Fibromyalgia is a complex condition. The widespread pain, chronic fatigue, sleep disturbances, memory issues, emotional distress, and gastrointestinal problems it can cause can be truly disabling. If fibromyalgia, also known as fibrositis or fibromyositis, prevents you from working and engaging in substantial gainful activity, you may qualify for Social Security Disability Insurance (SSDI) benefits.
Unfortunately, getting approved for SSDI for fibromyalgia can be difficult. Not only do doctors not know exactly what causes the condition, but there's no specific test to diagnose it. As a result, fibromyalgia is often a diagnosis of exclusion that's made after ruling out other possibilities like cancer, nerve diseases, and rheumatoid arthritis. To complicate matters even further, the Social Security Administration (SSA) doesn't include fibromyalgia in its Listing of Impairments or “Blue Book,” which means you'll have to go through a lengthy process to prove your disorder is sufficiently disabling. Here's a look at that process and following these tips – and working with an experienced Boston disability lawyer when you apply for SSDI benefits – may help improve your chances for approval.
Establishing Fibromyalgia as a Medically Determinable Impairment
After confirming that you're not participating in substantial gainful activity, the SSA will decide whether you have a medically determinable impairment. You must have a history of widespread body pain that's lasted for a minimum of three months; at least 11 of the 18 tender point sites (as identified by the American College of Rheumatology); repeated manifestations of six or more fibromyalgia signs, symptoms, or co-occurring conditions; and evidence that other disorders that could cause your symptoms have been excluded. The decision hinges largely on the quality and quantity of the evidence you provide with your application.
Keep These Tips in Mind When You Apply
- Provide longitudinal records. As single records that combine data comprised from various sources across the healthcare system, longitudinal records offer a more comprehensive account of your medical history. This is particularly vital when applying for SSDI for a condition like fibromyalgia, where symptoms and/or their severity can wax and wane.
- Have an official diagnosis. Doctors may mention fibromyalgia to patients after ruling out other causes for their symptoms but fail to put an actual diagnosis of fibromyalgia in the medical records. Make sure your medical records include an official fibromyalgia diagnosis, preferably from a specialist, such as an orthopedist or rheumatologist. (However, the SSA tends to put less stock in fibromyalgia diagnoses from mental health professionals.)
- Include medical evidence. Provide the results of the scans and other tests your doctor used when diagnosing you with fibromyalgia.
Proving That Fibromyalgia Prevents You From Working
Next, the SSA will evaluate your application and the accompanying evidence to determine whether your symptoms equal a listing in the Blue Book. Then, it will use the results of a Residual Functional Capacity (RFC) assessment to gauge the severity of your impairments and decide if you're capable of performing any other types of work.
Remember These Hints When Completing Your RFC Assessment
- Keep a journal of your symptoms. Detail all symptoms, not just pain, and include how they affect your daily life and ability to complete basic tasks. Include a copy of your journal when you submit your RFC assessment.
- Provide information on treatments you've tried. Include information on the various treatments, how they worked for you), and whether you experienced any side effects.
- Include additional supporting evidence from non-medical sources. Providing statements from family members, friends, neighbors, clergy members, and others about how fibromyalgia has affected you – and your physical and mental well-being – over time can be helpful.
Find Out How Our Skilled Boston Disability Attorneys Can Assist You
The experienced attorneys with Keefe Disability Law can guide you through the application process and increase your chances of getting approved for the SSDI benefits you need and deserve. Complete our online contact form or call our office at 508-283-5500 (toll-free 888-904-6847) to schedule a complimentary consultation to discuss applying for SSDI for fibromyalgia and how we can help. For more information, request a free copy of our guide, The Five Most Frequently Asked Questions About Social Security Disability.
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If you are looking to apply for social security disability, you need to speak with an experienced social security disability lawyer as soon as possible. Please contact us online or call our Natick Office directly at 888.904.6847 to schedule your free consultation.