GETTING SSDI BENEFITS FOR FIBROMYALGIA

 Fibromyalgia afflicts 4 million Americans or about two percent of the US population.  It plagues more women than men.  It is a painful condition that causes aches and diffuse body pain, often accompanied by fatigue and cognitive changes.

Fibromyalgia is often described as an "invisable disease" because it has no physical signs and there are no laboratory tests to confirm it. Yet, it is very real.

Many times, even family members aren't convinced about the seriousness of fibromyalgia.  If you can't convince them, imagine trying to convince Social Security that you are disabled because of this disease.

You need a definite, sharply focused plan to get SSDI or SSI for fibromyalgia.  Here are the problems to overcome:

1. No Blue Book Listing: SSA maintains a Listing of Impairments that breaks down hundreds of medical conditions and separates them according to how they impact the human body. There is no listing for Fibromyalgia in the Blue Book.
   

2. Issues with the “Medically Determinable Impairment” (MDI) Requirement:  You first must convince that Social Security that Fibromyalgia is a Medically Determined Impairment orMDI. This means that your fibro has been established via medical evidence of its existence, rather than just your allegations. Because there are no reliable diagnostic tests specifically for fibro, SSA may find that you do not meet the MDI criteria. In 2012, Social Security issued Ruling 12-2P, explaining what proof they need to consider Fibromyalgia as an MDI. The diagnosis should be made by a rheumatologist, using diagnostic criteria from the American College of Rheumatology (ACR).  A diagnosis from a general practice physician, and especially by a nurse practitioner, doesn't carry much weight.  Get under treatment by a rheumatologist, which is the proper specialist to diagnose/treat fibro.
   

3. Problems Ruling Out Other Conditions:  The symptoms of Fibromyalgia can also be caused by many other diseases.The job of the rheumatologist is to rule out the possibility of other diseases, including:
   

• Hypothyroidism;
• Rheumatoid arthritis;
• Lupus; or,
• Multiple sclerosis.

Narrowing down your ailment and eliminating other possible disorders can be a lengthy process, sometimes taking years.  But it certainly strengthens your SSDI claim and establishes that you have a Medically Determinable Impairment (MDI).

4. Assessments of Your Residual Functional Capacity (RFC):  SSA will want medical evidence of how fibromyalgia affects physical and/or mental functioning. This is called a Residual Functional Capacity (RFC). Your RFC is an evaluation of whether there is other work you can do as a person with fibromyalgia, and SSA will look at positions you have held in the past. The focus will be on your exertion levels, such as how much you can lift, be on your feet, or sit for extended periods of time. If you wait for Social Security to figure out your RFC, you won't like the result.  They nearly always find that your functional limitations are not severe enough to qualify for disability benefits.  The alternative is to get your rheumatologist to provide an opinion about your Residual Functional Capacity.  Caution:  This is not a letter stating something general, such as, "My patient definitely has fibromyalgia and is not able to work."  This is useless.  The doctor needs to complete a detailed form (available from your attorney), which specifies exact limitations in dozens of functions.
   

In short, if you suffer severe symptoms of Fibromyalgia, there is hope of disability approval.  However, it is one of the most difficult diseases to get approved.  And frustrating.  Using an experienced disability attorney (or non-attorney advocate/specialist) can greatly assist you in this journey.  You will not be charged any legal fees until you are approved by Social Security and receive your back pay that you have been waiting for.  More information or consultation:  (256) 799-0297.  The Forsythe Firm.