Facts about Ankylosing Spondylitis and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1) Ankylosing spondylitis (AS) is an autoimmune disease that primarily affects the spine and the joint between the ilium of the pelvis and the sacrum, otherwise known as the sacroilium. AS is a chronic disease and can result in fusion of the spine.
2) Symptoms for AS come in stages. It can begin with stiffness in the hip area and lower back, and chronic pain the hips and lower back. Pain is usually worse in the mornings or after a period of rest and non-movement. As the condition progresses the pain usually gets worse and may progress to other parts of the body. Advanced stages may include fatigue, nausea, chest tightness, anemia, eye inflammation, weight loss, and inflamed bowels.
3) Young men aged 18-30 years old are affected by the disease three times more often than women, although anyone of any age may find themselves with AS.
4) Activities such as swimming, Pilates, yoga, stretching, tai chi, and even jogging, have been used to help lessen stiffness and pain from AS, although these activities should be approved by a rheumatologist since they could be damaging if not used correctly and at the appropriate times.
5) Researchers believe that genetic factors may take part in the cause of AS, and have found that nearly 90 percent of AS patients are HLA-B27 (Human Leukocyte Antigen B*27 ) positive. On the flipside, only a small portion of those with HLA-B27 develop AS, so this connection is still a mystery.
6) The most common risk of AS is that inflammation will direct the body to heal itself by growing new bone in between the vertebrae, causing fusion, ridgidity, and the potential to stiffen the rib cage, causing limited lung function and also affecting the heart. This can cause difficulty breathing and heart problems such as aortitis.
7) Physical therapy and exercise are very helpful in the treatment of AS, as are medications to reduce inflammation and pain associated with symptoms. Surgery may be used in extreme cases, to replace joints or correct deformities from curvatures, although administering anesthesia may be challenging due to AS side effects such as breathing and pulmonary issues.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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