The question of whether degenerative arthritis qualifies as a disability is faced by millions whose daily lives are impacted by chronic joint pain. This condition, often referred to as osteoarthritis, is a progressive disorder that wears away the protective components of the joints, leading to stiffness, reduced mobility, and significant functional limitations. Because the disorder is chronic and tends to worsen over time, it can drastically affect a person’s ability to maintain employment. Qualification depends entirely on how severely the condition limits the person’s functional capacity to perform work tasks.
Understanding Degenerative Arthritis
Degenerative arthritis, or osteoarthritis, is the most prevalent form of arthritis, affecting the joints where two bones meet. The condition involves the gradual breakdown and loss of cartilage, which serves as a smooth, shock-absorbing cushion at the ends of the bones. As this protective layer erodes, the bones begin to rub directly against one another, causing pain, swelling, and a loss of motion.
This process leads to the development of bone spurs, also known as osteophytes, and can cause a grating sensation within the joint. The disorder most commonly affects weight-bearing joints like the knees, hips, and spine, but it is also frequently found in the small joints of the hands. Symptoms typically develop slowly, progressing from intermittent discomfort to continuous, debilitating pain that restricts movement and interferes with daily activities.
Defining Disability Under Federal Standards
A medical diagnosis alone is not sufficient to qualify for federal disability benefits; the condition must meet a strict legal definition. The federal government defines disability as the inability to engage in Substantial Gainful Activity (SGA) due to a medically determinable physical or mental impairment. This impairment must be expected to result in death or have lasted, or be expected to last, for a continuous period of at least 12 months.
The Social Security Administration (SSA) uses a five-step sequential evaluation process to determine eligibility. The first step checks if the applicant is currently earning income above the SGA threshold, a set monthly amount that changes annually. If the person is working above this threshold, the claim is denied immediately. The second step requires the condition to be medically severe, meaning it must significantly limit the ability to perform basic work activities such as sitting, standing, or lifting.
The third step determines if the impairment meets or equals one of the conditions listed in the SSA’s official Listing of Impairments, sometimes called the “Blue Book.” For degenerative arthritis, the condition must typically involve a major joint and result in an extreme limitation in the ability to walk or perform fine and gross movements. If the condition does not meet a listing, the evaluation proceeds to a comprehensive functional assessment to determine the applicant’s remaining capabilities. This shifts the focus from the diagnosis itself to the actual physical limitations caused by the arthritis.
Establishing Impairment: Medical Evidence and Severity
To prove that degenerative arthritis is severe enough to be considered a disability, the applicant must provide objective medical evidence. This evidence must demonstrate a medically determinable impairment, going far beyond a simple statement of pain. Required documentation includes imaging results, such as X-rays, MRI, or CT scans, which show structural abnormalities like joint space narrowing, bone spurs, or joint destruction.
Crucially, this objective evidence must correlate with documented functional limitations observed by a physician. The SSA requires a longitudinal medical record spanning an extended period to assess whether the severity of the symptoms is improving, worsening, or remaining unchanged despite treatment. The most important piece of evidence in an arthritis claim is the Residual Functional Capacity (RFC) assessment.
The RFC is a function-by-function evaluation detailing the maximum amount of work-related activity an applicant can perform on a sustained basis. For degenerative arthritis, this assessment quantifies limitations in physical abilities, such as how long a person can continuously sit, stand, or walk, and how much they can lift or carry. For upper extremity arthritis, the RFC details restrictions on fine motor skills, including handling, fingering, and gripping objects. The opinion of the treating physician, especially one specializing in orthopedic or rheumatologic care, is highly valued when supported by objective signs of joint damage and reduced range of motion.
Navigating the Application Process
Applicants can begin applying for disability benefits online, by telephone, or in person at a local field office. Once submitted, the application is forwarded to Disability Determination Services, a state agency where a claims examiner and a medical professional review the evidence against federal criteria. This initial review process typically takes several months, averaging between three and six months.
A high percentage of initial applications are denied, with historical denial rates often falling between 60 and 70 percent. If the claim is denied, the applicant has 60 days to file an appeal, which begins a multi-stage review process. The first appeal level is Reconsideration, followed by a Hearing before an Administrative Law Judge (ALJ), and then a review by the Appeals Council, if necessary.
Applicants must understand the distinction between the two primary federal programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is an insurance program based on the person’s work history and payment of Social Security taxes, requiring specific work credits to qualify. SSI is a needs-based program funded by general tax revenues, intended for people with limited income and resources, and does not require a qualifying work history. An individual may qualify for one or both programs, depending on their financial circumstances and work record.