Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a form of inflammatory arthritis that is often diagnosed in young men, but it can impact male or female of any age. A lifelong chronic condition, there is no cure for AS.  AS is a chronic disorder that will impact you for the rest of your life. According to a study conducted by the National Centers of Biotechnology Information (NCBI), AS can be an expensive condition for one to suffer from.

Ankylosing spondylitis affects various areas of the body (such as the heart, the eyes, the lungs, and kidneys), but it mainly attacks the joints of the spine and the joints between the pelvis and the spine, called the sacroiliac (SI) joints. Over time, the inflammation brought on by AS can lead not only to chronic pain and stiffness in affected areas, but can also result in "ankylosis" (new bone formation), which can cause the fusion or fixation of joints.

Individuals with ankylosing spondylitis may suffer from stiffening of the spine and reduced mobility that impairs their ability to engage in normal daily activities. They may also suffer damage to non-vertebral joints such as the hips, knees, ankles, and even shoulders. If the damage is severe enough, arthroplasty, or total joint replacement, may be advised. AS is a condition for which there is no cure, that, left undiagnosed and untreated, can cause severe physical impairments.

There are anti-inflammatory medications used to manage the pain and in severe cases, joint replacement surgery may be required. Regular rheumatologist visits, and exercise are often required to help make the symptoms tolerable and to reduce the severity of the pain.

If your AS is severe enough to keep you from being able to work, you may be eligible for monthly disability benefits from the SSA. AS would be evaluated using Section 14.09C of the Blue Book, which is the medical guide that is used by the SSA to determine if you meet the criteria set forth by the SSA to receive benefits. Section 14.09C focuses on Inflammatory Arthritis.

In order to qualify, you have to be able to demonstrate one of the following:

1. Fixation of the dorsolumbar or cervical spine that is measured on physical examination at 45 degrees or more flexion from the vertical position OR

2. A fixation of the cervical spine or dorsolumbar spine that is measured at 30 degrees or more of flexion but less than 45 degrees when measured from the vertical position. There must also be the involvement of at least two body systems with a modern amount of severity.

If you don’t meet the medical requirements for disability benefits, you may still be able to get approved using a residual functional capacity (RFC). This form is to be completed by your treating physician and should clearly state any limitations or restrictions that you have because of the condition.

Your rheumatologist or other treating doctor should be able to write up a list of your limitations to submit to Social Security, including the physical evidence from a physical exam or medical imaging (such as an x-ray or MRI) that supports the limitations. Among other things, your doctor should measure the degree to which you are able to bend forward and the ability to which you can perform movements of flexion, extension, lateral bending, and spinal rotation. In addition, if your breathing is affected, your doctor should submit chest expansion measurements. You should also submit a positive blood test for the gene HLA-B27 if you have it.

Any limitations or restrictions you have can rule out certain types of jobs, making it more likely that you will be approved for disability benefits. For example, an inability to stand or walk for more than two hours in combination with an inability to bend, crouch, or reach overhead would mean that there are very few jobs you can do. For more information on how Social Security assesses your limitations, see our articles on how Social Security uses your RFC to decide if you should be able to work.

If you need helping applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 20 years experience with Social Security Disability cases.