Is Psoriatic Arthritis a Disability? A Guide to PsA Benefits

If you have psoriatic arthritis, you may be eligible for benefits or other financial help. The critical question when you’re qualifying is whether your condition prevents you from working.

Applying for disability benefits may be the last thing on your mind when you’re trying to manage psoriatic arthritis (PsA).

But if your condition is affecting your ability to work — due to physical pain or mental health issues — then you may qualify, and they’re worth applying for.

However, applying for disability benefits is a long-term process, so expect to wait a while before they kick in. It’s normal to have to apply more than once before you’re approved.

Here are the basics you need to know about applying for disability insurance when you have PsA.

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Is psoriatic arthritis considered a disability?

Yes, PsA is considered a disability if it prevents you from being able to work.

That can happen with PsA. One study from 2016 found that around a third of people diagnosed with PsA said they had to miss work in the previous year due to their symptoms.

When they’re processing your application, the Social Security Administration (SSA) will want to know specifics about how PsA affects you.

They’ll look into the severity of your PsA, including how many joints it affects and how it negatively affects your ability to function in different areas of your life, according to one law firm that specializes in disability benefits.

Government disability programs

If you have PsA, you may qualify for Social Security disability insurance.

The two long-term disability benefit programs available through the SSA are:

Social Security Disability Insurance (SSDI)

This program will replace a portion of the wages you lost as a result of your condition for as long as you have it.

The amount you receive monthly depends on your Social Security earnings.

Supplemental Security Income (SSI)

This smaller emergency program provides cash to people with low or no income to help meet their basic needs.

It’s meant to supplement subsidized housing, food stamps, or other types of government assistance.

You can receive up to $841 every month from the federal government plus a supplemental amount some states may offer if you meet certain qualifications.

How to know if you qualify for benefits

When you apply for SSI or SSDI, you’ll need to meet these criteria.

• You have a PsA diagnosis from your doctor. When the SSA is assessing your application, they’ll need to see that your condition is impairing your ability to work.
• For SSDI: You may need to show you’re not currently able to work full time.
• For SSDI: If you’re older than 31 you’ll need to show you’ve worked at least 5 out of the last 10 years.
• If you’re under 50: You’ll need to show it hasn’t been possible for you to get or do any job available to you.
• If you’re over 50, the rules are a little less strict. You’ll need to show you can’t do a job like the main one you’ve been doing for the past 15 years.

To qualify for SSDI, you have to have paid Federal Insurance Contributions Act (FICA) taxes and your disability needs to meet Social Security criteria.

To receive SSI, on the other hand, you don’t have to have paid FICA taxes.

How to file for disability programs

The first step is finding out more information and filing your application for SSDI or SSI. You can do that online, by calling 800-772-1213, or by visiting your local SSA office.

Keep in mind that applying online may be the fastest way to apply since SSA offices and the SSA phone line often have long wait times.

If you’re wondering whether SSI or SSDI is a better fit for you, this government questionnaire may help you decide.

It’s also possible to qualify for both.

During your initial application, you’ll need to fill out forms stating information about your disability, employment and work history, and other personal information.

The SSA has put together a checklist you can follow to make sure you provide all the required information.

You’ll also need to provide the names and contact information of the healthcare professionals who manage your PsA — since the SSA will call them to confirm your condition prevents you from working.

The more you prepare your healthcare professionals to support your application the better. Make sure they can make a clear case for how your PsA prevents you from working.

For example, the Arthritis Foundation recommends having your doctor take color photos that show swollen joints.

It can take 3–6 months for you to receive an initial decision from the SSA. You should receive it in the mail.

If your application doesn’t get accepted

If you receive a rejection letter, keep trying.

Less than half the people who apply for disability benefits get them every year. You’ll increase your chances if you appeal the decision one or more times, recommends the Arthritis Foundation.

The appeal process is called “reconsideration” and requires you to be examined by an SSA-approved doctor who will assess your condition.

You can also hire an advocate or attorney to represent you. Some people do this after they’ve been rejected once or twice already, especially since the reconsideration process is complicated.

This professional representative may not charge you up-front but may take a cut of your first benefits payment.

The application and reapplication process can take as long as 1.5 years, but if you receive benefits, you may receive up to a full year of retroactive coverage.

Other disability programs

Private insurance companies also offer disability benefit policies — long-term and short-term.

You may have access to disability benefits through your employer’s private group insurance plan.

40% of workers in the United States. can get short-term disability insurance through their employer. This is meant to cover the gap between the onset of your health condition and when you start getting paid Social Security, according to the National Bureau of Economic Research.

However, disability insurance you can get through your employer will end if you quit, lose, or change your job.

In contrast, you can purchase an individual disability insurance plan privately. Individual plans typically have higher monthly premiums, but they also tend to offer better benefits.

The problem with many individual disability insurance plans is that they may limit your coverage for a pre-existing condition, which may affect the disability benefits you can get for PsA.

Making a disability insurance claim requires you to prove that your condition meets the definition of a disability as written in your policy. The more specific this definition is, the easier it is to prove your disability and receive benefits.

So, if you’re choosing insurance, aim for a policy that defines “disability” very specifically, the financial website Investopedia recommends.

And it’s a good idea to look into that definition in detail. A plan that defines a disability as limiting your ability to do “your occupation” may be better than a plan that defines a disability as limiting your ability to do “any occupation.”

With the latter, you may not be approved for benefits unless you can prove that PsA prevents you from working at any occupation at all.

Takeaway

Applying for disability benefits may seem like a hassle when you’re already managing life with PsA, but the significant support you can receive may be worth the effort.

If you receive a rejection after your initial application with SSA, try again. Jump through the necessary hoops, and hire an advocate or lawyer if you need to and you’ll increase your chances of receiving benefits.