Social Security Disability Benefits for Psoriatic Arthritis

Psoriatic arthritis is an inflammatory arthritis of multiple joints that occurs in patients who have psoriasis. Although figures vary, 15-36 % of patients who have psoriasis develop psoriatic arthritis. Approximately 2.4 million Americans have psoriatic arthritis. The psoriasis usually comes first (in 85%) and the arthritis follows, sometimes years later. 

In many patients, psoriatic arthritis may resemble rheumatoid arthritis. However, in other patients it looks different. For example, it can affect the lumbar spine and sacroiliac joints (which rheumatoid arthritis does not). Laboratory testing in people with psoriatic arthritis shows a 36% association with HLA-B27 antigen, which is a blood test for a “disease susceptibility” gene. Being positive does not necessarily mean you have psoriatic arthritis, but it increases your risk of developing it.  Another disease-susceptibility gene, HLA-C-06 correlates with psoriatic skin manifestations.
 
What Joints are Affected by Psoriatic Arthritis?

Psoriatic arthritis may affect most any joint(s) in the body.
 
The hands and feet are commonly affected in psoriatic arthritis, with pain and swelling of the digits and impaired ability to grasp objects, perform fine or gross movements, or perform repetitive activities. It is not unusual to develop considerable swelling of an entire finger or toe (called a “sausage” digit), which can impair function even further.
 
The hips, knees, shoulders, wrists, and other joints can be affected by psoriatic arthritis. Functional impairment from pain, stiffness, swelling, and deformities in these joints may cause difficulty with standing, walking, reaching above shoulder height, and lifting or carrying objects, at home or at work.
 
Enthesitisis a common occurrence in psoriatic arthritis. This is an inflammation of the entheses (the sites where tendons and ligaments insert into bone). Common areas affected by enthesitis include the bottoms of the feet (also called plantar fasciitis), Achilles' tendinitis, and inflammation occurring in tendons at the elbows, knees, ribs, spine and pelvis.
 
Spondylitis and sacroiliitisin psoriatic arthritis are areas of inflammation in the sacroiliac joints and the spine (like what occurs in ankylosing spondylitis). Inflammation in these areas can result in persistent back pain, stiffness, and impaired mobility. If severe or persistent, these symptoms can impair the ability to sit and perform even a “desk job.”
 
What Must Your Medical Records Have to Show to Get Disability Benefits?

Your medical records are the “heart and soul” of your disability case. A persuasive medical record must confirm that you have psoriatic arthritis. That's usually done by a rheumatologist, who performs laboratory testing (including an HLA-B27 antigen test) and radiographs (with or without MRI's) of the spine and affected joints.

Documenting your limitations:  How does your condition affect you? Be specific to articulate to your physician details of your physical limitations and how they impact you on a daily basis with regard to your daily living activities, your ability to stand/walk, lift/carry, and even sit for extended periods of time and need for breaks or rest from pain or fatigue. These are important factors and details regarding your functional capacity and important in evaluating whether you can perform your work or any work.