Osteoarthritis (OA), also known as Degenerative Joint Disease (DJD), is a group of mechanical abnormalities involving the degradation of joints, including articular cartilage and subchondral bone. If you’re struggling with OA in Louisiana, consulting a Louisiana Social Security Disability lawyer may help you navigate your options for disability benefits.

Primary OA is a chronic degenerative disorder related to, but not caused by, aging. As a person ages, the water content of the cartilage decreases due to a reduced proteoglycan content, making the cartilage less resilient. In healthy cartilage, the water content is balanced by compressive force driving water out and swelling pressure drawing water in. Collagen fibers exert the compressive force, while the Gibbs-Donnan effect and cartilage proteoglycans create osmotic pressure, drawing water in.

During the onset of OA, there is an increase in cartilage water content. This occurs because, while there is an overall loss of proteoglycans, it is outweighed by a loss of collagen. Without the protective effects of proteoglycans, the collagen fibers in the cartilage become susceptible to degradation, exacerbating degeneration.

Inflammation of the surrounding joint capsule can also occur, though it is often mild compared to what happens in rheumatoid arthritis. This inflammation can occur as breakdown products from the cartilage are released into the synovial space, and the cells lining the joint attempt to remove them. New bone outgrowths, called “spurs” or osteophytes, may form on the margins of the joints, possibly as an attempt to improve the congruence of the articular cartilage surfaces. These bone changes, along with the inflammation, can be both painful and debilitating.

OA/DJD symptoms may include joint pain, tenderness, stiffness, locking, and sometimes effusion. The main symptom is pain, leading to loss of ability and often stiffness. This pain is generally described as a sharp ache or burning sensation in the associated muscles and tendons. OA can cause a crackling noise (called “crepitus”) when the affected joint is moved or touched, and some people may experience muscle spasms and contractions in the tendons. Occasionally, the joints may also be filled with fluid. Increased pain is often associated with cold temperatures, high humidity, or a drop in barometric pressure.

OA/DJD commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees, although any joint in the body can, in theory, be affected.

As OA progresses, the affected joints appear larger, are stiff and painful, and usually feel better with gentle use but worse with excessive or prolonged use. This differs from rheumatoid arthritis.

In smaller joints, such as those in the fingers, hard bony enlargements called Heberden’s nodes (on the distal interphalangeal joints) and Bouchard’s nodes (on the proximal interphalangeal joints) may form. While these nodes are not necessarily painful, they do significantly limit finger movement. OA at the toes often leads to the formation of bunions, rendering them red or swollen. Some people notice these physical changes before experiencing any pain. OA is the most common cause of joint effusion in the knee.

What is the Difference Between Degenerative Joint Disease and Arthritis?

Osteoarthritis, also called degenerative joint disease, is the most common type of arthritis. It is associated with a breakdown of cartilage in joints and can occur in almost any joint in the body. It most commonly occurs in the weight-bearing joints of the hips, knees, and spine.

CAN I RECEIVE SOCIAL SECURITY DISABILITY BENEFITS FOR OSTEOARTHRITIS/DEGENERATIVE JOINT DISEASE?

Osteoarthritis/Degenerative Joint Disease can cause pain and other symptoms that can impact your ability to work. Social Security Disability benefits may be available to you if you are diagnosed with OA/DJD.

If you are not engaging in gainful activity due to OA or DJD, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the sequential evaluation process.

Generally, to establish Degenerative Joint Disease as a medically determinable severe impairment, you must show:

  • Objective medical imaging establishing osteoarthritis/degenerative joint disease;
  • Consistent complaints of pain or other symptoms for a period of time and which is not controlled through conservative treatment modalities

At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For OA/DJD, SSA will determine if your condition meets any of the Listing 1.02 – Major Dysfunction of a Joint or 1.04 – Disorders of the Spine.

  • 1.02 can be met if your OA/DJD is
    • Characterized by gross anatomical deformity (e.g., subluxation, contracture, bony or fibrous ankylosis, instability) and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s), and
    • There is involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in an inability to ambulate effectively, OR
    • There is involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in the inability to perform fine and gross movements effectively.
  • 1.04A can be met if your OA/DJD affects the spine and
    • Results in compromise of a nerve root (including the cauda equina) or the spinal cord
    • There is evidence of nerve root compression characterized by–
      • if there is involvement of the lower back, positive straight-leg raising test (sitting and supine).
      • motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss, and
      • limitation of motion of the spine,
      • neuro-anatomic distribution of pain,
  • 1.04B can be met if your OA/DJD affects the spine and
    • Causes spinal arachnoiditis confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, and
    • Is manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours.
  • 1.04C can be met if your OA/DJD affects the spine and
    • Causes lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, and
    • Is manifested by chronic nonradicular pain and weakness, resulting in inability to ambulate effectively.

The key to meeting the listing is to have the appropriate objective medical testing and a longitudinal medical history that addresses each of the requirements. In most cases, in my experience, the medical listing will not be met, but having a good knowledge of what you have to prove can help you discuss your case with your doctor.

If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your OA/DJD and pain), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.

TIPS FOR APPLYING FOR SOCIAL SECURITY WITH OSTEOARTHRITIS/DEGENERATIVE JOINT DISEASE IN LOUISIANA

  1. Make sure an imaging report (MRI, CT, X-ray) diagnosing OA/DJD is in your medical records. It is important that you “know your medical records.”
  2. Make sure your medical records document ALL of your symptoms and limitations. Your medical records should not just document your pain. Let your doctor how often you feel the symptoms, how severe each symptom is, and how long each episode lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms.
  3. See a specialist. Treatment of OA/DJD by an orthopedist, neurologist, rheumatologist, or chronic pain specialist will carry more weight than the same diagnosis from a family physician or internist professional.
  4. Comply with your doctor’s orders and try various modes of conservative or less invasive treatment, if recommended.
  5. See a mental health professional. If you are suffering from depression or anxiety as a result of chronic pain and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions. Pain is often accompanied by or is the cause of mental health conditions. Treatment of the depression can help with the pain.
  6. See your doctor regularly and keep your appointments.
  7. If you can, provide evidence of a long work history.
  8. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity.
  9. Include information from non-medical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time. These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
  10. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
  11. If you need assistance with your claim, contact a disability attorney who is knowledgeable in the requirements for obtaining Social Security Disability for degenerative joint disease. We have experience obtaining disability benefits for clients with degenerative joint disease. To discuss the details of your case, call disability attorney Loyd J. Bourgeois at 985-240-9773.