Applying for Ankylosing Spondylitis Disability Benefits

Ankylosing spondylitis (AS) is a chronic disease that can affect your quality of life. While treatments can reduce symptoms and slow the progression of this illness, some people find it hard to hold a job with this disease.

If your disease symptoms prevent you from working in the United States, you may be able to get aid from the Social Security Administration (SSA). While getting this aid can take time and patience, it can result in getting the money you need to survive.

If you qualify, Social Security funds can replace some of your lost income and free you from the stress of work if you have advanced symptoms.

This article describes who qualifies for this type of aid, the process involved, and what to expect at each stage of your request.

Who Qualifies for Ankylosing Spondylitis Disability

Most people who have ankylosing spondylitis live productive lives and continue to work. Strategies that include new treatments, remote work, and onsite accommodations can make it possible for you to continue to remain productive. It's not inevitable that you will be unable to work because of ankylosing spondylitis.

Generally, people who qualify for disability for ankylosing spondylitis must meet the SSA's criteria for disability. This includes the following requirements:

You must have worked in jobs covered by Social Security.

Almost every American worker, including those who are self-employed, must pay Social Security taxes. You can't collect Social Security benefits if you don't pay into the system.

You must have worked long enough and recently enough to earn credits that qualify you to receive Social Security benefits.

You earn Social Security work credits based on your yearly income. The amount of income required to earn a work credit varies annually. In 2023, each $1,640 in income qualified for one credit.

The number of credits required to qualify for disability depends on your age and the onset of your disability. Most people need 40 credits, with 20 earned in the last 10 years ending with the year your disability began.

You must have a medical condition that meets the strict definition of disability detailed in the Social Security Act.

The Social Security Act defines disability as a total disability. This means that you have a condition that prevents you from doing work you did previously or doing any other type of work.

Generally, you cannot perform basic, work-related activities like remembering, walking, standing, or sitting. This condition must have lasted or is expected to last at least one year or to result in death.

You must be unable to do work and engage in substantial gainful activity because of your condition.

If you are earning more than a set amount of money, you are considered to be engaging in substantial gainful activity. For 2023, this monthly threshold amount is $1,470 for non-blind people and $2,460 for people who are what the SSA considers blind.

Earning over these amounts every month disqualifies you from receiving disability benefits. This amount is adjusted annually.

You must have an impairment included in the SSA's list of medical conditions considered severe enough to prevent you from doing substantial gainful activity.

The SSA Blue Book, formally titled "Disability Evaluation Under Social Security," lists the conditions the SSA considers severe enough to interfere with working. Ankylosing spondylitis is listed in the SSA's list of medical conditions. It is included in Section 14.00, "Immune System Disorders—Adult."

Depending on your exact diagnosis, you may qualify for benefits by checking what spinal disorders qualify for disability. These conditions are included in section 1.00, "Musculoskeletal Disorders." This list includes the following conditions, as well as many others:

• Spinal osteoarthritis (spondylosis)
• Vertebral slippage (spondylolisthesis)
• Degenerative disc disease
• Facet arthritis
• Vertebral fracture or dislocation
  

When to Stop Working

The timing for when to stop working is different for everyone because ankylosing spondylitis affects people differently. However, the nature of this disease can impact your ability to maintain a job. Research indicates having ankylosing spondylitis affects sick leave usage, absenteeism, and work productivity.

Having the following symptoms and comorbidities can interfere with your ability to work and remain productive:

• Uveitis (inflammation of the eye wall)
• Inflammatory bowel disease (IBD)
• Psoriasis
• Osteoporotic fractures (broken bones due to bone thinning)
• Spinal inflammation
• Vertebral fusions
  

Ankylosing spondylitis symptoms in females can differ from symptoms in males. Females are more likely to have more pain at night and increased fatigue and stiffness. Females also experience enthesitis, an inflammation of the area where ligaments and tendons attach to bones).

(When research or health authorities are cited, the terms for sex and gender from the sources are used.)

