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Understanding Arthritis as a Long-Term Disability

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Did you know that muscle, back, and joint disorders count for more than one in four long-term disabilities?

The CDC reports that one in three people say arthritis alone affects their ability to do their job in some way. More than 50 million Americans have a doctor-diagnosed form of the condition, according to the Arthritis Foundation.

In certain circumstances, arthritis can prevent an individual from working for a substantial amount of time.

In these cases, one might consider filing a long-term disability insurance claim for their arthritis. Before doing so, it is important to understand how arthritis can result in a disability and consider tips for strengthening a claim for benefits.

What is arthritis?

Arthritis is commonly misclassified a single disease, but is actually an informal way of referring to joint pain and joint diseases.

Overall, there are approximately 100 forms of arthritis and joint conditions. There is no known cure for arthritis, which can occur in any age group, regardless of physical health.

There are two classifications of arthritis that are often connected to disability claims: osteoarthritis and inflammatory arthritis.

Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis - affecting approximately 27 million Americans - and is generally caused by wear and tear. It occurs when the cartilage of the joints wears away, causing bones to rub together and leading to pain, swelling and stiffness.

Common symptoms of osteoarthritis also include tenderness, loss of flexibility, abnormal sensations like grating of the joints, clicking and cracking, and bone spurs.

The pain, swelling and stiffness caused by OA can make it difficult to perform daily tasks at home and at work. For example, tasks like grasping a computer mouse, opening a box, driving a car or tucking in bed sheets can become nearly impossible.

The location of OA symptoms also have specific effects; when lower body joints are affected, activities like walking, lifting objects and climbing stairs become difficult. When finger and hand joints are affected, the acts of grasping and holding objects or completing delicate tasks become challenging and painful.

Rheumatoid arthritis

The most common form of inflammatory arthritis is rheumatoid arthritis (RA), which is estimated to affect nearly 2.1 million people in the United States. RA is considered an autoimmune condition that can affect men, women and children alike.

This chronic inflammatory condition occurs when your immune system attacks the lining of the membranes that surround your joints. This causes painful swelling that in turn can eventually lead to bone erosion and joint deformity.

RA most often affects the small joints in your wrists, hands, ankles and feet. As it progresses, the disease can spread to your neck, shoulders, jaw, elbows, knees and hips.

It is also considered a symmetrical disease, meaning that matching joints on each side of the body will show symptoms. This makes RA unique from other forms of arthritis.

Common symptoms include joint pain, joint swelling, tenderness, stiffness, fever, and weight loss. RA can also can rheumatoid nodules, which are firm, painful bumps of tissue under the skin.

While the location and severity of symptoms can vary widely from case to case, pain from RA is often continuous and progressive.

The joint damage caused by RA can be debilitating and disfiguring, making it difficult or even impossible to complete daily life tasks and occupational duties.

When is arthritis considered a disability?

The Arthritis Foundation reports that arthritis is the No. 1 cause of disability in the United States. People with arthritis or a rheumatoid condition also lose more workdays every year due to illness or injury than adults who have any other medical condition.

However, not everyone with arthritis is or will become disabled. How do you know if your arthritis is considered a disability?

The Social Security Administration (SSA) considers arthritis a disability when it is expected to last at least 12 months and is a "severe" impairment, which is one that significantly affects your ability to perform work-related activities.

The SSA then determines whether your arthritis meets one of the conditions established in its Listing of Impairments. Learn more from NOLO about how the SSA determines if you qualify for SSDI benefits for arthritis.

When seeking benefits through a group and individual long-term disability insurance policy, it is essential to understand how your policy defines a disability.

Once you understand how your insurance policy defines a disability, you can determine how your arthritis symptoms measure up and how to proceed with your claim for benefits.

Do they make you totally disabled, rendering you unable to work at all? Are you partially disabled, meaning that you can perform some of your job functions, but not all?

Additional examples of disabling arthritis symptoms

  • Inability to walk due to ongoing inflammation or deformity in weight-bearing joints
  • Inability to perform large and small movements due to ongoing inflammation in major peripheral joints in the arm
  • Systemic symptoms like fatigue, fever or weight loss
  • Severe impact of activities of daily living, social functioning, or cognitive functioning due to ongoing or recurrent symptoms

It is also important to note that you may experience disabling side effects of the medication you take to treat your arthritis.

Medications for arthritic joint pain often include acetaminophen combined with some form of opioid narcotic. These drugs have well-known side effects that may interfere with your ability to perform your occupational duties, such as drowsiness, fatigue, particularly if they require high mental concentration or physical acuity.

Tips to consider before filing a claim

Be aware of the own vs. any occupation distinction.

Pay attention to the language surrounding "own occupation" vs "any occupation coverage." Some policies may only provide benefits under the "own occupation" clause for up to 24 months, after which the "any occupation" clause kicks in.

This language states that although you cannot perform the specific duties of your profession, your disability does not prevent you from working in another occupation "for which you are reasonably suited by education, training or work experience."

This misleading language adds insult to injury by denying you further payment of benefits and forcing you to seek other employment that should be unimpeded by your arthritis, often for lesser pay.

Seek physician support and strong medical evidence.

If your arthritis prevents you from working, it is imperative to bolster your claim for benefits this through objective medical evidence and statements of support from your treating physician.

Examples of objective medical evidence for an arthritis claim include:

  • Imaging results like CAT scans, MRIs, x-rays or PET scans
  • Mobility evaluations that state specific functional limitations
  • Blood work that documents markers for types of autoimmune or inflammatory arthritis

Furthermore, any arthritis-related sleep disturbances, depression, thinking, or concentration issues should be documented, as they can also explain why you may be unable to work.

Do you have disability claim questions?

If you have filed or are preparing to file a long-term disability insurance claim, or believe your benefits have been wrongfully denied, contact our top-rated long-term disability insurance attorneys for a free consultation.

There is no risk involved in contacting DarrasLaw; if you have individual or long-term disability insurance questions, our legal team is here to help.

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