If you suffer from fibromyalgia and can’t work, you may qualify for Social Security Disability benefits. But winning disability for fibromyalgia is more complex most people realize. The Social Security Administration (SSA) has special rules for determining if your fibromyalgia qualifies for disability benefits.
First, you must have a diagnosis of fibromyalgia as defined by the 1990 American College of Rheumatology (ACR) for the Classification of Fibromyalgia or The 2010 ACR Preliminary Diagnostic Criteria. It’s very clinical so you may want to consider consulting with a disability attorney if you have questions.
As complicated as it is, you can still win Social Security Disability benefits for fibromyalgia.
How the SSA Defines A Fibromyalgia Disability
In the past, SSA disability examiners would only rule in favor of your fibromyalgia disability if it was accompanied by another medical condition (such as arthritis).
Fibromyalgia was known as a subjective condition. Even now, the causes of fibromyalgia are not understood.
To win disability benefits when you have fibromyalgia, you must have a history of widespread pain. This must include pain in all parts of the body (both the left and right sides of the body and above and below your waist) and skeletal pain. Your pain must be present (or must have been present) for a minimum of three months.
On top of these qualifications, the SSA will ask you to undergo a physical examination to test 18 tender points on your body. These points (nine per each side of the body) are:
- Shoulder muscles
- The muscle near your shoulder blade
- The outer portion of your elbow
- The base of your skull
- Your second rib
- The back and side of your neck
- The area below your hip
- The inner portion of your knee
- The top of your buttock.
A doctor will test all of these points on you by applying a force of nine pounds (approximately the amount of pressure needed to make a small indention in your skin) to determine your pain level in each area. To qualify for Social Security Disability, you must test positive for pain in 11 of these 18 areas.
In addition to this test, your treating doctor must rule out other physical and mental disorders.
As you can see, getting approved for disability benefits when you suffer from fibromyalgia isn’t easy. If you have questions or need help, call Gary Sells in New Orleans for help with your case.
Important Things to do if You Have Fibromyalgia and Need Disability
The most important thing you can do is work very closely with your doctor. In doing so, the goal is to get as much medical evidence as possible to prove you suffer from the symptoms of fibromyalgia. You will also need to show that your fibromyalgia is severe enough that it will prevent you from work for at least 12 months.
If you have fibromyalgia, winning disability benefits is going to be a tough battle. You may be turned down on your first try. If you are denied, you can appeal to an Administrative Law Judge (ALJ). If you do appeal and get a hearing, it’s important for your medical evidence and work history evidence to be organized and presented to the ALJ in a way that will prove you can no longer work because of your fibromyalgia.
Winning disability benefits is never easy – and if you suffer from fibromyalgia, it can be even more difficult. If you can’t work because of your fibromyalgia consider working with a disability attorney.
David Tuggle attended the University of Illinois at Urbana-Champaign where he earned his bachelor’s degree and his law degree. He is currently licensed to practice law in Illinois and Indiana.
He is a member of the Illinois Trial Lawyers Association, the Illinois State Bar Association, the Indiana State Bar Association, National Organization of Social Security Claimants’ Representatives (NOSSCR) and the Vermilion County Bar Association.
David has been voted by other attorneys at being in the top 5% of attorneys practicing Social Security Disability and Personal Injury law.
He lives in Danville with his wife, Sharon, and their four children.