Factors such as the type of work you do and the status of your disease can determine whether you are able to continue working. Depending on your specific work responsibilities, your employer may be able to provide accommodations to help you work within your physical limitations for many years after a diagnosis.

Ankylosing spondylitis is not considered a fatal illness or one that significantly affects the life span of most people.

Documentation to Gather

Before you apply for SSA disability benefits, you will have to gather specific documents to prove your eligibility. You will need the original copy of most documents like your birth certificate, though copies of your W-2 forms, self-employment tax returns, and medical documents are usually accepted.

The list of documents you need to complete your SSA disability includes the following:

• Original or certified copy of your birth certificate or other proof of birth
• Proof of U.S. citizenship or lawful alien status if you were not born in the United States
• Original or certified copy of U.S. military discharge paper(s) if you had military service before 1968
• W-2 forms(s) and/or self-employment tax returns for last year
  
• Medical records, healthcare providers' reports, recent test results, and other medical evidence in your possession
• Award letters, pay stubs, settlement agreements, or other proof of any temporary or permanent workers' compensation-type benefits you received
• Social Security numbers of your spouse and children
• Your checking or savings account number

Your documentation must also include a completed Adult Disability Report (Form SSA-3368-BK). This report consists of 11 sections over 15 pages that contain detailed information related to your medical treatment, work history, and education. The responses you provide are used to determine whether you are disabled at the time of your application.

Working With a Healthcare Provider

Working with a healthcare provider is important in obtaining disability. A healthcare provider can significantly contribute to the decision regarding your eligibility for Social Security disability.

A Disability Determination Services team makes the decision regarding your disability. This team consists of a physician/psychologist and a disability examiner working in the state in which you reside.

Sometimes, SSA may require you to visit a healthcare provider to clarify certain aspects of your condition. If this occurs, SSA will pay for any requested services.

The determination team may request details of an examination or the results of laboratory findings, such as an ankylosing spondylitis blood test to identify the presence of HLA-B27. This genetic mutation is found in 85% of people with the disease.

The team does not examine you. Its decision is based solely on the information provided in your claims folder. This information includes office notes, reports, clinical findings, and medical tests conducted by your healthcare providers. It also includes a statement from your healthcare provider about the activities you can do despite your impairment.

Working with a healthcare provider ensures that your provider is familiar with your condition and the limitations and degree of disability it causes. This can help them provide an accurate assessment of your condition.

Asking Others for Help

It's reasonable to consider asking others for help to complete your application for disability. The application process for Social Security disability benefits can seem complex and overwhelming, especially if you are dealing with symptoms of chronic pain.

You can ask someone to help you do the following tasks related to your interaction with SSA:

• Complete forms
• Call or visit your local Social Security office
• Interpret to another language
• Gather and provide information
• Receive mail for you at their address
• Take you to medical examinations or tests

You can get assistance with your claim by appointing a representative. To do this, you must sign a statement that names a specific person as your representative using SSA Form SSA-1696. Your representative does not have to be a lawyer, but the SSA must approve the person you appoint.

A representative can act on your behalf and help you with the following aspects of your claim:

• Complete and file forms.
• Review your file and understand the law.
• Receive information from SSA about your claim, including notices and letters.
• Represent you at informal or formal hearings.
• Give the SSA evidence on your behalf.
• Help you with appeals to your claim.
• Help you and your witnesses prepare for a hearing.

Where to Apply for Benefits

You can choose one of several ways to apply for disability benefits. You can apply for adult disability benefits online if you meet all the following criteria:

• You are age 18 or older.
• You are not currently receiving benefits on your own Social Security record.
• You can't work because of a medical condition expected to last at least 12 months or result in death.
• You have not been denied disability benefits in the past 60 days.

