Social Security and Fibromyalgia

Claimants who suffer from fibromyalgia have long struggled to win their Social Security Disability and SSI claims before the Social Security Administration. The main reason for these difficulties is that there is no objective medical testing to establish their condition. This led many judges to incorrectly view fibromyalgia as a “junk diagnosis.” Social Security Administrative Law Judges would frequently find that fibromyalgia claimants did not suffer a severe impairment under the Social Security Act because of the lack of objective medical evidence.

Unlike other medical conditions such as osteoarthritis of the joints, a herniated disk in the spine, or diabetes, fibromyalgia cannot be detected by x-rays, MRI studies, blood work, or other medical tests. Instead, the diagnosis of fibromyalgia is usually made by a patient presenting to his or her doctor with a constellation of symptoms that are present over a period of months or years.

These symptoms frequently include muscle pains throughout the body, fatigue, depression, anxiety, irritable bowel syndrome and headaches. Despite the lack of objective evidence, anyone who suffers from fibromyalgia knows that it is a very real disease and often disabling. Fibromyalgia can strike a person without rhyme or reason and is very difficult to treat. People who suffer from fibromyalgia often say that the disease makes them feel like they have the flu all the time and that they feel downright miserable.

Finally, Social Security Disability and SSI claimants who suffer from fibromyalgia are getting a little help in their fight for much deserved benefits with a Social Security Ruling that specifically addresses the evaluation of fibromyalgia under the Social Security Act. Social Security Ruling 12-2p became effective on July 25, 2012.

This Social Security Ruling states that fibromyalgia may be a medically determinable impairment when established by appropriate medical evidence, and can be the basis for finding a person disabled. Under SSR-12-2p, a claimant alleging disability due to fibromyalgia must have a diagnosis by a licensed physician who has reviewed that person’s medical history and has performed physical exams. In determining whether to award disability benefits, the Social Security Administration will review the treating physician’s notes and the claimant’s symptoms over time. The claimant’s diagnosis of fibromyalgia must be consistent with the evidence in the Social Security file (i.e. medical records, Disability Reports, Functional Reports, statements from family and friends) and must satisfy the evidence criteria required by either the 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia or the 2010 American College of Rheumatology Preliminary Diagnostic Criteria.

Even with this new Social Security Ruling, fibromyalgia cases continue to be complicated and difficult. However, this Ruling finally establishes a clear set of rules for proving the existence of fibromyalgia in a Social Security case. If your claim is denied by the Social Security Administration, contact the attorneys at McCroskey Law for representation. We can request a hearing before an administrative law judge and help you present evidence necessary for you to win your case.