Can I Receive Disability Benefits for Fibromyalgia?

Fibromyalgia is a chronic, potentially disabling condition that scientists don’t yet fully understand. While medical treatment can help manage symptoms, there is no cure for fibromyalgia. Some of the key symptoms include pain in multiple sites in the body, fatigue, and difficulty sleeping. There is no conclusive diagnostic test for fibromyalgia, and the diagnosis is usually based on a combination of symptoms and exclusion of other possible causes.

Fibromyalgia is not listed in the Social Security Blue Book, and for a long time, the complex nature of the condition and the unknowns surrounding it made it very difficult to pursue Social Security disability benefits (SSDI) for the condition. However, in 2012 the Social Security Administration (SSA) issued guidance specifically for claims based on fibromyalgia.

Guidelines for SSDI Claims Based on Fibromyalgia

The SSA now says that fibromyalgia may be recognized as a medically determinable impairment (MDI) if certain criteria are met. There are two sets of criteria that may be employed: the 1990 American College of Rheumatology (ACR) Criteria for the Classification of Fibromyalgia and the 2010 ACR Preliminary Diagnostic Criteria. 

Two of the three criteria are the same under either set of standards: 

• A history of widespread pain (in both sides of the body, above and below the waist, and spinal) that has lasted for at least three months, and
• Evidence that other possible explanations for the symptoms have been excluded through appropriate medical testing

In addition to these two requirements, the SSDI claimant must also show either: 

• Medical testing found at least 11 “tender points” among 18 listed locations on the body, or
• Repeated manifestations of six or more fibromyalgia symptoms, such as fatigue, memory problems, cognitive issues, waking tired, anxiety, depression, or irritable bowel syndrome

Evidence of Disability

If you’re pursuing Social Security disability benefits for this condition, you’ll need objective medical evidence stating so. Diagnosis from your physician is not sufficient, and the SSA will want to review your medical history and the tests used to exclude other possible causes. In addition, you may submit additional information from non-medical sources, including those who have had the opportunity to observe your medical limitations over time. 

Submit the Strongest Possible SSDI Claim

Most SSDI applications are denied at first. The more clear, complete, and on-point your application and supporting documentation are, the better your chances of approval. At Disability Help Group, we have extensive experience with disability benefits claims and appeals. We know what type of evidence is necessary to support your claim, and how to present it effectively. 

To learn more about how we can help you pursue disability benefits for fibromyalgia, call (800) 800-3332 right now, or contact us here for a FREE case evaluation.