Psoriatic arthritis is a long-term inflammatory condition that can lead to limited mobility, pain, and illness. A person may apply for disability benefits from the federal government.
Psoriatic arthritis (PsA) may severely affect a person’s joints. Coexisting conditions, such as diseases of the heart and blood vessels, can also contribute to the disabling effects of PsA.
Keep reading to learn about the qualifying criteria for disability benefits and how to apply.
The condition may be disabling due to limited mobility, as well as pain and illness. In some cases, a person may not be able to work, and may want to apply for federal disability benefits.
The Social Security Administration (SSA) makes the decision to approve or disallow an application for disability benefits.
The decision is based on things such as whether or not a person’s condition limits their ability to do substantial work. It also depends on if doctors expect the individual’s condition to last at least a year or to have a high probability of resulting in the person’s death.
A 2019 study notes that people with PsA may have physical and psychosocial effects that impact their jobs. This results in high rates of unemployment and absenteeism. It also leads to reduced work productivity.
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The SSA has two programs that provide financial assistance to people with disabilities.
The Social Security Disability Insurance program pays benefits to a person with a disability, and to some family members. To apply, an individual must have a certain amount of Social Security taxes on their income that they have paid.
The Supplemental Security Income program provides money for food, clothing, and shelter.
A person with PsA may apply for benefits if they meet the SSA conditions for people with inflammatory arthritis or musculoskeletal disorders.
The SSA divides up inflammatory arthritis conditions into four categories, as detailed below. An individual who meets the criteria in any category may qualify for disability benefits.
The criteria for this category includes evidence that a person has persistent inflammation or deformity in at least one major joint in a leg or foot.
They must also have medical documentation of either the need for an assistive device for walking, such as a walker, or an inability to independently use an arm and hand. In addition, they have at least one major joint affected in each upper extremity.
To be eligible under this category, a person must have inflammation and deformity in at least one major joint of an upper or lower extremity.
They must also have either involvement of at least two organs or organ systems, or have at least two systemic symptoms, such as tiredness and involuntary weight loss.
Category C includes a person with any type of spondyloarthritis, which is inflammation of the spine.
Symptoms include fusion of part of the spine in a minimum of a 45-degree angle of flexion from the upright position, or fixation of part of the spine in 30–45 degrees of flexion and involvement of at least two organs or organ systems.
For an individual to qualify under this category, they must have a minimum of two systemic symptoms, such as severe tiredness and involuntary weight loss. In addition, they must have a marked level of any of the following:
- limitations in maintaining social functioning
- limitations in performing activities of daily living, such as dressing and bathing
- limitations in finishing tasks in a timely manner due to problems with concentration, pace, or persistence
Sometimes a person with PsA can qualify for disability under the criteria for musculoskeletal disorders. The SSA divides up these disorders into categories based on several factors such as:
- involvement of systems beyond joints and bones, including nerve tissue
- surgery on a weight-bearing joint
- abnormality of a major joint in an arm or leg
A person may file a claim online if they meet the following eligibility requirements:
- They are at least 18 years old.
- They are not currently receiving any Social Security benefits.
- They are not able to work due to a health condition that is expected to last at least a year.
- They have not filed an application for disability benefits that has been denied within the past 60 days.
Before applying, someone will need to have the following information on hand:
- Social Security number (SSN)
- date and place of birth
- SSN and birth information for spouse
- birth dates and names of minor children
- bank routing number and account number
- name, phone number, and address of someone familiar with the applicant’s medical condition
- detailed information about conditions and injuries, including medications, medical tests, and dates of treatment
- income earned last year and this year
- employer’s name and address
- copy of Social Security statement
- dates of military service
- list and dates of employment within 15 years prior to disability
- information about application for workers compensation and other benefits
In addition to the above information, a person needs to have other documents, including
- birth certificate
- W-2 forms or self-employment tax return for previous year
- medical records, test results, and doctor reports
After a person completes an application, it can take from 3-5 months to get a decision from SSA. The wait time depends on the amount of time it takes for the agency to get whatever evidence it needs to make a decision.
Some private insurance companies offer health and disability insurance, as described below.
Private health insurance
This means an insurance company cannot drop or deny coverage of medical expenses for a person with psoriatic arthritis. It also assures coverage of essential benefits, including prescription medication, medical management, and surgery.
A person can apply for this type of health insurance online.
Private disability insurance
Some employers provide short-term disability insurance that pays benefits for 2 -24 months, or long-term disability insurance that may pay benefits for several years or until the disability ends.
People with PsA may be eligible to receive financial benefits from the federal government, such as Social Security Disability Insurance or Supplemental Security Income.
To apply, a person needs all the required information and documents that pertain to their health and employment. After the application is submitted, a decision from the SSA may take up to 3-5 months.
Some private insurance companies may offer disability coverage.