Fibromyalgia is a painful disorder that causes a number of problems for those suffering from it. Because it can interfere with your ability to work, fibromyalgia patients can potentially receive disability benefits. However, the Social Security Administration (SSA) frequently rejects these claims, so it’s not easy to successfully apply.
Having a knowledgeable Social Security disability attorney will improve your chances of receiving compensation for fibromyalgia. You can count on the Lancaster disability lawyers of Nikolaus & Hohenadel, LLP, to help you apply and to appeal an unfair claim denial.
Living with Fibromyalgia
Fibromyalgia is a condition that causes pervasive pain throughout the body. Those who have it experience fatigue along with problems affecting mood, sleep, and memory. Upwards of 5 million Americans suffer from this disorder, the cause of which is not exactly known. It is estimated that physical or emotional trauma can trigger the condition and that genetics may also play a role.
These are a few of the most common symptoms displayed in fibromyalgia patients:
- Intense, widespread aches and pains
- Sleep disorders, such as restless leg syndrome
- Difficulty concentrating, paying attention, and focusing
- Irritable bowel syndrome
- Migraine and other types of headaches
- Interstitial cystitis or painful bladder syndrome
- Temporomandibular joint disorders
The constant pain and fatigue caused by fibromyalgia can have an obvious impact on one’s daily functioning, including work. But the exact symptoms, and their degree of intensity, will vary from one person to another. Some individuals only experience symptoms every once in a while, so they may have difficulties one day but be fine the next. For others, the pain and fatigue are persistent and can make daily activities a real struggle. The variability of this condition makes it more likely that a claim for disability will be rejected.
Fibromyalgia and Social Security Disability
Because fibromyalgia can be unpredictable, it was not always viewed as a “real” condition worthy of the medical community’s consideration. Applicants were frequently denied unless they had a related condition that could be readily documented. However, in recent years, the SSA has decided to include fibromyalgia as a potentially qualifying disabling condition. That’s good news for patients, but it doesn’t mean that applying for disability benefits is a walk in the park.
The difficulty in identifying the underlying causes of fibromyalgia makes it more likely that an applicant will be rejected. There is also a lack of clear, objective evidence backing up a diagnosis. Symptoms are self-reported and cannot be demonstrated with things like x-rays and blood tests.
If you have this condition, you’ll need ample documenting evidence that demonstrates the effect it has on your day-to-day functions. Diagnosis by a general physician will likely be insufficient evidence to support your claim. Instead, the patient should work with a rheumatologist to treat the condition. A specialist will meet with you, evaluate the nature and frequency of your symptoms, and determine whether they meet the criteria necessary for a fibromyalgia diagnosis.
To receive Social Security disability compensation, your fibromyalgia must cause severe impairment. That means, specifically, that it limits your physical or mental ability to perform essential work functions such as standing, walking, and lifting objections. In other words, the SSA has to see evidence that the condition renders you unable to engage in substantial gainful activity.
Criteria that the SSA Relies Upon
Diagnosing a patient with fibromyalgia is not easy. As mentioned above, patients who don’t have another related condition have historically had trouble qualifying for benefits. Although it’s easier to qualify if you do have other issues, such as arthritis, you may still be approved if you have medical evidence to back up your claim.
To determine whether an individual has fibromyalgia, the SSA relies upon criteria put together by the American College of Rheumatology. These criteria establish whether a patient has what’s called a medically determinable impairment. First, there must be evidence that the patient suffered widespread, chronic pain for at least three months. Next, the doctor must have already ruled out other conditions and diseases such as lupus by way of objective medical evidence.
Finally, the patient must have one of the following:
- The presence of tender points in at least 11 of 18 tested areas of the body, on both sides of the body, and above and below the waist; or
- Repeated occurrences of at least six fibromyalgia symptoms (e.g. fatigue, cognitive problems, non-restorative sleep, anxiety, depression, irritable bowel syndrome, muscle weakness, headache)
Tips to Improve Your Social Security Disability Application with Fibromyalgia
To make sure you have the best chance of getting approved for fibromyalgia disability payments, do the following:
- Ensure you have a diagnosis of fibromyalgia in your medical records
- Ask for a referral to a specialist, such as a rheumatologist or an orthopedist, who can also diagnose you with fibromyalgia
- Obtain a copy of your records and understand what’s contained in them before you apply
- Ask your family and friends to write supporting statements describing your condition and how it affects your daily functions
- Gather and organize all of your work records that demonstrate your skills and abilities
A knowledgeable Social Security disability attorney can work with you on these and other critical steps in your application process. Your lawyer will also understand which forms to file, all records that have to be submitted, and how to complete your application. Finally, if your claim is wrongly denied by the SSA, your attorney can help with the appeals process. It all starts with retaining the right legal representation.
Contact Our Lancaster Social Security Disability Attorneys for Fibromyalgia Patients
Applying for Social Security disability benefits can be a challenge. But the disability attorneys of Nikolaus & Hohenadel, LLP, are up to it. If fibromyalgia is disrupting your ability to work, give us a call to find out how we can help. Schedule your consultation with us today.