Psoriatic Arthritis & Disability: Your Questions, Answeredby Amy Marturana Winderl Health Writer
Let’s go with the good news first: If you’re dealing with psoriatic arthritis (PsA), proper treatment can often minimize symptoms to a totally manageable status. Now the bad news: For some people, the disease comes with long-term health complications that wreak havoc on your usual routine. In PsA—a condition that combines the swollen, sore joints of arthritis with the painful skin lesions of psoriasis—the inflammation and joint damage can be so severe that it becomes too difficult to work. If that’s the spot you’re in, it's time to consider disability benefits.
How Do I Know If It's Time to Apply?
Applying for disability can be a confusing process. There are a number of criteria you have to meet to be considered disabled by the Social Security Administration, so it’s not as simple as filling out a form. That said, “our patients grow old with us; they have this condition for life, so we do see patients who eventually can’t work anymore,” says Laura Manning, R.N., a nurse coordinator at Johns Hopkins Arthritis Center. Read on for answers to your questions about disability benefits.
What Rights Do I Have at Work?
The Americans With Disabilities Act (ADA) requires companies with 15 or more employees to provide reasonable accommodations to those with disabilities. (Typically, your employer may request medical documentation that confirms you are qualified for these accommodations.) However, the guidelines are pretty general and a lot of specifics can be subjective, so if you’re not sure what should be made available to you, ask your local ADA center for more info. (Find your local center here.)
Can I Get a Standing Desk?
Standing desks can make working easier for some people with PsA. Talk with your HR department and manager to explain what would help you the most, says Patricia Findley, Dr.PH, associate professor of social work and director of the MSW program at Rutger’s University. Everyone’s needs differ: Maybe you'd benefit from a flexible schedule so that you can work from home on bad days and come in on good ones. Adjusted working hours, so you can deal with morning stiffness and arrive a bit later, could also help you.
What's Short-Term Disability?
Short-term disability typically allows you to take three to six months off and receive between 40 to 70% of your base salary, depending on your plan. Short-term disability could be helpful during periods when you’re trying new medications to get your PsA under control. To use this benefit, talk with your HR department and find out what they need to start your period of short-term disability plus how much time you can take. “It’s different from employer to employer and state to state,” Manning says.
What Disability Programs Does the Government Offer?
The two types of disability programs the government offers are Social Security Disability Insurance and Supplemental Security Income (SSI), both run by the Social Security Administration (SSA). These programs are meant to provide income to people who are unable to work because of a disability. The medical requirements and process are the same for both programs, so they’re typically referred to collectively as “disability.” For the rest of this slideshow, when we talk about disability, we’re talking about these government programs.
Do I Qualify for Disability Benefits?
The SSA’s definition of disability includes no longer being able to do work that you did before, not being able to adjust to other work, and having a disability that’s lasted or is expected to last at least one year. The agency also maintains a list of medical conditions that are considered severe and disabling. Both psoriasis and inflammatory arthritis are on the list. If you're not sure whether you meet the criteria, head over to the SSA website or your local SSA office for help answering your questions.
What’s the Application Process Like?
Wait, I have to apply? It’s true. Just because your psoriatic arthritis is turning your life into a living hell doesn't automatically guarantee you'll be covered for disability. First, you have to demonstrate you need it. That can be tough in cases of chronic illness, but don't give up. “Perseverance is key,” says Findley. Denials are common and many people will have to apply multiple times, so if you're turned down the first time, keep at it.
What Info Will I Need to Provide?
On top of asking for medical records and potentially requiring you to undergo an independent health evaluation, the SSA will also want to know about your work history. You need to have worked long enough and recently enough under SSA law to qualify for benefits. Your level of education and ability to perform certain tasks will also be taken into account—basically, says Findley, they want to assess what you’re capable of and see if you have skills not affected by your physical symptoms that you could use in a different job.
Should I Hire an Attorney?
You shouldn’t need to hire someone to apply for disability, says Manning, but if you can afford one, a lawyer or certified disability advocate might be able to help you get through the process faster and ensure that you have all the right documentation prepared. And there are a few instances when you’ll probably want an attorney’s help, like if your employer is unwilling to work with you and provide reasonable accommodations, and/or if your disability claim is denied.
How Can My Doctor Help?
“Your healthcare practitioner is key in this process,” says Findley. You’ll need your doctor's signature to request reasonable accommodations at work and to potentially provide medical evaluations as part of your disability application. “There is a lot of criteria to meet, so make sure you speak openly to your doctor about how your condition is affecting your ability to do your job, live your life, and go about the activities of daily living,” Manning says. “We have a section specifically for this in our charts.”
Will I Always Be Unable to Work?
Not necessarily. In fact, the early days after diagnosis can be some of the worst, because treatment hasn’t started to kick in. “Very often when patients first come in, they are in a high state of disease activity because they’ve been living like this for so long,” says Manning. “They’re swollen and can’t do much.” Ideally, proper treatment will reduce swelling and restore joint function. If you do have permanent joint damage, it can be harder to return to your previous routine, says Manning, but it varies from person to person.
How Can I Find Support?
Asking for help isn’t easy, especially if you’ve always been an independent person. That’s where a social worker can really help. “Most insurance companies will pay for it and most hospitals have social workers,” says Findley. “It’s good to connect with someone who understands chronic conditions.” And don’t underestimate the power of support groups. “Talking to someone with a similar condition means you can share resources,” Findley says. Check if your local hospital posts support group information. You can also find online support groups on social media platforms like Facebook.