Can Fibromyalgia qualify for social security?
Ask the Advocate
August 1, 2020
Fibromyalgia is now a recognized medically determinable impairment by Social Security. I will talk about the symptoms of fibromyalgia and how these symptoms relate to a Social Security Disability or SSI claim. I will also discuss the type of treatment that Social Security recognizes for this condition. You will also read about how the limitations from fibromyalgia can help show you are disabled.
Fibromyalgia is pain in several areas or all over body with no functional or structural disease to explain the pain. It is much more common in women than in men. In fact, women account for about 80 percent of fibromyalgia cases. The American College of Rheumatology defines fibromyalgia as a history of widespread pain lasting longer than three months, with pain in at least 11 of 18 tender points, and the pain cannot be attributed to another illness mimicking fibromyalgia.
Social Security will accept a diagnosis of fibromyalgia if a physical and neurological exam is taken by a rheumatologist. Symptoms include but are not limited to headaches, muscle weakness, muscle stiffness, multiple trigger points (tender), fatigue, numbness, depression, difficulty with memory or concentration, sleep disturbance and vestibular dysfunction. The disease is usually caused by some trauma such as sexual or physical abuse, or illness.
Social Security Ruling SSR 12-2p that was just passed July 24, 2012, addresses fibromyalgia. This ruling clearly shows Social Security now considers fibromyalgia to be a medically determinable impairment. To see this ruling go to Social Security's web site by clicking on the ruling SSR 12-2p.
There is not a listing for fibromyalgia so unless your doctor, with help from your representative, can show you equal one of the other listings you will have to use your limitations from your fibromyalgia to show you are disabled. If fibromyalgia is one of your medical conditions there are a few things you should know. First, you should be diagnosed and seen regularly by a rheumatologist, the diagnosis should include a physical and neurological exam including trigger points. It is important that you are being treated by a rheumatologist because SSA gives these doctors' opinions more weight when it comes to this condition. Make sure all the rheumatologist's records are submitted and that you have a fibromyalgia Medical Source Statement completed by him or her in your file.
The MSS specifically for fibromyalgia is extremely important because fibromyalgia has many possible limitations that cover both physical and mental limitations. Your testimony in these cases can be extremely important because so many of the symptoms are subjective. It is very important that your testimony come across to SSA and a judge (if it goes to a hearing) as credible. You may even want to have someone who sees you on a regular basis testify as to what you go through dealing with your condition on a daily basis.
It is very common for a person to have fibromyalgia and other medical conditions at the same time. So keep in mind that Social Security will look at all of your medical conditions together and how they limit you.
One difficulty often seen in these cases is that many times a person suffering from this condition will have gone through many doctors trying to find out what is wrong with them. A diagnosis is often times not made for months or years. This can create problems with onset date and sometimes the date last insured for benefit issues (being found disabled while still covered). It is a good idea to have records that show you complaining of your symptoms to other doctors, even if a diagnosis was not made yet. This way the evidence can show you actually were suffering from the condition well before you got a diagnosis and this can possibly lead to an earlier onset date.
An Accredited Disability Representative with more than 20 years experience, Diana Wade believes her clientele can be comfortable knowing that she is recognized by SSA and is a charter member of NADR. To contact Wade call (661) 821-0494, email [email protected] or visit http://www.CaliforniaDisability.net.