Fibromyalgia Disability Ruling from Social Security
Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2012/08/04 - Updated: 2025/02/14
Publication Type: Informative
Category Topic: Fibromyalgia - Publications List
Page Content: Synopsis - Introduction - Main
Synopsis: This article discusses the Social Security Administration's (SSA) recent ruling on fibromyalgia, providing clarity on how the condition is evaluated for disability benefits. It outlines specific criteria where fibromyalgia can be considered a medically determinable impairment, including a history of widespread pain, the presence of multiple tender points, and the exclusion of other disorders that could explain similar symptoms. Additionally, it describes an alternative scenario where the tender point requirement can be substituted by the presence of six or more common fibromyalgia symptoms like fatigue and cognitive issues. This information is crucial for individuals with fibromyalgia, as it not only aids in understanding the eligibility process for disability benefits but also informs healthcare providers and advocates on how to better document and argue cases for those affected. The article is particularly helpful for disabled individuals, seniors, or anyone dealing with chronic pain conditions, offering them a structured way to approach and potentially secure the financial support they might need due to their disability - Disabled World (DW).
Introduction
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.
Main Content
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 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.
Author Credentials: Ian is an Australian-born writer, editor, and advocate who currently resides in Montreal, Canada. He is the founder and Editor-in-Chief of Disabled World, a leading resource for news and information on disability issues. With a global perspective shaped by years of travel and lived experience, Ian is a committed proponent of the Social Model of Disability-a transformative framework developed by disabled activists in the 1970s that emphasizes dismantling societal barriers rather than focusing solely on individual impairments. His work reflects a deep commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.