Fibromyalgia Social Security Requirements
The SSA will first look to see that a person has a total disability. A total disability is a condition that is proven by a doctor. This is what the SSA calls a medically determinable impairment .
When assessing an MDI, the SSA will closely evaluate the medical source. Only a medical doctor is acceptable. The SSA will look beyond the diagnosis of fibromyalgia. The medical source must provide a substantial amount of proof.
This evidence includes a medical history review and a physical exam. From there, the SSA will review and assess the doctors notes to see if they show a fibromyalgia diagnosis. The SSA will then evaluate the symptoms and physical abilities of the patient as well.
Fibromyalgia And Disability are complicated. The disability must also:
- Have lasted, or be expected to last, for a full year; or
- Be expected to result in death; and
- Prevent substantial gainful activity
Fibromyalgia is a complex disorder that can be confused with other issues. People with fibromyalgia often have other disorders as well. People with FM may have headaches. People with FM may also have joint problems. Some people even have depression.
Many individuals with fibromyalgia are women. Other symptoms include extreme fatigue and difficulty thinking. Research shows that people with FM have a different brain chemistry. This makes the pain worse.
Sometimes, the pain is too much. It can be impossible to work. This is why Fibromyalgia SSA Disability benefits are so needed.
How To Win A Fibromyalgia Disability Case
Are you filing a claim under your employers group disability plan due to suffering from Fibromyalgia? If so, then you must show medical evidence that supports your disability claim. For example, Fibromyalgia symptoms such as memory loss and irritable bowel syndrome can be clinically diagnosed. If these symptoms prevent you from performing the duties of your job, then you can base your claim for disability benefits on them.
Additionally, you must show that you are receiving treatment for your disorder. Treatments for Fibromyalgia will vary depending on which symptoms you are experiencing. However, in most cases, treatment for Fibromyalgia consists of a combination of non-drug therapy and medication prescribed by a rheumatologist. Your fibromyalgia disability insurer will want proof that you are consistently seeking the appropriate forms of treatment.
Further, you must show that your Fibromyalgia symptoms are severe enough to impact your workplace performance. Our attorneys will help you compile a list of job duties that are impacted by those symptoms, as well as giving you methods to document how your limitations impact how you do your occupation.
Even still, filing a successful Fibromyalgia long term disability claim is difficult. ;You should consult with an experienced disability law firm as soon as possible. The lawyers at Tucker Law Group can help you present your case in the best possible light.
Is It Possible To Be Approved For Ssd With Fibromyalgia
Contrary to what you may have read elsewhere, it IS possible to be approved for Social Security Disability benefits with fibromyalgia; or;chronic fatigue syndrome;, as long as you meet the Social Security Administration’s criteria.
A 2012 policy update offered;guidance for evaluating claims involving fibromyalgia. The Social Security Administration also offers information on;evaluating evidence of chronic fatigue syndrome.
To be eligible for benefits, you must:
- Have an adequate work history
- Be unable to work for an extended period of time
- Have an illness or injury that is unlikely to improve within the next 12 months
It’s a misconception that there’s a “list” of conditions that are covered by SSD. Rather than maintaining a list, the agency looks at whether an individual’s symptoms are severe enough to be disabling and reasonably prevent employment.
You also have to have an adequate work history, which can pose a problem for people who become chronically ill when they’re young. If you haven’t worked long enough to be eligible, you may still qualify for;Supplemental Security Income .
However, being approved for SSDI benefits is not an easy process by any means, and most applications are rejected on the first attempt. More people are approved during an appeals process that can take a considerable amount of time.
If you are eligible for SSD, the steps ahead will help you avoid common pitfalls and strengthen your case.
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How To Document Your Fibromyalgia Disability Case
Get a proper diagnosis of fibromyalgia from a rheumatologist.Make sure the SSA has all your relevant medical records.Ask your physician to complete a Residual Functional Capacity form.RFC
- sitting, standing, and walking, both at a time and total in an 8-hour workday
- lifting and carrying weight
- bending, stooping, balancing, crouching, and crawling, and
- maintaining punctuality and proper attendance at work.
Keep a journal of your symptoms.
Obtain statements from third-parties familiar with your symptoms and limitations. Third-party reports from friends, family members, and especially former co-workers can bolster your disability case. These reports should include the individual’s first-hand observations of your physical or mental limitations, rather than providing opinions on your medical issues.
Contact an experienced disability attorney to handle your case. A disability attorney will work with you and your doctors to present the strongest possible case to Social Security. Most disability lawyers charge you a fee only if you win your case, and the attorney’s fee is collected from the backpay owed to you from Social Security.
|Take our disability quiz to help you determine whether you qualify for benefits.|
Your Fibromyalgia Disability Case
If you are disabled because of a Fibromyalgia disability that prevents you from working, you may well be entitled to Social Security Disability benefits. Although total disability based on a Fibromyalgia condition can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services can help to ensure that your Fibromyalgia disability case will have the highest possible chance of success.