If you don't meet all of these requirements, you can choose one of the following ways to apply:

• Call Social Security at 800-772-1213 (deaf or hard of hearing can call TTY 800-325-0778) at any time of day, 7 days a week. A representative can schedule a phone or TTY appointment for you to apply.
• Apply in person at your local Social Security office. Call the toll-free Social Security number before you go to the office to find out if you need an appointment to apply for benefits in person.
  

Length of Application Process

The application process is lengthy and detailed. It involves the following steps:

1. You will review the Adult Disability Checklist to find what information and documents you need to apply.
2. You will complete and submit your application online, via telephone, or in person.
3. Social Security reviews your application to ensure you meet the basic requirements for disability.
4. Social Security reviews your work history to confirm that you worked enough to qualify.
5. Social Security evaluates any current work activities and how they impact your application.
6. Your application is processed and forwarded to the Disability Determination Services office in your home state.
7. This state agency requests additional information as needed and decides whether you qualify for disability benefits.
   

When to Expect a Decision

You can expect a decision from Social Security regarding your disability in about three to five months. This time frame reflects the detailed review process required to evaluate your claim and determine whether you are eligible for disability.

The time it takes to receive a decision can be affected by the time it takes to get your medical records and other information or evidence required to decide on your case.

At any time during the process, you can check your application's status online using your Social Security account. You can also call the Social Security central number to check your case status.

You will receive a letter in the mail when a decision is made regarding your application for disability benefits.

Next Steps If You Were Denied

If you receive notice that your claim for disability benefits was denied, you can appeal the decision. You must request an appeal in writing within 60 days after you receive notice of the decision. You can use your "my Social Security Account" to check the status of any level of appeal filed online, by mail, or in person,

There are four levels of appeals in the process of determining disability. They include the following types of appeals:

• Reconsideration: You can request a reconsideration appeal online if your claim was denied for medical or nonmedical reasons. A reconsideration involves a complete review of all the evidence used in the first determination, plus any new evidence submitted, by someone who was not involved in the first review of your case.
• Hearing by an administrative law judge: You can request a hearing by an administrative law judge online if you disagree with the determination of your disability made at the reconsideration level. This hearing is conducted by an administrative law judge who was not involved in your initial or reconsideration determination.
• Request for review by the Appeals Council: You can request a review by an Appeals Council online if you disagree with the decision of a hearing by an administrative law judge. If a request for review is granted, the Appeals Council can deny or dismiss your request if it determines that the hearing decision aligns with Social Security law. The Appeals Council may also return the decision to an administrative law judge for further action or issue a new decision regarding your determination.
• Federal court review: A federal court review is the last level of the appeals process in your request for Social Security disability benefits. You can file a civil action in a Federal district court if you disagree with the decision of the Appeals Council or if you were denied your request for a review. You have 60 days after you receive notice of the Council's action to file a civil action in U.S. District Court.
  

Connecting With a Disability Lawyer

You have the right to connect with a disability lawyer at any time during your application or appeals process. If you work with a disability lawyer, you can assign them to act as your representative upon approval from SSA.

An experienced disability lawyer is familiar with the details of the system and the process of getting disability benefits. As the rules for disability benefits become more complex, it may benefit you to consult with a disability lawyer to improve your odds of getting benefits.

While there is no guarantee that a disability lawyer will help you earn a favorable decision regarding your disability, there is evidence that having representation can make a difference.

In a 2017 study, the federal Government Accounting Office (GAO) found that claimants who had representation, such as an attorney or family member, had a success rate nearly 3 times higher than claimants without representatives.

Summary

Ankylosing spondylitis can affect your quality of life and your ability to maintain a job. While treatments can relieve symptoms and slow disease progression, chronic pain and stiffness can make it hard to remain in one place and stay focused every day.

The Social Security Administration provides disability payments to people who can't work because of a severe medical condition. While getting this type of aid is a long and complex process, it can provide the money you need to survive.

You must meet certain criteria to qualify for disability. Getting this type of aid from SSA funds can replace some of your lost income. The payments can free you from the physical and mental pressure of work if you have advanced symptoms.