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Social Security Disability Benefits for Fibromyalgia

Social Security Disability Benefits for Fibromyalgia

Fibromyalgia is a long-term chronic condition which causes pain in the muscle and bones. Although it is listed in the SSA's Blue Book of Impairments under muskoskeletal impairments, people with a mere diagnosis of fibromyalgia are unlikely to win social security disability benefits on the basis of this report. Patients need to be specific as to what exactly your condition causes (fatigue, sleep loss, memory and mood issues).

Fibromyalgia Overview

Researchers have found out in a study that fibromyalgia amplifies painful sensations by affecting the way a patient's brain processes pain signals. Many people with fibromyalgia continue to work full or part-time. The initial symptoms often vary from physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over-time with no single event that triggers the condition.

According to a study, women are 35% more likely to develop fibromyalgia than men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. Unfortunatly, there is no cure for fibromyalgia, which means it has to be controlled by a variety of medical and non-medical resources such as pain medication for recurrent headaches, exercise, health medications, relaxation and stress-reduction methods.

How Fibromyalgia affects Work/Home Lifestyles

Fibromyalgia is a muskoskeletal disorder that can come on and off at any time. While many symptoms can be reduced by various methods mentioned above, some symptoms can last for up to three months. These include widespread pain, fatigue and cognitive disabilities. This greatly reduces a person's ability to perform substantial work and can be a life challenging situation if the patient is the head of the house or the sole breadwinner. Here is how fibromyalgia affects the patient's lifestyle:

  • i. Widespread pain: A dull ache that can last up to three months. Although there is often pain associated with fibromyalgia, it is only considered widespread if its lasts long (weeks to months) and occurs at both sides of the body and above and below the waist. This affects the disabled person's ability to retain focus on work, carry out physical tasks at work (for instance a bus conductor might not be able to perform well on their jobs, or a person could have difficulty to sit for longer periods of time in office);

  • ii. Fatigue: People with fibromyalgia, often awaken tired and with aching pains all over their body. The pain not only affects the day-to-day abilities but also affects the patient's sleep and causes sleeping disorders, such as restless legs syndrome, sleep apnea etc;

  • iii. Cognitive disabilities: The widespread pain and fatigue combined together with the stress and trauma by the condition, causes another side effect of fibromyalgia called 'fibro fog'. This condition impairs the ability to focus, pay attention and/or concentrate on mental tasks;

As discussed, there may be many ways a patient with fibromyalgia might have impacted lifestyles as a result of their condition. Hence it is very important that you have medical records since the beginning of your diagnosis explaining how your condition impairs your ability to perform tasks at work for instance, difficulty in staying put in one place, troubles having sharp focus on your reports, difficulty driving to and fro from work, recurrent migraines affecting your performance greatly, etc. The SSA is aware of how serious fibromyalgia may be; however, you must have medical and non-medical documentation to prove that your disability is severe enough to cause lasting impacts on your life. You might need your physician's statements, employer's statements and any other coworkers testimonials whom you may have worked with and who may testify to the seriousness of your condition. Also fibromyalgia may often co-exist with yet various other painful conditions, which you should also include in your medical documentation while filing for disability. These conditions include:

  • -Irritable bowel syndrome;
  • -Migraine and other types of headaches;
  • -Interstitial cystitis or painful bladder syndrome;
  • -Temporomandibular joint disorders;

Can I win SSDI with fibromyalgia?

While many people with fibromyalgia may work full or part-time and keep their symptoms under control that may not be the case with all patients. The chronic pain and fatigue associated with fibromyalgia make it very difficult for patients to perform substantial gainful activity, SGA. If you have tried various jobs and have found yourselves unable to continue performing work normally, you should consider applying for disability benefits. Remember while you may control your symptoms by many methods, you are eligible to apply for disability if you have physical pain that's directly work-related.

When you file for disability, the SSA will review all the documentations that you provide in order to decide whether your 'fibromyalgiaic' condition is disabling enough to prevent you from working. If your disability examiner, DE does not think that your condition is disabling enough, they might reject your disability application. So, it is very important how you advocate for your disability case in your SSDI application. Since fibromyalgia is difficult to diagnose -- typically, health care providers rule out other conditions through a physical exam and various blood tests -- it's important that you do your homework and present all medical records and testimonials starting from the onset date of your condition, before you apply for disability.

How to Apply for Disability for Fibromyalgia?

The SSA has made it available for disabled patients to file for disabilities using the SSA's online website. Also, if you live alone or are unable to carry out all the processes of finding, compiling and presenting the disability application properly, you can hire a disability attorney to help you in filing your application.

Once your disability application is submitted, you need to wait for a call from the disability examiner, DE to ask basic questions about your disability such as how the condition affects your day-to-day life. You will need to be as specific as you can, describing your limitations and why you cannot work. You will be asked to give the names and addresses of your doctors/physicians/employers. The Social Security office will contact each one for records and testimonials.

In many cases, all of these medical and non-medical documentation will be enough for the DE to come to a conclusion about your disability and a final decision of whether or not to grant you benefits. However, in some cases the DE or other SSA staff may require you to be checked by a physician under the SSA's own list of doctors.

What happens if your SSDI application is rejected?

The SSA has published a ruling explaining when fibromyalgia should be found as a "medically determinable impairment," which is the first test you must pass when applying for disability. In other words, your impairment cannot be established only by your reports of your symptoms. This is the requirement of having a medically determinable impairment (MDI). The ruling directs the disability examiner, DE and the judges, ALJs, to rely on criteria issued by the American College of Rheumatology (ACR) to determine whether an applicant has fibromyalgia, and thus has a medically determinable impairment.

According to the ruling, for fibromyalgia to be considered a medically determinable impairment, 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 as hypothyroidism, lupus and multiple sclerosis) through the use of lab tests or x-rays.

Due to its varying nature of symptoms, the fibromyalgia patients are often denied disability, especially with the application. However, if you're not approved, you will have the right to file for an appeal to the SSA. Since the administrative law judge, ALJ is an expert on these types of cases, the ALJ will give you ample amount of time to describe in detail how the fibromyalgia has retained it very difficult for you to work under substantial gainful activity, SGA. If this is the case, hiring an attorney will increase your chances to win your disability appeals process – because the disability attorneys have experience and know-how of what an ALJ might expect from your appeals presentation. Also a disability attorney may better guide you on what type of questions to expect and how to answer them properly.

For further details you can seek our legal counsel of disability attorneys here.

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Thursday, 01 October 2020