New Fibromyalgia Disability Ruling from Social Security Administration

• Publish Date: 2012/08/04 - (Rev. 2017/03/16)
• Author: Disability Rights Law Center - Alex Boudov, Attorney at Law
• Contact : california-disability.com

Outline: As fibromyalgia ranges from mild to severe it is difficult to determine if a fibromyalgia sufferer is impaired enough to be entitled to Social Security Disability benefits.

Main Digest

Social Security Administration Issues New Fibromyalgia Disability Ruling - Learn about the latest developments that may affect your right to Social Security Disability benefits.

A common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety. People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long. To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas.

Fibromyalgia is a common, long-term illness marked by body pain and tenderness in the joints, muscles, tendons and other soft tissues. Fatigue, sleep problems, headaches, depression and anxiety may also be signs of fibromyalgia.

The symptoms of fibromyalgia vary in severity over time, and may even be completely absent some days.

Social Security Disability benefits are reserved for those suffering from conditions so severe that they are rendered unable to work. But, given that the symptoms of fibromyalgia can range from mild to severe, it is not always easy to determine whether a fibromyalgia sufferer is impaired to such a level as to be entitled to Social Security Disability benefits. To help clarify the process of disability determination for fibromyalgia, on July 25, 2012, the Social Security Administration released a new ruling that details how they evaluate fibromyalgia in disability claims.

What Does It Take For Fibromyalgia to Qualify As an Impairment Under the New Ruling?

In disability findings in general, the Social Security Administration looks to the sufficiency of medical evidence to support a conclusion that a person's functional abilities are seriously limited. The new ruling describes the type of evidence the SSA needs to determine whether a person with fibromyalgia has a "medically determinable impairment."

A physician's opinion as to a patient's limitations alone is not enough to establish a medically determinable impairment. The physician must diagnose fibromyalgia and provide the type of evidence described in the new ruling, and this information must not be inconsistent with other information in the Social Security Disability applicant's case record.

Specifically, the new ruling sets out two instances in which fibromyalgia may qualify as a medically determinable impairment. First, if all three of the following are present:

• 1) A history of widespread pain - that is, pain in all quadrants of the body that lasted for at least three months
• 2) At least 11 positive tender points on the body (there are 18 "tender point sites" on the body, and they are "positive" if the patient experiences pain when the physician palpitates the area)
• 3) Evidence that other disorders that could cause these symptoms or signs were ruled out

In the second instance, the first and third factors above remain the same, but number two may be replaced by repeated occurrences of six or more fibromyalgia symptoms, signs or co-occurring conditions, chiefly fatigue, cognitive or memory problems, waking unrefreshed from sleep, depression, anxiety disorder or irritable bowel syndrome.

Contact a Social Security Disability Attorney

Filing for Social Security Disability benefits can be a long, challenging process. If your claim is not presented persuasively, it is likely you will be initially denied. If you are sick, or you are dealing with the illness of a loved one, fighting the government for the benefits you deserve is likely the last thing you want to dedicate your time and energy to. Contact a Social Security Disability attorney today to handle your case - by doing so, you'll drastically improve your odds of getting quick and easy access to the payments you need.

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