I've had several email requests on how to apply for SSD with fibromyalgia. If you're at the end of your rope, then now is the time to add more quality living time to your daily life. After all, if you're home you can concentrate on YOU and not the finances.
Although fibromyalgia is a mysterious disorder with subjective symptoms, the pain and exhaustion it causes can severely impact a person’s life. The condition is characterized by over ten different symptoms including widespread and chronic pain, allodynia (i.e., pain caused by pressure), fatigue, sleep disturbance, stiff joints, difficulty swallowing, bowel issues, bladder issues, numbness, tingling, and cognitive dysfunction. The cause is unknown and the symptoms vary from person to person. In the weeks an months before your final decision to apply keep these points in mind:
Because of the subjective nature of the disorder, you will need to work hard to win your case. It’s all about working with your doctors to establish your disorder, proving your case with strong evidence, and staying determined through any necessary appeals. Begin now by picking out a local attorney you'll feel comfortable with. You may even want to call to "get acquainted" letting them know of your plans. You must apply and be denied to retain an attorney, but it doesn't hurt to call and feel comfortable about your "back up" in case your application is denied.
- Visit your doctor regularly. Fibromyalgia symptoms vary from person to person, and the severity can fluctuate over time, so medical evidence is key to winning disability benefits. Your doctor will, of course, need to diagnose you with fibromyalgia after a comprehensive physical exam, but it’s also important that you have regular check-ups so that your doctor can monitor your condition. It is also extremely beneficial to see other specialists, such as an orthopedist, neurologist, or rheumatologist.
- Go over the criteria. The SSA will evaluate your claim based on the duration, severity, and frequency of your symptoms. Specifically, you need to have a history of widespread pain, severe symptoms, and proof that similar disorders were considered and ruled out based on solid evidence. If you haven’t had fibromyalgia for very long or the SSA determines that your symptoms are not severe enough to affect your work, you won’t qualify for disability benefits.
- Carefully prepare the documentation. Evidence is everything when it comes to Social Security disability benefits. Gather all of the medical evidence you can, including lab tests, medical records, doctors’ reports, etc. Statements from your employer will also be helpful if you have missed a lot of work or had trouble performing your duties due to pain, exhaustion, etc. Also, consider keeping a diary in which you track the frequency and severity of your symptoms.
- Don’t give up. Many people initially denied disability benefits go on to win their cases. Keep your head up, review your application, pay attention to deadline dates, and make your appeal. If your evidence is strong and you’ve followed our tips for how to get Social Security disability for fibromyalgia, you have every reason to believe you’ll succeed. –
To get Social Security disability for fibromyalgia, I highly recommend that you work with a disability representative. Not only will he be familiar with the system and ready to answer any questions that you have, but he will also monitor your case and stand by you throughout the application and appeals process.
In July 2012, Social Security issued a ruling explaining when fibromyalgia should be found as a medically determinable impairment. The ruling directs claims examiners and judges to rely on criteria issued by the American College of Rheumatology (ACR) to determine whether an applicant has fibromyalgia, and thus has an MDI "medically determinable impairment".
First, to be considered an MDI, the patient should have evidence of chronic widespread pain, including pain in the back, neck, or chest, and a doctor must have ruled out other diseases (such lupus, hypothyroidism, and multiple sclerosis) through the use of lab tests or x-rays. In addition, the patient must have one of the following:
- Tender points in at least 11 of 18 tender point areas of the body, with tender points occurring on both sides of the body and both above and below the waist. You can see a list of the tender points in the SSA's recent ruling on fibromyalgia.
- Repeated occurrences of six or more fibromyalgia symptoms, particularly fatigue, cognitive or memory problems (“fibro fog”), non-restorative sleep, depression, anxiety, or irritable bowel syndrome (IBS). Other possible symptoms include headache, muscle weakness, abdominal pain, Raynaud's phenomenon, seizures, and dizziness. These are all important components that MUST be documented regularly on your medical chart in each physician's office. By doing so, you are building a solid case.
The claims examiner assigned to your claim will review your medical records to see if they include evidence of the above criteria. The examiner will read your doctor's notes on your complaints of pain, fatigue, and possible cognitive difficulties on all your doctor visits. To assess the credibility of your complaints, the claims examiner (or judge, if on appeal) may ask your doctor to provide information about the extent and duration of your impairments, his or her opinion of how well you are able to function, what treatments were tried and whether they were helpful and had side effects, and how long the doctor expects your ability to function to be limited. The longer your medical record includes evidence of fibromyalgia symptoms and treatment, the better.
If the SSA determines that you have the medically determinable impairment of fibromyalgia, Social Security's evaluation is not over; in fact, it has just begun. The SSA will probably will develop a "residual functional capacity" (RFC) assessment for you to determine if there is any work you can do, including your past work. An RFC assessment is an evaluation of your ability to perform various exertional levels of work; for example, if you can't lift more than 10 pounds, you will be given a sedentary RFC. The SSA bases your RFC on your medical records, opinions from doctors and specialists, and statements from you and possibly your family members. In assessing your RFC, the SSA will rely on your doctor's opinion as to your abilities, like how long you can stand, sit, and walk, how much you can lift, and how well you can focus and remember instructions. These functional limitations are the key to showing the SSA why you can't work.
After creating your RFC, the SSA will compare it to the types of jobs available for someone with your RFC level and limitations. If your RFC rules out all jobs, even sedentary work, you will be found disabled. For more information, see our articles on how Social Security uses your RFC and Tips on Winning Disability With Fibromyalgia.