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Disability Benefits for Psoriatic Arthritis: Your Guide

Updated on March 17, 2021
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Annie Keller

  • Different types of disability benefits are available for people with psoriatic arthritis who qualify.
  • Applications for disability depend on your inability to work.
  • You may appeal if you are denied disability benefits.

Joint pain, chronic pain, stiffness, and other symptoms of psoriatic arthritis 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.”

Learning about disability benefits in advance can make applying easier, including what the U.S. Social Security Administration (SSA) considers in determining eligibility for disability and what information you’ll need to provide.

Disability Benefit Programs in the United States

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 are approved, you can receive benefits in the next month. Additionally, you may be eligible for back payments of SSI 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, Mississippi, North Dakota, 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.

Defining Disability

The SSA evaluates several factors when determining whether someone’s disability makes them eligible for benefits. Criteria for eligibility include the following:

  • You are likely ineligible for monthly benefits if you earn $1,260 or more a month. If you earn less than that amount, you may still be eligible for a reduced amount.
  • You must be incapable of performing basic tasks required for most jobs, including standing for extended periods, walking, lifting, sitting, and remembering. You must not have been able to perform these tasks for at least 12 months.
  • You must have a recognized disability. The Social Security Administration provides a Listing of Impairments that prevent working. Although psoriasis is listed under Skin Disorders, psoriatic arthritis is listed only by its effects under Immune System Disorders, along with several other forms of inflammatory arthritis.
  • You must be unable to perform any work you’ve done previously. A work history is not a prerequisite for receiving SSI.
  • 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.

Applying for SSDI and SSI

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.

Information About Yourself and Your Family

  • Your full legal name, date of birth, and Social Security number
  • Full names and dates of birth of your current or previous spouses, and dates of marriage, divorce, or death
  • Full names and dates of birth of your children
  • Bank account information

Medical Evidence About Your Psoriatic Arthritis

  • The name and contact information for your dermatologist, rheumatologist, and other medical providers who can discuss your condition
  • A complete list of medications, both past and present, as well as results for medical tests — such as X-rays that can show joint damage, dysfunction of a joint or lower back, and affected joints
  • A description of how psoriatic arthritis impacts your ability to do activities like shopping, cooking, cleaning, and other tasks of daily living

Members of the 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 don’t show much … so I’ve got to argue about their tests and misinterpreting the results.”

Total Employment History

  • Earnings from the past year
  • Any current employers or ones you have worked for in the past two years
  • A complete work history from the past 15 years, including any jobs from before you became disabled
  • Whether you are getting or intend to receive workers’ compensation
  • Military service

Documents

  • Birth certificate
  • Social Security card
  • Proof of citizenship
  • W-2 or other tax forms from the previous year
  • Any medical records about your condition
  • Proof of any workers’ compensation you have received

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.

Appealing a Disability Application Rejection

Processing an application for disability benefits takes an average of three to five months. It can take even longer to get approved.

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.

Only 21 percent of those who applied for disability benefits between 2009 and 2018 were approved on their first attempt. 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 2009 through 2018.

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 2009 and 2018 were approved during a hearing with an administrative law judge or the Appeals Council. If you are denied at this level, your last remaining option is a federal court hearing.

Get the Support You Need

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. More than 88,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you applied for Social Security disability benefits for psoriatic arthritis? Do you have any advice about the process? Comment below or start a conversation on MyPsoriasisTeam.

References

  1. Disability Benefits — Social Security Administration
  2. Supplemental Security Income (SSI) — Social Security Administration
  3. Understanding SSI — SSI Eligibility — Social Security Administration
  4. How You Qualify | Disability Benefits — Social Security Administration
  5. Part III — Listing of Impairments — Social Security Administration
  6. Disability Evaluation Under Social Security: 1.00 Musculoskeletal System — Adult — Adult — Social Security Administration
  7. Adult Disability Starter Kit — Social Security Administration
  8. Who is eligible for Supplemental Security Income (SSI)? — AARP
  9. SSI VS SSDI: What They Are & How They Differ — Benefits Access Blog — National Council On Aging
  10. Annual Statistical Report on the Social Security Disability Insurance Program, 2019 — Outcomes of Applications for Disability Benefits — Social Security Administration
  11. Federal Court Review Process — Social Security Administration
  12. Appeals Council Review Process in OARO — Social Security Administration
  13. Social Security Administration's Hearing Process, OHO — Social Security Administration
  14. Patient Navigation Center — National Psoriasis Foundation
Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Annie Keller specializes in writing about medicine, medical devices, and biotech. Learn more about her here.

A MyPsoriasisTeam Member said:

That's a good question I would like to know the answer to as well.

posted 15 days ago

hug

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