Obtaining SSD Benefits for Fibromyalgia

Fibromyalgia is a disorder that causes widespread muscle pain and fatigue. People in Erie County may want to apply for Social Security Disability (SSD) or Supplemental Security Income (SSI) benefits, but they may have heard that disability claims can be difficult for people with fibromyalgia. While fibromyalgia can present challenges during the SSD and SSI process, qualified applicants can obtain benefits just like people with other illnesses and injuries.

Traditionally, the SSA has focused on finding an objective basis for disability claims. As a result, qualifying for Social Security Disability requires applicants with fibromyalgia to provide objective evidence that their condition prevents them from performing gainful activity to any significant degree. The nature of fibromyalgia can make it difficult to provide an objective basis because there is no single medical test for the disease, and some symptoms, such as pain and fatigue, are subjective.

Symptoms and Causes of Fibromyalgia

Symptoms of fibromyalgia may include:

  • Muscle pain and fatigue
  • Tender points on the body, such as the neck, shoulders, back, hips, arms and legs
  • Trouble sleeping
  • Headaches
  • Morning stiffness
  • Problems with thinking and memory

The exact causes of fibromyalgia are unknown, although certain conditions are associated with this disorder. These include traumatic events, repetitive injuries and some diseases and illnesses. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, fibromyalgia may also occur spontaneously, causing some scientists to believe that it has a genetic component.

Family doctors, rheumatologists and general internists are the types of physicians most likely to have experience with fibromyalgia. The treatment of this disorder typically requires a team, which may include the patient’s primary care physicians and other medical professionals.

Qualifying for SSD with Fibromyalgia

While the subjective nature of some fibromyalgia symptoms can present challenges in the disability benefits qualification process, courts and the SSA are increasingly recognizing that this disorder can result in a medically determinable impairment that qualifies for disability benefits. For example, the United States Court of Appeals for the Second Circuit has recognized that fibromyalgia qualifies as a disability for the purpose of obtaining SSD benefits.

In July 2012, the SSA released a ruling to provide guidance on how it establishes that fibromyalgia is a medically determinable impairment. According to the SSA, a licensed physician must diagnose the patient with fibromyalgia based on a physical exam and the patient’s medical records. This process must be documented and provided to the SSA, which will review the documentation to ensure the patient’s condition is consistent with fibromyalgia. The SSA will also determine if these applicants have experienced changes in their condition, primarily their functional abilities and physical strength.

The SSA relies on criteria for fibromyalgia that were established by the American College of Rheumatology (ACR) in 1990. It may also use the preliminary diagnostic criteria for fibromyalgia published by the ACR in 2010.

Legal Representation May Help Your Case

This additional guidance may assist applicants in obtaining SSD benefits for an impairment caused by fibromyalgia, but the disability application process remains complex. A Buffalo attorney experienced with fibromyalgia and SSD can work with your doctors to properly document your disease, ensure that your case has complete medical documentation and help you through the process.