In previous years, a lack of understanding about fibromyalgia (FM) resulted in denial of disability benefits when the disease stood alone. Fibromyalgia was only credited as a medical disability if it was paired with another condition that could receive a substantiated diagnosis. However, Social Security has ruled fibromyalgia as a medically determined impairment (MDI), and Ruling SSR99-2p covers the initial assessment of fibromyalgia during the initial application process for disability benefits.
What Is Fibromyalgia?
Fibromyalgia affects the sufferer’s entire body, and the main characteristics of the impairment are long-term pain in the musculoskeletal system and problems with fatigue, memory, mood and sleep. Anxiety and depression also have links to FM, whether as primary or secondary symptoms. Symptoms of the condition may include numbness or tingling in the extremities, inability to exercise, migraine or tension headaches and irritable bowel syndrome.
The pain seems to arise from the patient’s muscles, and patients commonly report tender points, areas where firm pressure results in additional pain, in soft tissue throughout the body. Pain levels vary from mild discomfort to severely disabling; additionally, pain varies not only from one patient to another, but it also varies from one day to another in an individual patient.
Often, the only way to diagnose FM is by performing tests to eliminate the possibility of other conditions with symptoms that overlap or mimic the symptoms of fibromyalgia. Chemical sensitivity, major depression, chronic headaches and chronic fatigue syndrome have symptoms similar to FM and, in fact, often accompany it.
Doctors and researchers have not found a definite cause, though physical or emotional trauma, sleep disturbances, infection of an unknown virus and abnormal pain responses stemming from the brain all remain possible triggers.
Men experience FM, but women make up 80 percent of patients. Gender, family history and a previous rheumatic disease each increase the risk of developing the condition.
Disability Benefits for Fibromyalgia
One word summarizes the previous prospect of fibromyalgia sufferers receiving approval for disability benefits: dismal. Disability claims for FM would not pass the initial assessment stage because FM was considered too subjective. No amount of X-rays, blood tests or other diagnostic procedures proved the existence of fibromyalgia in patients. Unless another ailment listed by Social Security was named in conjunction with FM, claims were dismissed from disability consideration.
Today, fibromyalgia disability claims have a higher approval rate provided the diagnosis includes the following criteria set out by the American College of Rheumatology (ACR).
- Evidence that long-term, widespread pain exists.
- Evidence that other diseases or conditions have been ruled out.
- A minimum of 11 out of 18 listed tender points occurring above and below the waist on both sides of the body.
- Repeated instances of six or more symptoms common to fibromyalgia sufferers occur.
Thankfully, the Social Security Ruling and the ACR criteria reduced the barrier previously presented by the subjective nature of fibromyalgia as a disability. Unfortunately, until the Social Security Administration lists fibromyalgia as an official condition that qualifies as a disability in itself, some people will find their initial disability claims denied. When claims are denied, FM patients may require a lawyer to handle the appeal process to have the individual diagnosis of fibromyalgia approved as a disability. If you are in need of legal representation to fight for your rights in relation to your Fibromyalgia application or appeal, please do not hesitate to contact us today.