If you suffer from Rheumatoid Arthritis (RA) and are about to make, or have made a claim for long term disability benefits, you need to think about tracking your disease activity.
For many years, physicians relied upon their own clinical assessments and instinct to diagnose RA. This diagnostic approach did not lend itself to accurate tracking of the disease activity. In fact, until recently, there was no one standard test for assessing an individual’s RA levels.
Last May, however, the American College of Rheumatology (ACR) recommended six tools to measure RA disease activity. Rheumatologist, Salahuddin Kazi, MD, of the Dallas VA Medical Center, a coauthor of the ACR guidelines stated, “Using these tools consistently can help identify small changes that a patient may not notice and that may escape a physician’s observation.”
Listed below are three categories of measurement tools commonly used for patients with RA:
- Patient questionnaires. A simple version of such a test is the Visual Analog Scale (VAS), which features a horizontal line with the words NO PAIN on the left and WORST PAIN on the right; the patient makes a mark on the line to indicate the point on the spectrum that reflects how he or she is feeling. Other patient-focused tests are more detailed. For example, some ask questions about how much difficulty the patient has performing daily activities, such as bathing, dressing and climbing in and out of cars.
Please do not feel limited to using the structured space provided on these forms. Feel free to expand and explain in detail how long it took you to complete a task, how difficult it was for you, the assistance you needed to accomplish a task, or any other modification from how you used to perform the task. This is a great opportunity to document how your RA has affected your life. It might also be helpful to keep a personal journal of your daily activities.
- Joint counts, in which a doctor examines a specific set of a patient’s joints and tallies the number that are swollen and/or tender. The most common of these tests is the DAS28, which generates a “disease activity score” (hence the acronym “DAS”) based on an examination of 28 joints in the shoulders, arms, hands and knees.
- Lab tests that measure markers of inflammation. The most widely used measurements are erythrocyte sedimentation rate (ESR), which tracks how fast red blood cells fall in a test tube, and C-reactive protein (CRP), which is manufactured in the liver and rises when inflammation is present.
In addition to assisting in the treatment of RA, these tools can provide the patient/disability claimant with a form of objective evidence of disability. Objective evidence is often deemed essential by insurance companies in order to prove a disability claim.
If you have RA and need to make a claim for short term or long term disability benefits, you should consider getting help from an experienced attorney, or at the very least, someone who is familiar with the process. Although you can certainly be your own disability advocate, determining what is necessary, and how to effectively go about proving your claim can be very difficult. Developing and/or including compelling evidence of disability is vital to a successful claim. A disease tracking log can be a powerful and persuasive element of that evidence.
For more information on tests measuring RA, as well as for much more information on RA and other arthritis conditions, please visit the Arthritis Foundation at www.arthritistoday.org.
If you have been diagnosed with RA, and the symptoms and side effects of the medications to treat it become disabling, contact Kantor & Kantor for a no-cost consultation.
We understand and we can help.
www.kantorlaw.net (800) 446-7529