Social Security touches the lives of nearly every American, often during times of personal hardship, transition, and uncertainty. Social security programs serve as vital financial protection for working men and women, children, the disabled, and the elderly.
If you or a loved one has been diagnosed with fibromyalgia, you know that doing daily tasks can be painful and altogether impossible. If you have been working and are diagnosed with fibromyalgia, you may find that you are no longer able to work under the constant pain and stress. You may also have many questions like, do I qualify for Social Security, does fibromyalgia qualify, and what types of documents do I need to prove that I am disabled and unable to work?
For more than 20 years, our Fayetteville AR disability lawyers have fought on behalf of hard-working northwest Arkansans. Our team of dedicated attorneys and staff understands that you did not choose to stop working at the trade or occupation, but rather that an impairment, disability, or illness became so severe that you had no other option. Our law firm is proud to work with and fight for the honest, dedicated people of Bentonville, Fayetteville, Rogers, Bella Vista, and all of northwest Arkansas. Call (479) 316-0438 to start fighting for your benefits.
What is Fibromyalgia?
Fibromyalgia is a painful condition that typically develops in women between the ages of 12 and 60. While this medical condition affects men as well, females are ten times more likely to develop it than men. Current estimates state that nearly two percent of the population of the United States suffers from this disease.
Individuals who suffer from this painful condition often experience widespread pain throughout their entire body. Additionally, many people who have fibromyalgia have an abnormally low tolerance for pain. Combined, chronic pain and a low tolerance lead to intensified symptoms that significantly negatively impact their quality of life.
Some individuals who suffer from fibromyalgia often experience anxiety, depression, and extreme fatigue in addition to the physical pain associated with the condition. In many cases, specific parts of the body will be extremely sensitive or painful to the touch. These areas often also swell or appear red. Other common symptoms include muscle spasms, joint pain, and pain in the shoulders, neck, hips, and back.
While each person’s symptoms vary to some degree, the most common symptom is chronic pain. Typically, this pain starts in one part of the body, such as the neck, and continues to another part. The pain could be severe, sometimes feeling like an intense burning. While it feels similar to arthritis, the condition does not grow worse and it does not damage the muscle, soft tissue, or bones.
Other common symptoms include:
- Fatigue, ranging from medium to severe
- Low endurance
- Sleep problems
- Painful menstruation
- Irritable bowel symptoms
- Restless legs
- Concentration or thinking problems (often called the “fibro fog”)
Many of these symptoms resemble other medical conditions. Because there are no tests to confirm that you have fibromyalgia, diagnosing the condition is challenging. Your healthcare provider will test for the condition through a combination of physical exams, an examination of your symptoms, and ruling out other potential medical conditions.
There is no known cause for fibromyalgia. Some researchers believe there could be a link between stress and sleep disorders. There is also some evidence that it is linked to endocrine, immune, or biochemical problems. Demonstrating that you have fibromyalgia is challenging. Proving that the condition seriously impairs your ability to work is even harder. Having our knowledgeable Arkansas disability lawyers by your side will help you in this difficult task.
What is the Definition of Disability?
Not every disability is the same while you may think of someone who is in a wheelchair as being disabled, that is not always the case. Fibromyalgia syndrome is a common and chronic disorder characterized by widespread pain, diffuse tenderness, and a number of other symptoms. Fibromyalgia can make daily tasks difficult if not altogether impossible. To someone who is suffering with fibromyalgia it may seem obvious that they are not able to work under such severe and debilitating pain, however disability is defined in the Social Security Act as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. The person’s medical condition must prevent them from doing work that they did in the past, and it must prevent the person from adjusting to other work. The Social Security Act defines disability very strictly and has set forth a clear set of eligibility rules. The Social Security’s disability program differs from those of private plans or other government agencies and does not provide temporary or partial disability benefits, like Workers’ Compensation or veterans’ benefits do.
To receive disability benefits, a person must meet the definition of disability under the Social Security Act (Act). A person is disabled under the Act if they cannot work due to a severe medical condition that has lasted, or is expected to last, at least, one year or result in death.
What is a Medically Determinable Impairment?
It is not always simple to qualify and be approved for Social Security Disability. The SSA uses very specific terms that may be hard to understand or might be utterly incomprehensible. The specific term used by the SSA to define an acceptable disabling condition is “medically determinable impairment” (MDI). Medically determinable impairment is defined as an impairment that results from anatomical, physiological, or psychological abnormalities, which can be shown by medically acceptable clinical and laboratory diagnostic techniques. A physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings. You will not be able to prove your claim using only your own testimony. The purpose of this step is to weed out frivolous cases in which the claimant has no medically determinable impairment or only a slight impairment. If your treating doctor has provided a diagnosis for your medical condition, you will likely have a medically determinable impairment. However, even if your doctor disagrees on the proper diagnosis, the SSA will usually conclude that you have a medically determinable impairment.
