Fibromyalgia is a chronic medical condition that causes muscle and joint pain, stiffness, sleep problems, and daytime fatigue. As many as six million Americans suffer from fibromyalgia, making the condition the second most common musculoskeletal disease after osteoarthritis

Fibromyalgia is often debilitating. The pain and fatigue of fibromyalgia can be overwhelming, and can make it difficult for a person to work, socialize, and engage in basic activities. For many, the stress of handling life with fibromyalgia leads to depression and social isolation.

Historically, most Social Security disability (SSDI) claims in which the only diagnosis is fibromyalgia have been difficult to prove. This is because fibromyalgia was not well understood.  There was no diagnostic test. A diagnosis of fibromyalgia was often used when symptoms were present, but no underlying cause could be found.

Now we know more about fibromyalgia. The cause of fibromyalgia is still unknown, but scientists have found that there are certain differences in the brain chemistry and blood work of patients with fibromyalgia. This allows for better diagnosis of the condition.

In July 2012, the SSA issued a ruling outlining the criteria for the evaluation of fibromyalgia. Applicants could receive SSDI or SSI for fibromyalgia if they had medical documentation of certain symptoms.

 

To qualify for SSDI or SSI for fibromyalgia, all of the following must be true:

  1. The patient must have medical documentation of chronic widespread pain in the back, neck, and chest.
  2. The medical documentation must show that the doctor ruled out other diseases that could cause the same symptoms, and that lab tests and other medical exams were given to screen for those diseases.
  3. One of the following is true and well-documented:
    • The patient experiences pain in at least 11 of 18 possible tender points on the body. Those tender points that are painful are located on both sides of the body and above and below the waist or
    • The patient suffers from at least six additional fibromyalgia symptoms, including:  non-restorative sleep, fatigue, anxiety, depression,  irritable bowel syndrome (IBS), and cognitive or memory problems.

 

Were you denied SSDI for fibromyalgia? Our Omaha disability benefit lawyers may be able to help you appeal this decision. Contact us at 402-933-5405 to schedule a free consultation. To learn more about how a Nebraska Social Security attorney can help you, request a free copy of our guide: Why You Should Hire an Attorney to Handle Your Social Security Disability Claim.

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