Fibromyalgia is a complex medical disorder characterized by widespread pain in the muscles and joints that persists for more than 3 months. Clients often tell me they just “hurt all over”.
Many people who have this impairment also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. It is most common among women aged 20 to 50.
Fibromyalgia is difficult to accurately diagnose because all objective tests such as x-rays and blood analysis are normal. The primary method of diagnosis is a physical exam by an experienced rheumatologist.
When I had my 1st Fibromyalgia case 30+ years ago, many doctors did not believe this disorder was a real medical condition. Many disability Judges did not recognize Fibromyalgia as a legitimate impairment. Fortunately, those days are over.
Legal analysis of Fibromyalgia and Social Security disability.
In 2012 the Social Security Administration adopted SSR 12-2p that sets forth the procedure it will use to evaluate this medical cndition. This Ruling requires the following evidence in order to establish Fibromyalgia as a medical impairment.
First, you must have a physical exam by a licensed doctor.
Second, the findings from the physical exam must be consistent with either the 1990 American College of Rheumatology (ACR) Criteria for the Classification of Fibromyalgia or the 2010 ACR Preliminary Diagnostic Criteria. See https://gpnotebook.co.uk/simplepage.cfm?ID=x20141217144402775001.
To satisfy this 2nd requirement, an individual seeking disability needs records from a rheumatologist. Simply having your family doctor say you have this impairment is not legally adequate.
Once Fibromyalgia is established per SSR 12-2p, SSA will use the criteria of SSR 16-3p to evaluate the severity of the symptoms. The kinds of evidence SSA considers include:
1. The limitations in daily activities caused by chronic pain;
2. The location, duration, frequency, and intensity of the pain;
3. Factors that precipitate and aggravate the pain;
4. The type, dosage, effectiveness, and side effects of medication the individual takes or has taken to alleviate pain;
5. The number and variety of treatments or medical procedures the individual receives or has received for relief of pain;
6. The number of visits to health care providers seeking pain relief.
7. The number of different health care providers the individual has seen in an effort to find pain relief.
8. The emotional impact of chronic pain.
Due to the subjective nature of this impairment, all Fibromyalgia cases are difficult to prove. I believe an individual needs at least 12 months of treatment from a rheumatologist in order to have a meaningful prospect of proving disability to disability Judge. Moreover, it is important for your treating rheumatologist to be willing to support your application for disability.
In summary, Fibromyalgia and Social Security disability is a complex subject. It is impossible to address all of the relevant considerations in a single blog post. If you have Fibromyalgia and are considering applying for Social Security disability benefits, feel free to contact me for a free phone consultation by clicking here – Contact a Disability Attorney.
Valuable information about Fibromyalgia can be obtained from the links below.