Ankylosing spondylitis (AS) can qualify as a disability under Social Security, VA benefits, and the Americans with Disabilities Act, but it doesn’t automatically count as one. Whether you’re approved depends on how severely the condition limits your movement and daily functioning, not simply on having the diagnosis. About 40% of people with AS eventually develop complete spinal fusion, and the disease is associated with reduced work productivity and impaired physical function, so many people with AS do meet disability thresholds.
How the ADA Defines Disability for AS
The ADA doesn’t maintain a list of conditions that automatically qualify as disabilities. Instead, it defines disability as any physical or mental impairment that substantially limits one or more “major life activities.” For AS, those activities include walking, bending, standing, sleeping, and working. If your symptoms meet that standard, you’re protected under federal law regardless of whether your spine looks severely damaged on imaging.
This means your employer is legally required to provide reasonable accommodations if you need them. The practical significance: you don’t need to be “disabled enough” for Social Security to still have legal protections at work.
Workplace Accommodations You Can Request
The Job Accommodation Network, a resource funded by the U.S. Department of Labor, outlines a wide range of accommodations for inflammatory arthritis conditions like AS. Not every person with AS needs accommodations, and the degree of limitation varies widely. But if you do, these are some options your employer must consider:
- Flexible positioning: A sit/stand workstation, an ergonomic adjustable chair, or the ability to alternate between sitting and standing throughout the day.
- Modified breaks: Periodic rest breaks to stretch, walk, or change positions. Break reminder software can help structure these.
- Reduced physical demands: Restructuring your role to limit lifting, reaching, pushing, or pulling. Separating heavy items into smaller loads or reassigning lifting duties if they’re not central to your job.
- Remote work: Working from home, where you can freely shift between lying down, sitting, and standing.
- Stress management: Access to a private workspace, reduced distractions, or adjusted supervisory methods to lower stress triggers that can worsen flares.
- Assistive technology: Voice-to-text software, grip aids, or dictation tools if hand or wrist involvement makes typing or writing difficult.
Qualifying for Social Security Disability
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) use a stricter standard than the ADA. You need to show that your condition prevents you from performing substantial gainful activity and is expected to last at least 12 months. AS falls under the Social Security Administration’s listing for inflammatory arthritis, but approval isn’t easy. Only 21% of all disability applicants between 2010 and 2019 were approved on their first attempt. About half of those who appeal a denial at the reconsideration stage are denied again.
To strengthen an application, you’ll need thorough medical documentation: imaging showing structural damage, records of your range of motion over time, treatment history, and evidence of how your symptoms affect daily activities. The SSA looks at whether your condition limits your ability to work any job, not just your current one, which is a high bar.
If your initial application is denied, the appeals process matters. Many people with AS are eventually approved at a hearing before an administrative law judge, where you can present your case in person and bring testimony from your rheumatologist. The process can take a year or more, so filing early and keeping detailed records is worth the effort.
VA Disability Ratings for AS
Veterans with ankylosing spondylitis are rated under the VA’s general rating formula for diseases and injuries of the spine. The percentage you receive directly determines your monthly compensation and depends on how much spinal mobility you’ve lost.
- 10%: Forward flexion of the lower spine between 61 and 85 degrees, or muscle spasm and tenderness that doesn’t cause an abnormal gait.
- 20%: Forward flexion between 31 and 60 degrees, or muscle spasm severe enough to cause abnormal posture such as reversed curvature of the spine.
- 40%: Forward flexion of 30 degrees or less, or favorable ankylosis (fusion in a functional position) of the entire lower spine.
- 50%: Unfavorable ankylosis (fusion in a non-functional position) of the entire lower spine.
- 100%: Unfavorable ankylosis of the entire spine.
Cervical spine involvement is rated separately and can add to your overall combined rating. If AS affects your neck with forward flexion of 15 degrees or less, or causes fusion of the entire cervical spine, that qualifies for a 30% or higher rating on its own. The VA also considers flare-ups, pain during motion, and how symptoms affect your ability to work when assigning a final rating.
How AS Progresses Over Time
AS tends to worsen gradually, which means your disability status may change as the disease advances. Spinal new bone formation is typically slow, often taking several decades to progress to complete fusion. But roughly 40% of patients do eventually reach complete spinal fusion, sometimes called “bamboo spine,” where the vertebrae lock together and the spine loses nearly all flexibility.
Biologic medications, including TNF inhibitors and IL-17 inhibitors, can significantly improve quality of life and work productivity. A large study from the British Society for Rheumatology found that patients on biologic therapy experienced greater improvement in most work-related outcomes compared to those on conventional treatment. However, the same study found no significant improvement in actual days missed from work, and the proportion of patients leaving employment was similar in both groups (about 5% in the biologic group versus 4% in the non-biologic group over 12 months). Biologics help many people stay functional, but they don’t eliminate the possibility of progressing to disability.
If your condition worsens after an initial denial or a low VA rating, you can reapply or request a reevaluation. Keeping a long-term record of your declining range of motion and increasing limitations makes these updates much smoother.