FIBROMYALGIA & DISABILITY BENEFITS

In July 2012 Social Security issued Ruling SSR 12-2p on fibromyalgia.  The gist of it is that fibromyalgia may be a medically determinable impairment and it can be the basis for a finding of disability.  

Social Security has instructed all its administrative law judges and other adjudicators to follow SSR 96-7p to evaluate a claimant's statement about symptoms and functional limitations.

This was kind of a milestone for sufferers of fibromyalgia.

For years, fibromyalgia was a little understood disorder and some Social Security judges did not consider it to be a "medically determinable impairment. Judges often ruled that disability could not be established merely on the basis of symptoms and that a medically determinable impairment must be deomonstrated by medical signs and laboratory findings.  There is no laboratory test for fibromyalgia.  It is usually diagnosed by exclusion of other disorders and by locating "tender points."  Many Social Security adjudicators simply did not believe that the disease existed - or if it did - it was not severe enough to cause disability.

Once a medically determinable Impairment (MDI) has been established by a physician (MD or DO), as required under SSR 06-3p, then SSA will look at evidence from any treating source, including those which are not "acceptable medical sources" (non-doctors). Evidence may also include statements by family, friends, former employers, teachers, etc. to establish daily limitations of function over time.  There still is no specific "listing" for fibromyalgia but it may equal another listing--such as 14.09D for inflammatory arthritis.

It is extremely important that the claimant provide Social Security with the full history of fibromyalgia symptoms and treatment over time.  The SSA acknowledges that it is a disease that can "wax and wane."

At last, a Social Security ruling provides judges and other adjudicators with a framework to find that "widespread pain and other symptoms associated with fibromyalgia, such as fatigue, may result in functional limitations that prevent a person from doing the full range of unskilled work.  Persons with fibromyalgia may also have non-exertional physical or mental limtiations because of pain or fatigue.

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Source:  Some of the information in this blog is from NOSSCR, Social Security Forum, Vol. 34, No. 7, July, 2012.

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