woman in painCan I get SSDI for Fibromyalgia?

Fibromyalgia has been one of those nebulous diseases that people were diagnosed with when nothing else fit and the doctor could not determine the source of a problem. It has been contested that the disease even actually exists. For a long time the Social Security Administration did not feel that having Fibromyalgia was an adequate reason to provide Social Security disability benefits (SSDI). However they have added it to the list of conditions that may enable a person to receive benefits.


What is Fibromyalgia?

 Fibromyalgia is a relatively newly designated disease, first defined in 1990 and then re-defined just five years ago. It has many different symptoms ranging from widespread musculoskeletal pain to bowel and bladder problems, mood disorders and fatigue. Some people report sensitivity to light, noise and/or touch as well as memory problems.

The cause remains a mystery, but it is believed it may stem from a misfiring of the central nervous system. Anxiety and depression may play a role in causing the central nervous system to become overly stimulated. There is no available test to diagnose it and it remains to be a diagnosis provided when everything else is ruled out.

It is believed that about 5% of the world’s population suffers from this syndrome. Women seem to be more affected than men at double the rate for men. Genetics may play a part in who contracts the disease.

Treatment for Fibromyalgia

Treatment is as varied as the symptoms of fibromyalgia itself. Most treatments are aimed at reducing whatever symptom the patient complains of whether it is pain or irritable bowel or anxiety. Doctors also recommend the patient get adequate sleep and eat a healthy diet while attempting to remove life stressors. Prescription pain medications are sometimes prescribed, but most doctors frown on that treatment as it has not been proven to be affective over the long term. Anti-depressant and nerve medications have shown to be effective for some patients.

Fibromyalgia and SSDI

Since fibromyalgia symptoms range from slight to severe, having the disease without other factors may result in the initial denial of Social Security disability benefits. The reason cases are denied is that Fibromyalgia is a “hidden” disease. Its cause cannot be determined and the physician, as well as the Social Security Administration, must rely on the patient’s own words about their symptoms. Often there is not additional proof such as would come from diagnostic tests.

Furthermore, the SSA must be able to determine that you are unable to work gainfully due to the disease, not just that you have fibromyalgia and that you suffer from it.

The SSA will consider fibromyalgia to be a medically determinable impairment (a disease that MIGHT qualify for benefits) when the applicant has had wide-spread chronic pain for at least the past three months and all other causes have been diagnostically ruled out. In addition, the applicant must also have either tenderness or pain at at least 11 of 18 specified points and/or repeated occurrence of at least six of the following symptoms:

$11.       Irritable bowel,

$12.       Fatigue,

$13.       Cognitive or memory problems,

$14.       Anxiety,

$15.       Depression and/or

$16.       Waking up without feeling rested.

Winning SSDI Benefits for Fibromyalgia

As stated previously, although the SSA has decided that fibromyalgia is a disease that can be considered for disability benefits, it is often difficult to actually be approved if that is the only physical impairment the applicant suffers from. In order to be awarded benefits you must show that the symptoms are so severe that it substantially hinders your ability to work your former job or other jobs.

You should be able to provide excellent medical records to show that you have been tested for various medical problems that rule out treatable causes for your symptoms.

Because the disease is hidden, you should also have notarized testimony from several people to substantiate your claims of inability to work. These witnesses should be co-workers, supervisors, friends and family members. Take your time to develop a good cross-section of people who know you well and can provide solid personally-witnessed testimony to your difficulties. You should also submit any work records such as attendance sheets or derogatory work reviews to prove that your illness is causing work-related problems.

You will probably want to undergo psychological testing to prove anxiety and/or depression and to affirm that anti-anxiety medication does not relieve your symptoms enough to work gainfully or hinders your ability to work due to the dosage required.

Be sure to include all of your medical conditions on your initial application. You have a much better chance of being approved if you have other physical problems in addition to fibromyalgia that hinder your work ability.

Have tests conducted by several different doctors to rule out other health problems. A specializing doctor, such as a rheumatologist, will carry more weight on your application or in your denial hearing that a general practice physician.

Fibromyalgia Application Denied

Some reports are that the majority of applicants with fibromyalgia as their primary reason for disability are denied at the initial application and first appeal stages. This is because the reviewers are simply looking at paperwork submitted by the applicant and physicians. Normally this paperwork does not tell the full story of the debilitation this disease is causing the applicant. However, if an appeal is made before a judge and the personal aspects can be entered into testimony the patient often wins benefits. Having a disability lawyer properly present your case can be vital to success.

You, It and Them

Fibromyalgia affects every aspect of the patient’s life. While the SSA simply looks at how the disease hinders the ability to work, the patient must interact with family, stressors and work. Obtaining help from medical experts, taking medications as prescribed and trying to live a healthy lifestyle may all help to reduce the symptoms, but when the disease prevents you from working substantially and gainfully it is time to get help from the Social Security Administration in the form of SSDI benefits too. Contact one of our lawyers today by completing the form on this page. We will provide you with a FREE case evaluation and offer options going forward. 



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