Is Fibromyalgia Considered a Disability? Can You Qualify for Benefits?
The Social Security Administration recognizes fibromyalgia as a qualifying disability. But like all other qualifying impairments, a claimant’s approval for disability benefits depends on whether their impairment is severe enough to prevent them from working regularly.
At The Clauson Law Firm, your disability claim is as important to us as it is to you. We know what it means to your ability to meet your daily expenses. We have been helping disabled people get their full disability benefits for decades, and we’ve represented clients with virtually every physical and mental impairment. We’re ready to prepare, file, and fight for the best Social Security disability claim possible for you. Let The Clauson Law Firm help resolve whatever disability benefits issues you are facing. Call 833-680-0177.
Fibromyalgia and Social Security Disability: Understanding the Connection
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. It affects millions of people worldwide, significantly impacting their quality of life and ability to work. For individuals with fibromyalgia who are unable to sustain employment, Social Security Disability benefits can provide crucial financial support. In this article, we will explore the connection between fibromyalgia and Social Security Disability and outline the process of obtaining disability benefits.
Understanding Fibromyalgia
Fibromyalgia is a complex condition that affects the central nervous system, amplifying painful sensations and causing a variety of symptoms. It is often accompanied by other conditions such as migraines, irritable bowel syndrome, and depression or anxiety. While the exact cause of fibromyalgia is unknown, it is believed to involve a combination of genetic, environmental, and psychological factors.
Anyone can get fibromyalgia but more women get it than men. Although children can get fibromyalgia, most cases begin in middle age and your chance of getting the illness increases with age. In many cases, fibromyalgia appears in people who also suffer from other diseases, especially rheumatic diseases, other conditions that cause pain, or mood disorders.
Some of the diseases that seem to be most commonly associated with include rheumatoid arthritis, osteoarthritis, lupus, depression and anxiety, irritable bowel syndrome, and chronic back pain.
Social Security Disability Benefits
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are two federal programs that provide financial assistance to individuals with disabilities. To qualify for SSDI, applicants must have a work history and have paid into the Social Security system. SSI is a need-based program available to individuals with limited income and resources, regardless of work history.
Although SSDI and SSI are very different programs, paying different benefits, and using different eligibility criteria, both programs use the same definition to determine what qualifies as a “disability.”
The Social Security Administration defines disability as
“a medically determinable physical or mental impairment that lasts or is expected to last 12 months (or results in death) and prevents the person from performing ‘substantial gainful activity.”
Substantial gainful activity is assessed by measuring the amount of income a claimant can earn in a month. In 2023, the level of income set as the eligibility cap is $1,470 per month for non-blind disability claimants and $2,460 for blind claimants.
Eligibility for Fibromyalgia
To qualify for Social Security Disability benefits based on fibromyalgia, individuals must meet the following criteria:
- Documented medical evidence: A formal diagnosis of fibromyalgia from a qualified medical professional is crucial. The medical records should include detailed documentation of symptoms, examinations, laboratory results, and treatment history.
- Note about disability lawyers: When you work with an experienced disability lawyer like Clauson Law, the lawyer’s staff will do what’s necessary to collect all the documents you need from all of your healthcare providers. They will contact all the laboratories, scanning facilities, therapists, and other service providers who may have any important records that can make the difference between a successful disability claim and an unwarranted denial of benefits.
- Functional limitations: Fibromyalgia must also significantly limit an individual’s ability to perform basic work-related activities such as standing, walking, lifting, and concentrating. These limitations should be well-documented and supported by medical evidence.
- Note about multiple impairments: It’s important to remember that even if a physical or mental impairment does not fit into the specific criteria to qualify for disability benefits by itself, many claimants win benefits because they have multiple impairments that combine to render the person sufficiently disabled under the Social Security guidelines.
The Social Security Administration uses a measure called Residual Functional Capacity (RFC) to assess the amount of work a claimant who does not fit the precise criteria under a specific claimed impairment or group of impairments. This method of assessing disability claimants often reveals that the person simply does not possess the ability to function in the workplace sufficiently to maintain a job.
Applying for Social Security Disability
The application process for Social Security Disability benefits involves completing detailed forms and submitting supporting documentation. It is essential to provide a thorough description of symptoms, limitations, and the impact of fibromyalgia on daily functioning. Including statements from treating physicians and medical records that demonstrate the severity of the condition can strengthen the claim.
The Disability Evaluation Process
After submitting a claim, the Social Security Administration (SSA) reviews the application to determine disability eligibility. The evaluation process may involve obtaining additional medical evidence, consulting with medical experts, and assessing the functional limitations caused by fibromyalgia. It is crucial to cooperate fully and provide any requested information promptly.
When you work with an experienced disability lawyer, they will communicate with the Social Security case review representatives and keep you informed about the status of your claim. And by having the professionals at Clauson Law handle your SSD or SSI claim, you can be confident that all of the appropriate documents are submitted in an orderly, organized, and compelling package.
When people try to prepare and file their own disability claims, their inexperience and unfamiliarity with the rules often results in important documents being omitted, causing the case to be delayed for months longer than necessary because they need to resubmit missing documents. That kind of needless error does not happen when you work with skilled, experienced, Social Security disability attorneys.
Appealing a Denied Claim
If a claim is initially denied, never accept the denial as final!
Not only is it possible to appeal the decision, a very high percentage of denied claims are reversed on appeal and ultimately win approval of benefits. The appeals process typically involves requesting reconsideration and attending a hearing before an administrative law judge. In rare cases, you might even seek review from the Appeals Council or federal court. It is advisable to consult with a qualified Social Security Disability attorney who can provide guidance and advocacy throughout the appeals process.
Building a Strong Disability Claim
To increase the chances of a successful disability claim for fibromyalgia, consider the following tips:
- Maintain regular medical treatment: Consistent medical care and adherence to treatment plans help establish the severity and ongoing nature of fibromyalgia symptoms.
- Missing scheduled treatments or doctor’s appointments can have a devastating impact on an otherwise justified disability claim. Canceling appointments and rescheduling on occasion is not a problem because records of rescheduled treatments are simple a reflection of real life. But missing appointments or repeatedly canceling checkups is a sign that a claimant may not be in as much pain as they claim, or that they are not cooperating with a possibly beneficial treatment.
- Keep a symptom diary: Documenting daily symptoms, their frequency, and their impact on daily activities can provide valuable evidence of functional limitations. Such diaries are of great help to both your treating physician and your disability law attorney. When people experience a painful episode that is particularly noteworthy, they often forget about it by the time they see their doctor at the next appointment. The symptom diary allows them to report incident that the doctor can use to better diagnose the condition and gauge improvement or deterioration.
- Seek support from healthcare professionals: Obtaining supportive opinions and functional assessments from treating physicians can strengthen the claim.
Obtaining Social Security Disability benefits for fibromyalgia requires a thorough understanding of the eligibility criteria, the application process, and the importance of strong medical evidence. While the process may be complex and challenging, with proper documentation and the support of qualified medical professionals and expert disability law attorneys, individuals with fibromyalgia can access the financial assistance they need to help manage their condition and improve their quality of life.
Contact The Clauson Law Firm for Fibromyalgia Disability Benefits
Clauson Law Firm represents Social Security Disability claimants from all over the United States. You don’t need to live in North Carolina for us to help you win the disability benefits to which you are entitled.
Call us today for answers to any questions you have about fibromyalgia disability benefits or any other physical or mental impairment that you think might qualify for Social Security Disability benefits.