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Disability Benefits For Fibromyalgia
Social Security Disability Lawyers: Riverside, Orange;& San Bernardino Counties
Disability Benefits for Fibromyalgia
On the one hand, it may be more difficult to get long-term Social Security Disability benefits for a diagnosis of fibromyalgia, because in fibromyalgia, there are often no objective diagnostic tests, including lab tests, x-rays, or imaging studies , that confirm the diagnosis of fibromyalgia. Social Security may therefore take the position that because there are no objective’ abnormal findings, the medical records don’t prove you have fibromyalgia or that your fibromyalgia pain is real.;How then can you can prove to Social Security that you have fibromyalgia and that your fibromyalgia pain is real?;Before we talk about that, it may be helpful to first review the causes of fibromyalgia and how it is diagnosed.;What Causes Fibromyalgia?
The actual cause of fibromyalgia is not known. Several theories have been proposed, but they are only theories. Since there is no known;cause, it stands to reason that there is also no known;cure;for fibromyalgia. ;The most commonly proposed theories as to how people develop fibromyalgia include the following:
;What Are the Symptoms of Fibromyalgia
- Widespread pain index 7
- Symptom severity scale score 5 or WPI 3 – 6
- SS scale score 9
- Absence of another disorder that would otherwise explain the pain
- Lift or carry, is;less than 10 pounds
- Walk or stand, is;less than 2 hours;
- Sit, is;less than 6 hours
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What Medical Conditions Qualify For Disability Benefits
Any medical condition can qualify for disability benefits. Generally speaking, most disability benefits programs in Canada do not give benefits based on a medical diagnosis. Rather, they provide benefits based on the level of disability caused by the medical condition. So the focus will always be on the level of disability caused by your medical condition, rather than only the name of your medical condition or diagnosis. To qualify for benefits, you must show that the level of disability from your medical condition meets the eligibility criteria of the disability benefits plan in question.
Following is a list of common medical conditions that qualify for disability benefits. For each of these conditions we discuss the unique challenges you will face.
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How Is Your Disability Application Evaluated
The SSA takes all documentation into consideration before making a decision on your disability application. Once you submit your application, a team of doctors that works with the SSA will evaluate all of its components.
The team of doctors will also include a psychologist to see if FM has resulted in any mental impairment. These impairments are based on:
- at 800-772-1213, or if youre hard of hearing, TTY 800-325-0778
Until March 2020, you were also able to apply for benefits at your local Social Security office. However, in-person service is currently suspended due to the COVID-19 pandemic.
The SSA says you can apply for benefits as soon as you receive a fibromyalgia disability diagnosis.
Why Winning Disability Benefits Is Complicated With Lupus And Fibromyalgia
Lupus and fibromyalgia are the kinds of medical condition that change over time. Physical and mental symptoms might unpredictably wax and wane.
Thats difficult to explain to disability claims examiners.
Your medical records also might be complicated if you went to many different doctors searching for an explanation for your symptoms.
Fibromyalgia, in particular, doesnt often come with clearly observable, objective medical evidence to prove it is afflicting your body and affecting your ability to work. A diagnosis relies on your reports of how youre feeling.
Thats a tough hurdle for a Social Security Disability claim.
Social Security requires that a medically determinable impairment come with appropriate medical findings.
When your case reaches the level of a hearing with a Social Security administrative law judge, you might find the judge using this lack of objective diagnosis as a way to deny your disability claim for fibromyalgia.
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Filing For Future Years
If your Disability Tax Credit application has been approved you or your supporting person may then claim the Disability Tax Credit for all future years during which the impairment remains. As mentioned earlier it is possible to receive a judgement of permanent impairment in which case you or your supporting person will be able to automatically claim the DTC on your or their tax return every year. Keep in mind though that, as mentioned earlier, such grants of permanent disability are rare.
What Conditions Automatically Qualify You For Disability
Some conditions automatically qualify for disability benefits if you have a confirmed diagnosis. The Compassionate Allowances List Acute leukemia . Lou Gehrigs disease Stage IV breast cancer. Inflammatory breast cancer. Gallbladder cancer. Early-onset Alzheimers disease. Small cell lung cancer. Hepatocellular carcinoma.
What Help Is Available To Me
Chronic pain disorders like fibromyalgia can take its toll on a persons day-to-day activities. As the pain persists and worsens, even the most common tasks we take for granted like getting up to use the restroom become monumentally difficult challenges.
To combat fibromyalgia symptoms, the Canada Revenue Agency provides disability benefits to help maintain differently-abled Canadians standard of living. In the case of fibromyalgia, the Disability Tax Credit is one such program available to Canadians to offset any financial obstacles for chronic pain treatments.
Claiming a fibromyalgia Disability Tax Credit is tricky. The DTC application process can be lengthy and complicated, so a large number of differently-abled Canadians dont submit a claim.
