- How Does the Social Security Administration Decide if I Qualify for Disability Benefits for Fibromyalgia?
- About Fibromyalgia and Disability
- Winning Social Security Disability Benefits for Fibromyalgia by Meeting a Listing
- Residual Functional Capacity Assessment for Fibromyalgia
- Getting Your Doctor’s Opinion About What You Can Still Do
How Does the Social Security Administration Decide if I Qualify for Disability Benefits for Fibromyalgia?
If you have fibromyalgia, Social Security disability benefits may be available to you. To determine whether you are disabled by fibromyalgia, the Social Security Administration will consider whether your fibromyalgia qualifies as a severe medically determinable impairment at Step 2 of the Sequential Evaluation Process. See Fibromyalgia as a Medically Determinable Severe Impairment. If your fibromyalgia qualifies at Step 2, the Social Security Administration then considers whether your condition is severe enough to equal a listing at Step 3 of the Sequential Evaluation Process. See Winning Social Security Disability Benefits for Fibromyalgia by Equaling a Listing.
If your fibromyalgia is not severe enough to equal a listing, the Social Security Administration must assess your residual functional capacity (RFC) (the work you can still do, despite your fibromyalgia), to determine whether you qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process. See Residual Functional Capacity Assessment for Fibromyalgia.
Fibromyalgia, also known as fibrositis and fibromyositis, is an impairment characterized by a lack of objective findings. Its cause is unknown, there is no cure, and the symptoms are subjective.
Notwithstanding the lack of objective findings, fibromyalgia can have a devastating impact on your ability to work.
Fibromyalgia is defined by the American Collegeof Rheumatology (ACR) as “widespread pain in all four quadrants of the body for a minimum duration of 3 months and at least 11 of the 18 specified tender points which cluster around the neck and shoulder, chest, hip, knee, and elbow regions.”
Other typical symptoms are irritable bowel syndrome, chronic headaches, temporomandibular joint dysfunction, sleep disorder, severe fatigue, and cognitive dysfunction.
At Step 2 of the Sequential Evaluation Process, you must have a medically determinable impairment that is severe. The Social Security Administration has accepted that fibromyalgia can constitute a medically determinable impairment. A medically determinable severe impairment must be established through medically acceptable clinical and laboratory diagnostic techniques.
Generally, to establish fibromyalgia as a medically determinable severe impairment, you must show:
- Widespread pain for at least three months.
- Pain on palpation in at least 11 of the 18 tender point sites (as identified by the American College of Rheumatology).
- Morning stiffness or stiffness after sitting for a short period of time.
To determine whether you are disabled at Step 3 of the Sequential Evaluation Process, the Social Security Administration will consider whether your impairment is severe enough to meet or equal a listing. The Social Security Administration has developed rules called Listing of Impairments for most common impairments. The listing for a particular impairment describes a degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work. A claimant who meets or equals a listing is considered disabled.
The Social Security Administration has no listing for fibromyalgia. Since fibromyalgia is not a listed impairment, you cannot be found to meet a listed impairment based on your fibromyalgia alone. However, the specific findings in your case should be compared to any pertinent listing to determine whether “medical equivalence” may exist. In other words, you may be entitled to Social Security disability benefits if the severity of your condition equals an existing listing for a different impairment.
If you have psychological problems related to fibromyalgia, they should be evaluated under the mental disorders listings. The Social Security Administration should consider whether your impairments meet or equal the severity of a mental listing. See Can I Get Social Security Disability Benefits for Depression, Bipolar Disorder, or Mania? and Can I Get Social Security Disability Benefits for Anxiety, Phobias, Panic Attacks, Obsessive Compulsive Disorder, or PTSD?