But in 2012, Social Security Ruling 12-2(p) changed that. This ruling recognizes that Fibromyalgia may be a medically determinable impairment which may be disabling.
As with most other diseases, a diagnosis of fibromyalgia does not automatically qualify for a disability benefit. As with other impairments, Social Security will consider the claimant's
- Age
- Education
- Past relevant work experience, and
- Residual Functional Capacity
It is necessary to establish the severity and frequency of symptoms before a disability benefit will be approved. Basically, if the claimant is under age 50, it will be necessary to prove that he/she cannot perform any type of work which exists in the national economy--including unskilled, sedentary work.
If the claimant is over age 50, depending on education and past work experience, it may only be necessary to prove that he/she cannot perform any past relevant work--i.e., work he/she has performed during the most recent fifteen-year period prior to filing for disability. Thus, the ability to perform a job that the claimant had back in 1999, for example, would not be disqualifying, since it was outside the fifteen-year period.
Something you may encounter with fibromyalgia is the need for a specialist to diagnose the illness. Social Security likes to see a diagnosis and treatment by a rheumatologist. Also, they want the diagnosis to be based on criteria established by the American College of Rheumatology (ACR). There are some specific things they want the doctor to check before making a diagnosis. If the doctor is not a rheumatologist, Social Security will sometimes question the validity of the diagnosis.
Also, there is sometimes confusion about the ACR's criteria for fibromyalgia. There are actually two different sets of criteria published by the American College of Rheumatology: one from 1990 and another from 2010. The 1990 diagnostic criteria require the finding of 11 "tender points." However, the 2010 criteria do not require the finding of tender points. Sometimes, even Social Security judges will insist that your diagnosis is not accurate because no tender points are identified. They are relying on the old (1990) criteria, not the updated (2010) criteria.
Is it difficult to win disability when fibromyalgia is the only impairment?
Frankly, I think the answer to that is, Yes.
There may be many reasons for this. First, it's difficult to win Social Security disability benefits, generally. Also, there is no laboratory test or imaging study to establish this disease. The symptoms will vary somewhat from person to person, although there are certainly common similarities. Still, fibromyalgia will affect individuals differently. Functional limitations can be difficult to establish: how long can the claimant sit, stand, walk? How much can he/she lift and carry? How many days would he/she be absent from work because of the impairment? Finally, there are the old stigmas that judges have a hard time letting go of.
What are my recommendations if you have fibromyalgia and see a disability claim in your future?
1) Involve a rheumatologist in your care.
2) See the specialist regularly and follow prescribed treatment.
3) Keep some kind of diary or journal and write down your symptoms, type and location of pain, and document fatigue, nausea, insomnia--difficulty with memory or concentration-- and any other symptoms, including how often they occur.
4) Talk to your doctor about whether he/she will provide you with a form called a "Medical Source Statement" or "Residual Functional Capacity" in support of a disability claim. Not all doctors will do this, even if they feel you are really disabled.S
Things that may hurt your disability claim
1) Not going to the doctor regularly
2) Failure to follow recommended treatment, not taking medications, etc.
3) Working or going to school after your alleged onset date may have a negative impact on a disability claim. Working and earning wages of at least $1,180 per month will disqualify you for SSDI benefits.
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