Fibromyalgia - Condition and Symptoms
Fibromyalgia, a chronic pain disorder also known as fibromyositis, fibrositis, muscular rheumatism, and FM, is a disabling condition that causes extreme suffering for millions of people in the United States. Although Fibromyalgia is known to cause widespread, lasting pain all over the body, accurate diagnosis of the condition is often extremely difficult because there is no definitely attributed medical cause.
Determining whether a patient suffers from FM can often be determined only through a “diagnosis of exclusion,” after other possible conditions including bone, muscle, or nerve disease, cancer, rheumatoid arthritis, anemia, or possible infection are ruled out by extensive testing.
In addition to chronic, severe muscle and joint pain, symptoms of Fibromyalgia often include balance and coordination problems, difficulty sleeping, recurring migraine headaches, irritable bowel problems, memory and thinking problems (often called “fibro fog”), chronic fatigue, and depression.
Back to topIs Fibromyalgia a Disability?
Many applicants who suffer from fibromyalgia who apply for a social security disability benefits get their applications denied to begin with and this is because the Social Security Administration (SSA) doesn't have a disability "listing" in its Blue Book for fibromyalgia.
However, recently the SSA has published a ruling that provides guidance to disability claims examiners and administrative law judges (ALJs) on how fibromyalgia cases need to be assessed. This ruling has helped to lower the number of fibromyalgia applicants who are denied benefits at their initial application.
Just describing your fibromyalgia symptoms does not mean you will qualify for a social security disability benefits. You have to provide specific evidence about your symptoms related to fibromyalgia and pain and how that impacts your ability to work.
Back to topFiling for Social Security Disability with a Fibromyalgia Diagnosis
If an individual is disabled and can no longer work because of Fibromyalgia, that person may be entitled to disability benefits under Social Security Disability. Unfortunately, there is no listing for Fibromyalgia in Social Security’s guide to disabling conditions (also known as the Blue Book), so proving total disability and achieving disability benefits because of an FM diagnosis can be difficult because there are no specific criteria for approval.
If possible, it is in a claimant’s best interest to apply for disability benefits on the basis of Fibromyalgia in conjunction with other disabling conditions such as Degenerative Disc Disease or Rheumatoid Arthritis, mainly due to the fact that diagnoses of FM are quite difficult to make accurately. As a result, the Disability Determination Services (DDS) that decide to accept or reject Social Security Disability applications are often skeptical of medical professionals using Fibromyalgia as a catchall diagnosis for symptoms of chronic pain. In addition, the DDS will often place much greater value on a Fibromyalgia diagnosis made by a medical specialist, such as an orthopedist or rheumatologist (doctors who focus on bone or tissue disorders), than on one made by a family doctor, general practitioner, or mental health professional.
Lastly, it is imperative that an individual applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) makes sure to communicate with his or her doctor to ensure that the Fibromyalgia diagnosis is explicitly contained in the medical records before proceeding with a disability application. In many cases, enlisting the help of medical and legal professionals to help ensure that all necessary materials are present to completely and accurately support a Fibromyalgia disability case can greatly increase a claimant’s chances for approval.
Back to topMedical Evidence
Providing medical evidence is important to prove fibromyalgia. You have the best chance of getting disability benefits for fibromyalgia if you provide up-to-date medical records, a report from a rheumatologist who confirms your symptoms and/or trigger-point test results, and statements from family and former co-workers who know you suffer from fibromyalgia.
You need to prove that you are experiencing chronic widespread pain, in the back, neck, or chest. You need to provide proof that you are not suffering from another disease like lupus, hypothyroidism, and multiple sclerosis by providing lab tests or x-rays.
The patient must also be suffering from the following:
Repeated occurrences of at least 6 or more fibromyalgia symptoms such as:
- severe fatigue;
- non-restorative sleep;
- irritable bowel syndrome (IBS);
- depression;
- cognitive or memory problems ("fibro fog");
- anxiety.
Other likely symptoms may include seizures, headache, dizziness, muscle weakness, abdominal pain and Raynaud's phenomenon.
Another form of evidence is proving you have at least 10 out of 18 tender points throughout your body. The list of the tender points can be found in SSR 12-2p, SSA's ruling on fibromyalgia.
Back to topWhy a Doctor Is Important
Because there is no widely accepted medical test which diagnoses fibromyalgia your doctor will use diagnostic tools help determine see if another condition may be causing the symptoms. Blood tests are usually conducted to rule out medical conditions which have similar symptoms.
If you cannot find sufficient evidence to prove your fibromyalgia stops you going to work you can ask your doctor to conduct a Residual Functioning Capacity (RFC) Assessment which assesses you ability to lift objects and how easy it is for you to move. stand and sit without help. Your cognitive ability is assessed as well.
Back to topHow Fibromyalgia Can Affect Someone’s Ability to Work
When you are diagnosed with fibromyalgia you may find it hard to carry out daily activities, including working at many different types of jobs. You are likely to experience fatigue, brain fog, and widespread pain which may make it hard to concentrate on daily activities as you are so preoccupied with the pain.
In order to be eligible for disability, you cannot do work and engage in substantial gainful activity (SGA) because of your medical condition. You have to prove that the symptoms from your fibromyalgia will prevent you working for at least 12 mouths.
Back to topYour Fibromyalgia Disability Case
If you are disabled because of a Fibromyalgia disability that prevents you from working prevents you from working, you may well be entitled to Social Security Disability benefits. Although total disability based on a Fibromyalgia condition can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services (DDS) can help to ensure that your Fibromyalgia disability case will have the highest possible chance of success.
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