Disability Benefits

If you are a person who cannot work because of your arthritis or another rheumatic disease, you may qualify for help from the federal and state governments. Two programs run by the Social Security Administration (SSA) make monthly payments to people who are disabled and cannot work. These programs are called Social Security Disability Insurance (SSDI) and Supplemental Security Insurance (SSI).

What is a disability?

SSDI and SSI are different programs with different rules and regulations. They both use the same definition of disability. It is different from the definition used by other government programs because it focuses on long-term, or lasting, disability.

To qualify as having a disability for Social Security, you must have a physical or mental impairment that is expected to keep you from doing any substantial gainful activity (paid work) for at least a year, or to result in death. Disability decisions are made by a Social Security disability evaluation specialist and a consulting physician in your state. They will examine your medical records and work history to decide if your impairment is severe enough to prevent you from working. If additional medical information is needed, SSA may ask you to have a "consultative" medical exam by your own or another doctor. SSA will pay for the exam.

How do they decide if I have a disability?

SSA asks five questions to decide if you qualify as disabled. They are:

• Are you working?
• Is your condition severe?
• Is your condition found in the List of Disabling Impairments?
• Can you do the work you did previously?
• Can you do any other kind of work?

When a decision on your claim is reached, you will receive a written notice from SSA. The notice will tell you how much money you will receive each month or will explain why your claim is being turned down. If you are turned down by SSA for disability benefits, you have the right to appeal. Ask your physician to examine you and give his written opinion about whether you qualify as a person with a disability from a medical viewpoint. Studies show that SSA’s judgment of whether a person with arthritis is disabled is often different from the judgment of rheumatologists. Your doctor’s opinion is very important and may provide a basis for appeal if your claim is turned down.

SSA may review your case from time to time to check that you are still disabled. If they think medical improvement is possible, they will review your case after three years. If they don't expect improvement, your case will be reviewed after seven years. SSA may ask for an updated physician’s report to see if your condition has improved enough for you to return to work. If SSA finds that your condition has improved and you are no longer disabled, your SSDI or SSI benefits will stop, unless you are enrolled in a vocational rehabilitation program.