This is the requirement of having a medically determinable impairment MDI. The ruling directs claims examiners and judges to rely on criteria issued by the American College of Rheumatology ACR to determine whether an applicant has fibromyalgia, and thus has a medically determinable impairment. In short, the SSA must see medical signs of an impairment that could reasonably be expected to produce your symptoms.
Proving this can be difficult with FM, since the illness is usually characterized by subjective reports of widespread pain, tenderness in the muscles, joints, and soft tissues, fatigue, dizziness, and "fibro fog. According to the ruling, for fibromyalgia to be considered a medically determinable impairment, the patient should have evidence of chronic widespread pain, including pain in the back, neck, or chest, and a doctor must have ruled out other diseases such lupus , hypothyroidism , and multiple sclerosis through the use of lab tests or x-rays.
In addition, the patient must have one of the following:. The claims examiner assigned to your claim will review your medical records to see if they include evidence of the above criteria. The examiner will focus on your doctor's notes on your complaints of pain, fatigue, and possible cognitive difficulties. To assess the credibility of your complaints, the claims examiner or judge, if on appeal may ask your doctor to provide information about the extent and duration of your impairments, his or her opinion of how well you are able to function, what treatments were tried and whether they were helpful and had side effects, and how long the doctor expects your ability to function to be limited.
The longer your medical record includes evidence of fibromyalgia symptoms and treatment, the better. If the SSA determines that you do have a medically determinable impairment, fibromyalgia, Social Security's evaluation is not over; in fact, it has just begun.
The SSA will develop a "residual functional capacity" RFC assessment for you to determine if there is any work you can do, including your past work. An RFC assessment is an evaluation of your ability to perform various exertional levels of work; for example, if you can't lift more than 10 pounds, you will be given a sedentary RFC.
At that age, the Social Security Administration considers you to be a younger individual and presumes that you are not disabled based upon their regulatory guidelines. The diagnoses of fibromyalgia is based upon a combination of subjective symptoms which cannot easily be established and are not always well documented. The SSA relies heavily on medical records when making disability determinations. If your complaints are not substantiated by the medical records, your claim will most likely be disapproved.
While you are not required to utilize the services of an SSDI lawyer during the benefit application process , it is crucial to put your best case forward from the very beginning. If Fibromyalgia is your primary disabling condition, you should consider consulting with an experienced Social Security Disability attorney before entering your claim. If you are denied benefits at the initial stage , it then takes a significant period of time to get a hearing date before an Administrative Law Judge ALJ , with some offices reporting a wait of months.
See more ». This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks. By continuing to browse this website you accept the use of cookies. Click here to read more about how we use cookies. Get My Free Case Evaluation! Fibromyalgia Symptoms that Can Qualify You for Social Security Disability Fibromyalgia symptoms can be different in different people and change over time. You could still qualify with other symptoms.
Contact Us Today! Although it may be impossible to do, try to avoid being diagnosed with fibromyalgia by a mental health professional. Because, in the same way that family doctors misdiagnose their patients and overuse the fibromyalgia diagnosis, so do psychiatrists. This is a regular occurrence, in fact, for patients who are being treated for depression.
Nevertheless, a fibromyalgia diagnosis by a mental health practitioner is usually interpreted by a disability examiner to mean this: that the disability claimant's symptoms and complaints are psychosomatic in nature.
In other words, all in their head. Therefore, again, for the fibromyalgia sufferer who is trying to win disability benefits, it is always sound advice to seek a supporting diagnosis from a specialist like a rheumatologist. All Social Security disability cases are decided chiefly on the basis of a claimant's records. This is true at the intial application level, reconsideration level, and at the hearing level. Applying for disability without knowing what your records state about your condition is unwise.
Many claimants have been surprised to find that the doctor who claimed to support their case did not indicate the same level of support in his or her treatment notes that he or she submitted to the SSA.
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