Arthritis

Arthritis and its Impact on Full-Time Work: Understanding the Disease and its Limitations

Arthritis is a common condition that affects millions of people worldwide. It refers to inflammation and degeneration of one or more joints, leading to pain, stiffness, and reduced mobility. While there are different types of arthritis, such as osteoarthritis, rheumatoid arthritis, and psoriatic arthritis, they all share the potential to significantly impact an individual’s ability to perform full-time work. In this article, we will explore what arthritis is, its effects on the body, and the various ways it can disable someone from engaging in full-time employment.

Arthritis is the number-one cause of disability in the United States, and one-third of workers with arthritis have limitations that affect their ability to work.

Arthritis is characterized by inflammation in the joints, which can result from multiple factors, including age, genetics, injury, or autoimmune disorders. The two most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA). Osteoarthritis occurs when the protective cartilage that cushions the joints wears down over time, leading to friction, pain, and stiffness. Rheumatoid arthritis, on the other hand, is an autoimmune disease where the body’s immune system mistakenly attacks its own joints, causing inflammation and damage.

Effects of Arthritis on Full-Time Work

The effects of arthritis on your ability to work will vary based on the type of arthritis and the area or areas of your body it affects.

1. Pain and Stiffness: One of the primary symptoms of arthritis is joint pain and stiffness. Individuals with arthritis may experience chronic pain that worsens with movement, making it challenging to perform repetitive tasks or activities that require prolonged standing or sitting. Morning stiffness can be particularly severe, making it difficult to start the day and impacting timeliness and productivity at work.
2. Reduced Mobility and Range of Motion: Arthritis can limit joint mobility and range of motion, affecting an individual’s ability to perform physical tasks required for certain jobs. Daily activities like bending, lifting, or carrying heavy objects can become painful and challenging. Mobility issues may also restrict movement and impair performance in jobs that require agility and flexibility.
3. Fatigue and Energy Drain: Many people with arthritis experience chronic fatigue, which can be both physically and mentally draining. Pain, inflammation, and poor sleep quality associated with arthritis can contribute to excessive tiredness throughout the day. Fatigue can reduce productivity, slow down the work pace, and make it challenging to sustain full-time employment.
4. Functional Limitations: Arthritis can result in functional limitations that impact job performance. Fine motor skills may be affected, making tasks like typing, writing, or handling small objects difficult. Grip strength can be reduced, affecting the ability to hold tools or manipulate objects. These limitations can impact a wide range of professions, from office work to manual labor.
5. Cognitive Impact: In some cases, arthritis can also have cognitive effects. Chronic pain, fatigue, and the emotional toll of dealing with a chronic condition can impact concentration, memory, and cognitive processing speed. This can affect complex problem-solving, decision-making, and other cognitive tasks required for certain occupations. Pain medication can also affect an insured’s cognitive abilities.
6. Emotional and Mental Health: Living with chronic pain and physical limitations can have a significant emotional and mental health impact. Arthritis can cause frustration, anxiety, stress, and even depression, which can further impair work performance and productivity. Mental health challenges may require additional support and accommodations to maintain full-time employment effectively.
7. Workplace Modifications: Depending on the severity of arthritis symptoms, individuals may require workplace modifications or accommodations to continue working full-time. This can include ergonomic adjustments to workstations, assistive devices, flexible schedules, or reduced work hours to manage pain and fatigue. In some cases, individuals may need to explore alternative job roles that are less physically demanding.

How Courts Evaluate Arthritis Claims

Many courts around the country have reviewed an insurer’s denial of disability benefits for disability caused by arthritis. A review of those cases shows several issues for you to consider when preparing your own claim:

• Osteoarthritis in the hip: In Kochenderfer v. Reliance Standard Life Ins. Co., No. 06-CV-620 JLS (NLS), 2009 WL 4722831, at *10 (S.D. Cal. Dec. 4, 2009), an ERISA case in the Southern District of California, an anesthesiologist developed osteoarthritis in both hips and could no longer stand for any length of time. Under her policy, after three years, she had to meet the definition of disability from “any occupation,” and her insurer Reliance Standard terminated her benefits. The Court held that if she could only sit or stand for an hour to two hours at most without dramatically increased pain, that pain meant that she could not do it and, therefore, could not work a sedentary job.
• Multiple disabling conditions, including arthritis: Often, arthritis is not the only disabling factor in an insured’s health situation. The pain from arthritis can cause depression and anxiety. The pain may also include fibromyalgia or musculoskeletal issues like degenerative back or knee conditions. In James v. AT & T W. Disability Benefits Program, 41 F. Supp. 3d 849, 878 (N.D. Cal. 2014), Diana James had a sedentary job at the phone company as a customer service representative. She was diagnosed with facet syndrome and low back pain, as well as arthritis in her knees, elbows, and fingers. She also received a diagnosis of depression. The Court held that the insurer failed to consider James’ “overall condition” and instead tried to “carve a claimant’s overall disability into discrete parts.” By ignoring the totality of James’ disability as caused by multiple issues, the insurer got it wrong.
• Rheumatoid arthritis: Skeen v. Rite Aid Corp., No. 208-CV-03177GEBEFB, 2010 WL 231383, at *8 (E.D. Cal. Jan. 12, 2010) Claudia Skeen, a manager at Rite Aid, had rheumatoid arthritis. However, her symptoms were mild and controlled with ibuprofen. While Social Security found her to be disabled, Standard Insurance concluded she could work. But the Court refused to consider the Social Security decision because it was issued after Standard denied Ms. Skeen’s claim. Similarly, in Lukianczyk v. Unum Life Ins. Co. of Am., 505 F. Supp. 3d 1033 (E.D. Cal. 2020), the plaintiff, a hospital accountant, had diagnoses of rheumatoid arthritis and chronic fatigue syndrome. But her physicians did not impose any restrictions or limitations on her activities, and the Court, therefore, held that she had none. These cases are important reminders that having a diagnosis alone does not mean you qualify for insurance benefits. Your insurer will be looking at your symptoms and how they create restrictions and limitations on your daily activities.
• Objective evidence of arthritis: Warren Thompson was a partner in an accounting firm. Thompson v. Standard Ins. Co., 167 F. Supp. 2d 1186 (D. Or. 2001) He developed significant arthritis, requiring hydrocodone to control the pain. Standard denied the claim on the basis of “very little objective findings in terms of joint swelling or laboratory abnormalities.” On appeal, Mr. Thompson submitted a Whole Body Bone Scan that confirmed degenerative arthritis in his shoulders, knees, toe, wrist, and cervical spine. Standard still refused to approve the claim, citing “insufficient proof” that he could not work his sedentary job. The Court awarded benefits, noting that pain is real even if it cannot be measured on a test, and the available testing confirms the arthritis causing disabling pain.

Increasing Your Chances of a Favorable Outcome with Arthritis Disability Claims

When making a claim for arthritis, remember that your doctor needs to hear about the symptoms that are causing you to be unable to work and needs to provide specific restrictions and limitations based on those symptoms. It is not enough to simply have a diagnosis of arthritis. Also, you will want to have objective tests to confirm your diagnosis. Be aware that some insurance policies now include two-year limitations on benefits based on “subjective symptoms or conditions,” which generally means any disability that cannot be proven with a test. Where arthritis can be confirmed with blood tests and bone scans, make sure that you have such documentation in your file.