Does Chronic Pain Due to Fibromyalgia Qualify Me for Disability?

 Posted on May 24, 2016 in Social Security Disability Medical Conditions

In a previous post, we discussed how a person suffering from chronic pain may qualify for Social Security Disability Insurance benefits. There are many medical conditions that can produce chronic pain. One of the more common is fibromyalgia.

What Is Fibromyalgia?

According to the National Institutes for Health (NIH), fibromyalgia is a “chronic disorder characterized by widespread pain, diffuse tenderness, and a number of other symptoms.” While fibromyalgia is often compared to arthritis, another rheumatic condition, they are significantly different disorders. For one thing, fibromyalgia does not cause inflammation or damage to a person’s joints the way that arthritis does.

The exact causes of fibromyalgia are unknown. The vast majority of people diagnosed with fibromyalgia are women—up to 90 percent of cases according to the NIH. In general, the symptoms of fibromyalgia emerge during middle age. The principal symptoms are chronic pain and fatigue. Other symptoms may include sleep disturbances, cognitive or memory problems, headaches, and numbness of tingling in the extremities. Fibromyalgia also frequently overlaps with other pain disorders, such as chronic fatigue syndrome and inflammatory bowel disease.

How Does Social Security Assess Fibromyalgia?

Unfortunately, because doctors are unable to identify a precise cause for fibromyalgia, it can be difficult to prove it is a disabling condition to Social Security officials. After all, the most common symptom of fibromyalgia is chronic pain—the frequency and severity of which only the patient can describe. And in many cases, Social Security administrative law judges (ALJ) are inclined to simply dismiss subjective complaints of pain as a ruse designed to scam the government.

However, in 2012 the Social Security Administration did publish written guidelines for assessing disability claims based on fibromyalgia. The guidelines explain that a disability applicant should present a physician diagnosis of fibromyalgia “that is not inconsistent with other evidence in the person’s case record.” Social Security notes there are two sets of criteria for diagnosing fibromyalgia. The first set has three requirements:

• The patient has a “history of widespread pain” in all parts of the body that has persisted for at least three months;
• A physical examination establishes “at least 11 positive tender points” out of 18 sites on the body; and
• There is medical evidence excluding any other physical or mental disorder as the cause of the pain and tender points.

The second set of criteria is similar to the first. The key difference is the second requirement. Instead of requiring proof of tender points, a person may establish fibromyalgia through the “repeated manifestations of six or more” symptoms, including fatigue, memory problems, and many others.

A Chicago Disability Benefits Lawyer Can Help

Proving any type of disorder to Social Security is difficult. When your disorder involves chronic pain the hurdle is even higher. A Chicago Social Security Disability attorney can assist you with building your case. Contact Pearson Disability Law, LLC, if you need to speak with a lawyer right away.

Sources:

http://www.niams.nih.gov/health_info/Fibromyalgia/

https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html