Unfortunately, many Social Security disability benefits applicants who suffer from fibromyalgia are denied. This is due in part to the fact that Social Security does not formally list the condition in their Blue Book, which lists medical conditions that qualify for benefits. However, the SSA has published guidelines on how administrative law judges and disability claims examiners can assess specific fibromyalgia cases. So, is fibromyalgia a disability? And how can you get your fibromyalgia case approved for benefits? Let’s find out below.
SSA’s Criteria for Fibromyalgia Cases
Traditionally, the outlook of disability benefits approval for cases where fibromyalgia was the only listed condition were poor. Since symptoms of that specific condition are largely subjective, it is not fully understood and varies from person to person.
However, the SSA has established criteria for fibromyalgia that has allowed sufferers to receive approval. This criteria includes:
- Experiencing symptoms related to the condition for at least three months;
- Documenting evidence that rules out any other condition;
- Giving and obtaining statements from yourself and others that describes your restrictions on daily activities due to the condition; and
- Proving that your condition prevents you from working.
In addition, you must also experience 11 out of 18 tender points on your body, or experience six of the following symptoms:
- Problems with memory or thoughts (fibro fog)
- Irritable bowel syndrome
- Waking up exhausted
- Abdominal pain
While you need to obtain a doctor’s diagnosis for your condition, cases of fibromyalgia are often won based simply on symptoms and limitations. Since disability benefits rely solely on an inability to work, you will need to effectively prove that your condition prevents you from working.
Proper Documentation for Fibromyalgia is Key
The key to any successful disability case is obtaining proper documentation. Documentation must go beyond medical records. Other sources should include records of missed workdays, and a written statement from your employer.
Another great source of documentation is to keep a fibromyalgia diary in which you keep track of all the days that you experience pain. You should also write down how your condition particularly affected your ability to conduct your daily routine each day. Also, take into account the symptoms that you felt on any given day.
Additionally, have your rheumatologist document their professional opinion on how your conditions affects your ability to:
- Lift or carry heavy objects
- Sit, stand, or walk for eight hours a day
- Perform fluid movements like bending, balancing, or crawling
- Keep punctuality and attendance at work
Once you hand over all your documentation, the SSA will review your entire case and decide to either approve or deny your benefits. If your case is subsequently denied, then consult with an experienced disability benefits lawyer to weigh your options.
Call in the Professionals
Is fibromyalgia a disability? While not specifically listed in the SSA’s Blue Book, sufferers of fibromyalgia can still obtain the benefits that they need. Further your chances of success by consulting with a seasoned disability benefits lawyer that knows the SSA’s requirements for the condition. Our knowledgeable legal team at Donald J. Hanrahan is ready to help.