Does the Social Security Administration Recognize Fibromyalgia?
In the past, many of those who applied for Social Security benefits because they had fibromyalgia had their claims denied. This was partially due to the lack of a specific listing for the condition. However, in July 2012, Social Security published a ruling (SSR 12-2p) to explain how disability claims examiners and judges should evaluate whether fibromyalgia constitutes a “medically determinable impairment” (MDI). (To be even considered as a basis for disability benefits, a medical condition must be a severe MDI.) Citing diagnostic criteria used by the American College of Rheumatology (ACR), Social Security found that fibromyalgia should be considered an MDI when the following two criteria have been met:
- There is evidence of widespread chronic pain that has lasted at least three months, and
- Objective tests (laboratory testing, MRIs, and x-rays) have ruled out other possible conditions.
- In addition, one of the following must also be present:
- Positive tender point sites in at least 11 of 18 of tested areas, above and below the waist and on both sides of the body, or
- Repeated occurrence of at least six fibromyalgia symptoms, especially fatigue, cognitive and memory issues (“fibro fog”), waking unrefreshed, irritable bowel syndrome, depression, and anxiety.
Under the new ruling, a claims examiner that is assigned to your claim will review your medical records to determine they include evidence of the above-mentioned criteria. Additionally, the examiner will read your doctor’s notes on all of your complaints, including pain, fatigue and possible cognitive difficulties, including “fibro fog.” The claims examiner may ask your doctor to provide additional information to assess the credibility of your claim, including the extent and duration of your impairments and their opinions of how well you are able to function with the condition. Remember that these criteria establish only whether your fibromyalgia is a medically determinable impairment, not whether you are disabled. Even if you satisfy the above requirements, you still must demonstrate to Social Security that you’re incapable of performing your past work and any other jobs in the U.S.
Proving You Suffer From Fibromyalgia in Arkansas
As discussed earlier, there are no diagnostic tests that will indicate you suffer from fibromyalgia. CT scans, MRIs, or X-rays cannot be used to establish that the medical condition exists. The only way to diagnose fibromyalgia is to consistently document a person’s tender points and correlate this information with reports of sleeplessness and depression. For purposes of Social Security benefits, it is crucial to record how symptoms of this debilitating condition negatively impact an applicant’s ability to perform ordinary tasks.
Currently, there are still questions in the medical community regarding whether fibromyalgia should be treated as a physical or mental impairment. Unfortunately, this lack of consensus affects the legal realm of a disability claim. Many cases are denied because they fail to fit into Social Security’s narrowly tailored boxes. Our Bentonville disability lawyers will help you tick those boxes.
For many people suffering from fibromyalgia, their physical pain is intertwined with their psychological issues. For instance, the chronic pain often results in depression. However, as the person’s level of depression increases, their pain intensifies. This vicious cycle is apparent in many people with the condition.
To prevail in a Social Security claim, you would have to demonstrate that your debilitating pain has a definite and provable underlying cause. When your pain is directly related to a mental condition, the SSA is unlikely to approve your disability claim.
The origin of your diagnosis is important if you wish to obtain disability benefits. Fibromyalgia is a very challenging condition to diagnose. If your diagnosis comes from your family doctor or a general practitioner, it will not carry much persuasive weight with the SSA. To increase your chances of success, your diagnosis should come from an orthopedist or rheumatologist. In fact, our Fort Smith disability lawyers strongly recommend having your condition confirmed by a specialist before beginning the disability claims process. Over half of all claims are denied by the SSA. You want to ensure that you are filing a claim with sufficient and compelling medical documentation.
An experienced rheumatologist can usually correctly identify and diagnose fibromyalgia. However, the problem remains that the condition is pain. It is impossible to prove pain through an objective test, even though it can be medically diagnosed. A medical source statement and detailed treatment notes from a rheumatologist are often necessary to have a hope that your claim will be approved.
Notwithstanding the above, the pain associated with fibromyalgia can sometimes be established through a psychological assessment. Unfortunately, it is not uncommon for someone who has fibromyalgia to be hesitant to believe they are also suffering from a psychological condition as well as a physical one. However, Social Security classifies pain as a psychological symptom, not a physical one. Our Rogers Social Security Disability lawyers will work closely with your healthcare providers and other specialists to develop a body of medical evidence that will assist you in your claim.
Our Fayetteville, Arkansas Disability Lawyers Have the Experience to Help
If you or a loved one has been diagnosed with fibromyalgia and are considering filing for SSI, you should consider hiring an attorney who can help you navigate the intricate process and who has proven results. For more than two decades, our Springdale Social Security Disability lawyers have worked to secure benefits for the people who need it most. If you or a loved one has a medical condition and cannot work, it is important to speak with one of our experienced disability lawyers. You can arrange for a free legal consultation by calling (479) 316-0438.