Arthritis and Musculoskeletal Pain are a leading Cause of Disability

Arthritis and musculoskeletal pain are a leading cause of long-term disability in North America and account for about one third of disability cases.  The Arthritis Society of Canada states that about 20 per cent of Canadians are currently living with arthritis and for about 40 percent of these cases, their pain is severe enough to significantly affect their ability to participate in many activities. The U.S. Centre of Disease Control and Prevention (CDC) similarly reports that one out of four adults say that they suffer from severe joint pain caused by arthritis and for about half of those patients, their pain is significant and chronic.

Types of Arthritis

There are many types of arthritis, but the most common of these are rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PsA), fibromyalgia and gout.

• Osteoarthritis results from the breakdown of the protective cartilage inside your joint.  This eventually causes the bones in the joint to rub against one another, resulting in severe pain.  
• Rheumatoid arthritis is an autoimmune disorder in which a person’s joints and other healthy tissue or organs are attacked by their own immune system.  When the immune system attacks the lining of the joints (the synovium), the persistent inflammation eventually results in permanent damage to the joints.
• Similar to RA, in psoriatic arthritis, the person’s immune system attacks healthy tissue and causes inflammation and pain.  Arthritis is caused when PsA attacks the joints, while enthesis is a condition that results when PsA affects the connective tissue where ligaments or tendons attach to our bones.
• Fibromyalgia is a widespread pain condition in which a person’s brain processes pain signals differently.
• Gout is another type of inflammatory process where your body produces an excess of uric acid that may accumulate in the blood and form crystals in your joints.  This may result in very painful inflammation of the joint and it most often affects the big toe.
• Lupus is a serious autoimmune and inflammatory disease that impacts many parts of the body, including the joints, organs (such as the kidneys and skin), the brain and blood.  In addition to pain, lupus can cause fever, rash, hair loss, fatigue, light sensitivity and kidney problems.

Arthritis and related disorders affect different persons in different ways, and associated pain can vary from mild to excruciating.  Persons suffering from arthritis frequently have difficulty with mobility, including walking, getting up and sitting down, and climbing stairs, and their ability  to perform everyday activities (such as getting dressed or doing chores).  People suffering from arthritis often experience additional symptoms beyond reduced mobility, dexterity and function, such as difficulty sleeping, fatigue, the inability to concentrate and mood disorders such as depression.  According to the Arthritis Society of Canada, people suffering from arthritis are twice as likely to report being unable to work as Canadians; twice as likely to suffer from a mood disorder such as depression; and 1.5 times more likely to suffer from an anxiety disorder, than other Canadians.  Further, severe joint pain due to arthritis often accompanies other chronic conditions, including back problems, heart disease, diabetes and obesity.

Musculoskeletal Conditions

A musculoskeletal disorder (MSD) is a condition or injury that affects the musculoskeletal system (including the muscles, nerves, ligaments, tendons, spinal cord and blood vessels) and the body’s ability to move. Musculoskeletal disorders are often caused by repetitive motion, overuse and stress on the affected tissue, but are not limited to these causes and may result from multiple circumstances, including injuries suffered in falls, collisions and other incidents.  Also, men and women differ in the types of musculoskeletal disorders more likely to affect them.  MSDs may arise from work-related and/or extra-curricular activities.

Musculoskeletal disorders may be relatively short-lived, such as a sprain, or may be lifelong and result in long-term disability.  Musculoskeletal conditions most often affect the joints (as in the case of RA), bones, muscles, spine and may impact multiple areas of the body (as in the case of lupus and fibromyalgia).   The most commonly disabling MSDs are back and neck pain, osteoarthritis, injuries, fractures arising from weakened bones, and systemic inflammatory conditions such as rheumatoid arthritis.  

In addition to arthritis, some of the most common musculoskeletal disorders are:

• Osteoporosis
• Tendonitis
• Carpal tunnel syndrome
• Muscle sprain
• Tendon sprain
• Ligament sprain (such as an ACL injury or tear to the major knee ligament)  
• Thoracic outlet compression
• Ruptured or herniated disc
• Degenerative disc disease
• Bone fractures

According to the World Health Organization (WHO), low back pain, which is associated with a musculoskeletal injury or disorder, is the leading single cause of disability worldwide.   Although the likelihood of MSD generally increases with age, older adults are certainly not the only ones affected; many persons of working age and even children may suffer from MSD, including arthritis.

Like arthritis, musculoskeletal disorders can substantially diminish a person’s dexterity and mobility.  Severe MSD may lead to early retirement from work, reduced finances, and a diminished ability to participate in social situations and physical activities.  Also, musculoskeletal disorders are commonly associated with depression and/or anxiety disorder. 

Long-term disability

When arthritis or another musculoskeletal disorder prevents you from effectively performing the required aspects of your job, you may be eligible to claim long-term disability (LTD) benefits under your disability insurance plan and/or Canada Pension Plan (CPP) disability benefits.   Many work tasks can be impacted by arthritis or an MSD.  In addition to heavy lifting and other physically demanding tasks, depending on the nature of the condition, MSD’s can make it difficult or impossible to sit or stand for long periods of time, work on a keyboard, and perform many other functions that may be essential to your job.

Before being eligible to claim LTD for your condition, you must have been under the regular care of a physician for your disorder. Your doctor should perform a physical exam in order to make a considered diagnosis and recommend treatments. Some of the indicators of MSD that your doctor will likely check for include: pain, muscle weakness, swelling, muscle atrophy, redness and unusual reflexes.  Your doctor may order a blood test (for example, to check for rheumatic arthritis) or may order medical imaging tests, such as an MRI or X-ray, to check for bone or soft tissue injuries.  

Your treating physician’s reports provide critical input on your application for disability benefits.  When first applying for disability benefits, your physician’s opinions and assessments must describe, specifically, how your condition prevents you from performing the essential aspects of your job. And after 2 years, in order to continue qualifying for LTD benefits under most policies, you must provide medical evidence to show that your specific symptoms prevent you from performing any job for which you are suited, or may become suited, by  education, experience and training. 

The fact of the matter is that many persons who are genuinely disabled by arthritis or another MSD do not receive the LTD benefits they deserve.  If your LTD claim was unfairly denied, consult with a knowledgeable Kitchener disability claims lawyer at Dietrich Law. Our legal team offers vast experience dealing with disability insurers and we understand what is required in making a successful claim.  And, at Dietrich Law, our top priority is getting you the disability benefits you are owed.

Sources:

• arthritis.ca
• www.arthritis.org/living-with-arthritis/pain-management/understanding/types-of-pain.php
• www.cdc.gov/arthritis/pain/index.htm
• www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions