October 7, 2015
Can I Receive Social Security Disability Payments For Fibromyalgia?
The short answer is yes, you can receive Social Security disability benefits if you have fibromyalgia. In my experience, though, you may face some obstacles along the way. Although doctors have been diagnosing fibromyalgia for many years, it was not until 2012 that the Social Security Administration (SSA) issued guidelines addressing fibromyalgia as a disabling condition in policy ruling SSR 12-2p.
While SSR 12-2p requires that a diagnosis of fibromyalgia be made by a licensed physician, it has been my experience that having a diagnosis from a rheumatologist greatly improves the likelihood that the SSA will accept that diagnosis as valid. As with any type of impairment, Social Security gives greater weight to the diagnoses and clinical findings of a physician who specializes in treating your disabling condition.
SSR 12-2p states that a diagnosis of fibromyalgia alone is not sufficient proof of a disabling condition. Social Security will review the doctor’s treatment notes to make sure that the doctor’s clinical findings and treatment notes over time show that your physical strength and functional abilities are limited enough to be disabling. A short summary of the criteria the SSA considers in determining whether your diagnosis of fibromyalgia is disabling includes:
1. A history of widespread pain that has persisted for at least three months
2. At least one of the following:
a. At least eleven positive tender points on examination
b. Repeated manifestation of at least six fibromyalgia signs or co-occurring conditions, especially fatigue, cognitive or memory problems, waking unrefreshed, depression, anxiety disorder, or irritable bowel syndrome
3. Evidence ruling out other disorders that could cause these symptoms
If you have fibromyalgia, you probably know that this short summary cannot begin to convey how completely your symptoms affect your life. The pain you experience on a daily basis and the other associated symptoms can prevent a person from working a full time job and make it impossible to perform in a competitive work environment. The SSA will take into consideration your inability to physically perform a job, including how pain and weakness affect your ability to sit, stand, walk, or lift. Further, Social Security will consider non-exertional limitations, including symptoms such as “fibro fog” that can limit your ability to concentrate, remember tasks, and remain alert.
If you have been diagnosed with fibromyalgia and find yourself unable to work, it may be in your best interest to apply for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits. The application and appeals process may prove to be confusing and frustrating, but in my experience if you continue to move forward with the process in a timely manner you can increase your chances of winning your claim.