In previous years, a lack of understanding about fibromyalgia 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.
Is Fibromyalgia a Disability?
It is a disorder causing prominent musculoskeletal pain. This pain can be accompanied by fatigue, sleep deprivation, memory, and mood issues. It causes painful sensations, which, in turn, affects the brain’s ability to process pain signals.
Fibromyalgia and disability are very closely related as it affects the sufferer’s entire body. Anxiety and depression also have links to fibromyalgia, whether as primary or secondary symptoms. 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 differs from one patient to another, and it varies from one day to another.
Often, the only way to diagnose fibromyalgia 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 fibromyalgia and, in fact, often accompany it. Fibromyalgia social security disability benefits are more difficult to get compared to disability benefits for many other diseases.
Prominent symptoms of fibromyalgia
It is not at all easy to identify that you have fibromyalgia. This is one of a very few diseases that show no initial signs and symptoms. Its symptoms can closely resemble those of arthritis. But, as fibromyalgia affects soft tissues and not bones, the risk factors are different. Symptoms may include-
- Numbness or tingling in the extremities
- Inability to exercise
- migraine or tension headaches
- Irritable bowel syndrome
- Slow or confused speech
- Muscles spasms
- Poor quality sleep
- Extreme tiredness
- Lack of concentration
- Trouble with remembering and learning things
- Inability to pay attention and concentration – often termed as fibro fog.
Fibromyalgia can have severe and lifelong effects
Doctors and researchers have not found a definite cause. However, physical, or emotional trauma, sleep disturbances, an unknown viral infection, and abnormal pain responses stemming from the brain all remain possible triggers.
Risk factors in fibromyalgia include-
- Traumatic injury.
- Rheumatoid arthritis.
- Autoimmune disorders like lupus and genetic factors.
Both men and women experience fibromyalgia, 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 likelihood of people living with fibromyalgia to receive approval for disability benefits in the past: dismal.
Disability claims for fibromyalgia would not pass the initial assessment stage because fibromyalgia was considered too subjective. No number of X-rays, blood tests or other diagnostic procedures proved the existence of fibromyalgia in patients. Unless another condition listed by Social Security was named in conjunction with fibromyalgia, claims were dismissed from Fibromyalgia disability benefits 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 people with fibromyalgia present.
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, Fibromyalgia patients may require a lawyer to handle the appeal process to have the individual diagnosis of fibromyalgia approved as a disability.
The chance of getting approved for SSD/ SSI for Fibromyalgia increases when you have:
- Relevant medical records to prove your disability.
- Laboratory testing reports.
- Written documents mentioning doctors’ opinions
- Written statements from friends, family, and co-workers will also be helpful.
Proper Documentation of your Disability case
It is common knowledge that the documentation plays a crucial role in making your case stronger. While applying for disability benefits for fibromyalgia and submitting your application, it is essential to provide accurate supporting documents.
Fibromyalgia Disability Criteria depends on following factors. If you meet the criteria, the next step is to submit all relevant documents. The criteria to receive disability benefits are;
- The applicant must be facing severe symptoms.
- The symptoms must be present for at least three months.
- Fibromyalgia is preventing the applicant from working and earning a living.
- The applicant can provide evidence (documented) to show their severe health condition.
- A written statement provided by the applicant and other associated people about all inabilities/ restrictions faced on a daily basis due to fibromyalgia.
The following specific documents must be submitted along with the disability application.
- A document by a rheumatologist showing confirmation of diagnosis.
- Details of all doctors, caseworkers, and hospitals where the applicant has been treated
- If work was missed due to health reasons associated with the condition, a statement could be provided from the employer in support of lost wages.
- Past, and current medical records such as lab test reports, prescribed medications, visits to the psychologist, etc.
- A detailed summary of past employment
- Submitting RFC (Residual Functional Capacity) completed by the physician regarding the specifics of the medical condition will be an added advantage.
There are many limitations that fibromyalgia patients have to face. Generally, rheumatologists explain the constraints well in advance to their patients. The limitations can differ from person to person. The patients can face the following difficulties-
- Sitting, standing, and walking for a long duration (at least an eight-hour workday)
- Problems with lifting and carrying heavy loads
- Hindered fluid movements like bending, crawling, and balancing
The Social Security Administration determines a person’s disability by following a strict procedure. They closely monitor all the documents before making any decisions on the determination of disability applications. Once you submit the application along with all documents, the SSA will verify all the documents with the help of qualified doctors associated with the agency. Many fibromyalgia patients suffer mental conditions. The SSA will ensure that their psychologist check if you are suffering from the following mental impairments.
- Concentration issues
- Memory loss/ weak memory
- Trouble with calculations
- Speech trouble
- Word-finding issues
- Poor speed of information processing
The team at the SSA will interpret your medical information with strong attention to detail. They will also try to determine how long your condition is likely to last. This will help them in approving the right amount of monetary benefits for your medical situation.
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.