Rheumatoid arthritis (RA) is diagnosed by blood tests and X-rays. There is a specific blood test for the disease called rheumatoid factor, which is most often used. There are also specific doctors, rheumatologists, which specialize in connective tissues and diseases of the joints.
The cause of RA is unknown. It is suspected that fungi, bacteria and viruses are the cause, but there has been no proof to this theory. It could be genetic, have environmental causes or be due to certain infections, but whatever the cause, the immune system attacks the body’s tissues and results in inflammation.
The symptoms of the disease come and go, due to the tissues being inflamed. When the tissues are not inflamed, the disease is not active. Symptoms include stiffness, muscle aches, joint aches, fatigue, lack of appetite and a low-grade fever.
You must have a diagnosis of inflammatory arthritis. Generally, you will need to have clinical and serologic (blood work) findings to document your diagnosis of rheumatoid arthritis.
To meet the requirements of the listing 14.09 A, you could have persistent inflammation or deformity of one or more of the peripheral weight bearing joints that result in severe limitation of your ability to ambulate effectively. Or, one or more of the major peripheral joints in each upper extremity that results in limitations so significant that it causes severe limitations with fine and gross movements.
You could meet or equal the requirements of 14.09 B, if you have persistent inflammation or deformity in one or more peripheral joints with:
1. Involvement of two or more organs/ body systems with at least one of the organs/body systems having a moderate level of severity; and
2. At least two of the following constitutional symptoms or signs (fever, malaise, severe fatigue, or involuntary weight loss).
There are other parts of this impairment listing that would be used to evaluate other types of inflammatory arthritis, here we are focusing on RA.
Seronegative RA is the diagnosis of RA without the presence of certain antibodies in the patient’s blood. It is one of two main types of RA diagnoses.
In most cases of RA diagnoses, the patient tests positive for rheumatoid factor and/or anti-CPP antibodies. These indicate that the patient is seropositive and that they possess the antibodies that cause an attack on joints and lead to inflammation.
When a patient tests negative for rheumatoid factor and anti-CCP antibodies, yet they still display strong symptoms indicative of RA, they can achieve a diagnosis of seronegative RA.
The seronegative part means they don’t possess the antibodies that seropositive patients do. Otherwise, seronegative patients may also simply possess extremely low levels of the antibodies – not enough to warrant a seropositive diagnosis. Many seronegative RA patients go on to develop antibodies years after their initial diagnosis. This is one of the many reasons that a patient can still be diagnosed with RA even if they are seronegative.
RA is a chronic disorder that causes the immune system to attack the joints, resulting in inflammation of the lining, or synovium, of the joints. It can also affect other areas of the body, such as the skin, eyes and lungs. RA causes pain, stiffness, redness, warmth and swelling around the joints, causing the lining to thicken and eventually release enzymes that begin to digest the cartilage and bone. It has been estimated that rheumatoid arthritis affects 2.1 million Americans or 1 percent of the United States population.
If this happens, there is a loss of alignment, pain and sometimes a loss of movement. Because it is a chronic disease, it progresses as time passes, although early detection and treatment can help those with the disease to live more productive lives.
It is very important that you tell your doctors about all the symptoms and disabilities you are experiencing and make sure your medical records include a diagnosis (with testing) prognosis, and complete description of your limitations that result from RA, including those mentioned above. Your medical records will be the primary source of information used in your case, and if you fail to mention any symptoms, limitations, or disabilities to your doctor, or if the doctor neglects to record them, they won’t be included. You should make sure your doctor records everything you tell him/her.
Many people suffer from multiple symptoms that make it impossible to work. SSA will determine if the combination of impairments is sufficiently disabling to keep you from returning to work.