Can I Get Social Security Disability Benefits for Arthritis or Joint Damage?

Residual Functional Capacity Assessment for Joint Dysfunction

What Is RFC?

If your joint problems are not severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process, the Social Security Administration will need to determine your residual functional capacity (RFC) to decide whether you are disabled at Step 4 and Step 5 of the Sequential Evaluation Process. RFC is a claimant’s ability to perform work-related activities. In other words, it is what you can still do despite your limitations. An RFC for physical impairments is expressed in terms of whether the Social Security Administration believes you can do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

Subjective Symptoms Must Be Credible

Individuals vary in symptomatology, and your subjective symptoms should be taken into account. But you must be credible. It is important that you do not lose your credibility by alleging symptoms that are so severe that they are not believable in light of the objective medical evidence. For example, if you have only a 10% loss of joint space and 10% loss in range of motion and your joint is not deformed and has no soft tissue damage, you will have difficulty convincing a medically knowledgeable Social Security Administration adjudicator that you have significant functional limitations.

Joint space narrowing of less than 20% or 30% similarly would not result in a finding of significant limitations unless you also have significant pain or other abnormalities. The same is true of less than 20% or 30% loss of joint motion with no other abnormalities other than minor X-ray changes.

Lower Extremity Joint Dysfunction

Arthritis of weight-bearing joints (ankles, knees, and hips) may produce limitations in walking, standing, climbing, kneeling, crawling, squatting, and in use of leg controls. All of these limitations may result in a lower RFC, but it is difficult to give specific examples based on lower extremity joint dysfunction because of the large number of pathological and functional conditions that are possible.

Medically Required Hand-Held Assistive Devices

To meet the listing you must need a hand-held assistive device for walking that requires both arms, such as a walker. But suppose you need a device that requires only one arm, like a cane?

To find that a hand-held assistive device is medically required, you need medical documentation establishing the need for a hand-held assistive device to aid in walking or standing, and describing the circumstances for which it is needed (i.e., whether all the time, periodically, or only in certain situations; distance and terrain; and any other relevant information). If you need a hand-held assistive device only for prolonged walking, walking on uneven terrain, or ascending or descending slopes, you will ordinarily be able to do sedentary work.

Since most unskilled sedentary work requires only occasional lifting and carrying of light objects such as ledgers and files and a maximum lifting capacity for only 10 pounds, if you use a medically required hand-held assistive device in one hand, you may still have the ability to perform the minimal lifting and carrying requirements of many sedentary unskilled occupations with the other hand. (Bilateral manual dexterity is needed when sitting but is not generally necessary when performing the standing and walking requirements of sedentary work.)

For example, if you must use a hand-held assistive device to aid in walking or standing because of an impairment that affects one lower extremity (e.g., an unstable knee), or to reduce pain when walking, and you are limited to sedentary work because of the impairment affecting the lower extremity, and you have no other functional limitations or restrictions, you may still have the ability to perform sedentary work that exists in significant numbers. On the other hand, if you must use a hand held assistive device for balance because of significant involvement of both lower extremities (e.g., because of a neurological impairment), your occupational base may be significantly eroded.

Knee Surgery for Osteoarthritis and Projected Ratings