Fibromyalgia Disability Ruling from Social Security Administration

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

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Fibromyalgia is 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. 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.

Attribution/Source(s):

This quality-reviewed article relating to our Fibromyalgia section was selected for publishing by the editors of Disabled World due to its likely interest to our disability community readers. Though the content may have been edited for style, clarity, or length, the article "Fibromyalgia Disability Ruling from Social Security Administration" was originally written by Disability Rights Law Center, and published by Disabled-World.com on 2012-08-04 (Updated: 2021-08-13). Should you require further information or clarification, Disability Rights Law Center can be contacted at california-disability.com. Disabled World makes no warranties or representations in connection therewith.

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