Social Security Disability (SSDI & SSI) for Fibromyalgia

It can sometimes be tough to be accepted for disability benefits due to Fibromyalgia. It is not listed in the Social Security Administration’s (SSA) Listing of Impairments, or “Blue Book”. So, it is a bit more difficult to prove the need for benefits. To address this issue, the SSA published a ruling that provided specifications on how to assess the condition. The following information will help applicants understand how the SSA views and assesses fibromyalgia.

Criteria for Disability

It used to be that to be approved for disability benefits with fibromyalgia, you must also have symptoms of another condition, such as arthritis or degenerative disk disease. However, that is no longer the case. Now, you must meet the following criteria.

– Symptoms that have lasted for at least three months and are severe

– Documented evidence that the symptoms are not caused by a different condition

– Statements from you and third parties that document the condition’s effect on your everyday activities

– The condition prevents you from working

– At least 11 of the recognized 18 tender points above and below the waist and on each side of the body or at least six ongoing symptoms of the condition

– Memory issues or difficulty with thought processing (fibro fog)

– Fatigue

– Irritable Bowel Syndrome

– Depression

– Waking up exhausted

– Anxiety.

Medically Determinable Impairment

Now that more information is known about fibromyalgia, the SSA considers fibromyalgia to be a medically determinable impairment. With most conditions, to qualify for benefits, you must be able to back-up your claim with medical evidence such as test results, lab work, and other medical signs that the condition exists in your body. The SSA will not grant benefits on a listing of your symptoms alone. However, the SSA now recognizes that doing this is extremely difficult with fibromyalgia, so they depend on criteria issued by the American College of Rheumatology (ACR) to determine whether or not you have fibromyalgia, and if so, the extent of it.

Documenting Your Fibromyalgia

The key to being awarded disability benefits is having thorough documentation to support the claim. So, you need to go beyond simply submitting your medical records and doctor’s notes. Your documentation should include:

– Official notification from your employer regarding missed days due to your condition

– Confirmed diagnosis from a rheumatologist

– Visit dates and contact information for all treating doctors, hospitals and caseworkers

– Tests and results

– Current medications

– Lab work and results

– Psychologist visits

– Residual Functional Capacity (RFC) about your impairments (documented by a doctor)

– Summary of previous jobs

Keep a Diary

Keeping a daily diary of your condition can help your application get approved. In the diary, keep track of important information such as on what days you experience pain and how it interferes with your everyday life. Be sure to include any mental or psychological stress you experience as a result of your condition as well. Keeping an up-to-date journal of your symptoms is one of the best ways your doctor can make the appropriate diagnosis and can show the SSA that your symptoms are severe, frequent, persistent and legitimate.

Rheumatologist’s Opinion

Ask your rheumatologist for his or her professional opinion about your condition that you can include with your application. The opinion can include assessments regarding:

– Your ability to sit, stand and walk during a normal eight-hour workday

– Lifting and carrying heavy loads

– Executing fluid movements such as bending, balancing and crawling

– Maintaining regular attendance and punctuality at work.

Reviewing the application

The SSA will have a team of doctors that includes a psychologist review your submitted application. The doctors will determine if any of the following impairments are present:

– Memory loss

– Lack of speed in processing information

– Trouble concentrating

– Trouble calculating

– Trouble with speech

– Trouble finding words.

Once these conditions are evaluated, the doctors will make a prediction on how long the condition is likely to last.

Work with an Attorney

Even with using updated criteria, it is still sometimes difficult to be awarded disability benefits the first time you submit an application. You can increase your chances of an approved application by working with a disability attorney who has experience with fibromyalgia cases. An attorney will work with you and help you develop a strong case that can be presented to the SSA. An attorney will also be able to answer any questions you have and will be present with you in court. Also, most disability attorneys work on a contingency basis, which means they only get paid if you win your case.