most cases, these disability lawyers do not require a set, upfront payment; rather, they will take a percentage of any benefits you do receive.
If you are denied at this level, you can ask the Appeals Council to review your case and make a decision on it. About 8 percent of SSDI claims between 2012 and 2021 were approved during a hearing with an administrative law judge or the Appeals Council, according to the SSA. If you are denied at this level, your last remaining option is a federal court hearing.
MyPsoriasisTeam is the social network for people with psoriasis, psoriatic arthritis, and their loved ones. More than 124,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.
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Very reasonable and professional. Well done
I have two thousand psoriatic arthritis patients in 35 years of specialistic practices, and two hundred on Otezla (Apremilast), of forty-three medical… read more
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