And thats where we can help.
The National Benefit Authority specializes in all things related to the Canadian Disability Tax Credit. As Canadas biggest service provider of the DTC, our in-house specialists are experienced in filling out the tedious paperwork , helping to determine our clients disability tax credit eligibility, and recovering previously rejected DTC claims. We do all the difficult, draining work for you, so you and your family can focus on your recovery, and whats important to you.
The Disability Tax Credit amount differs on a case-by-case basis, though some claims can be upwards of $50,000 per application. Get the Canadian disability benefits youre entitled to by working with the NBA!
Fibromyalgia And Disability Benefits In Detail
The level for SGA is a monthly amount of earnings. Blind individuals are permitted to make more and still qualify. The SGA amount usually changes slightly every year.
As of 2019, non-blind individuals cannot earn over $1,220 for the month. Blind persons can earn as much as $2040. If you exceed SGA, you do not qualify for benefits. People with short-term and partial disabilities do not qualify.
People with Fibromyalgia Qualify For Disability if:
These criteria can be very complicated. The SSA will require a lot of medical proof. You will have to show a diagnosis. You will have to show a history of problems. You will need a lot of paperwork. You may need second opinions. Sometimes, the SSA will ask that you visit a specialist.
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Filing An External Appeal
An external appeal may be more effective than an internal appeal because it allows a third party, the court system, to interpret your eligibility for benefits.
After gathering evidence to support your fibromyalgia-based disability claim, your lawyer may be able to negotiate an out-of-court settlement with the insurance carrier.
If the insurance carrier refuses to make a settlement, your lawyer may be able to defend your rights in court. The court may award you compensation if it determines the insurance carrier denied you unfairly.
Fibromyalgia: Causes Symptoms And Treatment
Fibromyalgia, also known as fibromyositis, fibrositis, or fibromyalgia syndrome , is a chronic illness marked by widespread pain and tenderness in the muscle, joints, tendons, and soft tissues. It has no known cause, but may arise from a combination of genetic factors, physical injuries, emotional trauma, and lifestyle. The symptoms of fibromyalgia are many, but generally include diffuse pain or soreness, fatigue, digestive problems, dizziness, headaches, and numbness or tingling in the hands and feet. Common cognitive and psychological manifestations of the illness include memory issues , depression, and anxiety.
Treatment for fibromyalgia generally involves a fair amount of experimentation. Many physicians prescribe a combination of physical therapy, exercise, cognitive-behavioral therapy, and medication to manage the symptoms of fibromyalgia.
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Get Help From Professionals
More so than in other cases, hiring a lawyer to appeal a denial of benefits for fibromyalgia can really help, since disability lawyers are familiar with the Social Security ruling on fibromyalgia and the latest court decisions on when disability should be granted for fibromyalgia. This knowledge can help disability attorneys find errors made by the claims examiner or judge in the disability determination and use them to your advantage.
In addition, if only a primary care physician or internist has given you a fibromyalgia diagnosis, try to arrange a visit with a specialist; a diagnosis made by a rheumatologist will be more credible to a disability examiner or judge and will strengthen your Social Security disability claim or appeal. If cognitive or mental issues add to your inability to work, a neurologist’s opinion may be helpful as well. Your primary care doctor’s opinion can also be helpful, not so much on the diagnosis of fibromyalgia, but to supplement the rheumatologist’s opinion on the details of your claim.
Winning Social Security Disability Benefits For Fibromyalgia Requires Specific Medical And Vocational Evidence
SSA will want to know whether you have a medically determinable impairment, and your condition so limits your functional abilities that it keeps you from working or as SSA calls it, performing any substantial gainful activity.
What evidence does the SSA need to find that fibromyalgia is disabling?
- Objective, diagnostic medical evidence. In cases of fibromyalgia disability, SSA wants to establish the presence of a medically determinable impairment of fibromyalgia. SSA will consider either of the following two sets of criteria for diagnosing FM:
- 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia.Criteria include history of widespread pain throughout your body for at least three months, the 18 tender points test, and evidence that other disorders that could cause the symptoms or signs are excluded. or
- 2010 American College of Rheumatology Preliminary Diagnostic Criteria.Criteria include history of widespread pain throughout your body for at least three months, repeated manifestations of six or more FM symptoms, signs, or co-occurring conditions, and evidence that other disorders that could cause the symptoms or signs are excluded.
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Know The Status Of Fibromyalgia Disability In Canada
The first question, Is Fibromyalgia considered a disability in Ontario, is an easy one. It is, but to be successful with a claim, its wise to hire a lawyer and assemble all the documentation noted above. Next, its important to understand that getting CPP disability benefits represent one of eight types of payments you can get if you can show that Fibromyalgia keeps you from working. Other categories of benefits you might be able to get include employment insurance, short-term disability, a tax credit, provincial benefits, workers comp, veterans affairs benefits, and long-term disability insurance.