Arthritis is classified as an Immune System Disorder by the SSA in its Blue Book:

How Arthritis is Evaluated by SSD:

Section 6. Inflammatory Arthritis (14.09).

Subsection A. General regarding Inflammatory Arthritis.

The spectrum of inflammatory arthritis includes a vast array of disorders that differ in cause, course, and outcome.

Clinically, inflammation of major peripheral joints may be the dominant manifestation causing difficulties with ambulation or fine and gross movements.

There may be:

  • joint pain,
  • swelling, and
  • tenderness

The arthritis may affect other joints, or cause less limitation in ambulation or the performance of fine and gross movements.

However, in combination with extra-articular features, including constitutional symptoms or signs (severe fatigue, fever, malaise, involuntary weight loss), inflammatory arthritis may result in an extreme limitation.

b. Inflammatory arthritis involving the axial spine (spondyloarthropathy).In adults, inflammatory arthritis involving the axial spine may be associated with disorders such as:

  1. Reiter’s syndrome;
  2. Ankylosing spondylitis;
  3. Psoriatic arthritis;
  4. Whipple’s disease;
  5. Behçet’s disease; and
  6. Inflammatory bowel disease.

c. Inflammatory arthritis involving the peripheral joints.In adults, inflammatoryarthritis involving peripheral joints may be associated with disorders such as:

  1. Rheumatoid arthritis;
  2. Sjögren’s syndrome;
  3. Psoriatic arthritis;
  4. Crystal deposition disorders (gout andpseudogout);
  5. Lyme disease; and
  6. Inflammatory bowel disease.

d. Documentation of inflammatory arthritis.

Generally, but not always, the diagnosis of inflammatory arthritis is based on the clinical features and serologic findings described in the most recent edition of the Primer on the Rheumatic Diseases published by the Arthritis Foundation.

e. How inflammatory arthritis is evaluated under the listings.

(i) Listing-level severity in 14.09A and 14.09C1 is shown by an impairment thatresults in an “extreme” (very serious) limitation.

In 14.09A, the criterion is satisfied with persistent inflammation or deformity in:

One major peripheral weight-bearing joint resulting in the inability to ambulate effectively (as defined in 14.00C6)

OR

One major peripheral joint in each upper extremity resulting in the inability to perform fine and gross movements effectively (as defined in 14.00C7).

In 14.09C1, if you have the required ankylosis (fixation) of your cervical or dorsolumbar spine, SSD will find that you have an extreme limitation in yourability to see in front of you, above you, and to the side.

Therefore, inability to ambulate effectively is implicit in 14.09C1, even though you might not require bilateral upper limb assistance.

(ii) Listing-level severity is shown in 14.09B, 14.09C2, and 14.09D by inflammatory arthritis that involves various combinations of complications of one or more major peripheral joints or other joints, such as:

  1. inflammation or deformity,
  2. extra articular features,
  3. repeated manifestations, AND
  4. constitutional symptoms or signs.

Extra articular impairments may also meet listings in other body systems.

(iii) Extra-articular features ofinflammatory arthritis may involve any bodysystem for example:

  • Musculoskeletal (heelenthesopathy),
  • ophthalmologic (iridocyclitis,
  • keratoconjunctivitis sicca, uveitis),
  • pulmonary (pleuritis, pulmonary fibrosis ornodules, restrictive lung disease),
  • cardiovascular (aortic valve insufficiency,
  • arrhythmias,
  • coronary arteritis,
  • myocarditis,
  • pericarditis,
  • Raynaud’s phenomenon,systemic vasculitis),
  • renal (amyloidosis of thekidney),
  • hematologic (chronic anemia,thrombocytopenia),
  • neurologic (peripheralneuropathy,
  • radiculopathy,
  • spinal cord orcauda equina compression with sensory and motor loss),
  • mental (cognitive dysfunction, poor memory), and
  • immune system (Felty’s syndrome (hypersplenism with compromised immune competence)).

(iv) If both inflammation and chronic deformities are present, your impairment is evaluated under the criteria of any appropriate listing.

14.09 Inflammatory Arthritis.

As described in 14.00D6 above with:

A. Persistent inflammation or persistent deformity of:

1. One or more major peripheral weight-bearing joints resulting in the inability to ambulate effectively (as defined in 14.00C6); or

2. One or more major peripheral joints in each upper extremity resulting in the inability to perform fine and gross movements effectively (as defined in 14.00C7).

Or

B. Inflammation or deformity in one or more major peripheral joints with:

1. Involvement of two or more organs/body systems with one of the organs/body systems involved at least to a moderate level of severity; and

2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).

OR

C. Ankylosing spondylitis or other spondyloarthropathies, with:

1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45° or more of flexion from the vertical position (zero degrees); or

2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 30° or more of flexion (but less than 45°) measured from the vertical position (zero degrees), and involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity.

OR

D. Repeated manifestations of inflammatory arthritis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:

1. Limitation of activities of daily living.

2. Limitation in maintaining social functioning.

3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.