Can I Receive Disability Benefits If I Have Fibromyalgia?

 Posted on December 08, 2015 in Social Security Disability Medical Conditions

Fibromyalgia is a medical condition affecting millions of Americans, mostly women. The key symptoms of fibromyalgia, according to the Mayo Clinic, are pain, fatigue, and cognitive difficulties. In many cases, these symptoms are so severe patients are unable to work and may be entitled to Social Security Disability insurance benefits.

Social Security Fails to Consider “Onset” Date of Woman's Fibromyalgia

Social Security does have specific guidelines regarding the assessment of a fibromyalgia-based disability claim. Fibromyalgia must be diagnosed by a physician. There must be documented evidence the claimant has suffered “widespread pain” over a period of “at least three months.” Additional symptoms Social Security looks for are “fatigue, cognitive or memory problems, waking unrefreshed, depression, anxiety disorder, or irritable bowel syndrome.”

Even with these guidelines, Social Security officials still wrongly deny claims presented by fibromyalgia patients. In a recent case, an Illinois magistrate ordered Social Security to reconsider the claim of a 53-year-old woman diagnosed with fibromyalgia. The claimant testified “she typically had pain all over her body and frequently dropped things.” In addition, her medical records indicated she had “difficulty with fatigue,” anxiety, and depression—all indications of fibromyalgia.

Despite this evidence, a Social Security administrative law judge (ALJ) determined the claimant's fibromyalgia “was not a severe impairment” and denied her claim for disability benefits. The ALJ emphasized the fact the claimant was not formally diagnosed with fibromyalgia until five months after she stopped working (known as the “date last insured” in Social Security language). Nor did the claimant exhibit certain fibromyalgia systems until after the date last insured.

But on appeal, the magistrate said the ALJ and Social Security misapplied the law. Under the applicable law in Illinois, “the critical date is the date of onset of disability, not the date of diagnosis.” In other words, the ALJ needed to assess when the claimant's symptoms began to manifest as fibromyalgia, which the evidence indicated occurred long before she received the formal diagnosis. The magistrate noted there were “repeated manifestations of fibromyalgia like symptoms prior to the date last insured.” For example, the claimant was treated several times (prior to her date last insured) for headaches and sleep disorders, both classic symptoms of fibromyalgia.

Indeed, the magistrate went on to criticize the ALJ for failing to consider the claimant's history of fatigue and arthritis when assessing her ability to perform future work. “This failure to properly evaluate the limiting effects of plaintiff's fatigue and aching pain” constituted reversible error, according to the magistrate, who ordered Social Security to reconsider the woman's case.

Get Help from a Disability Lawyer

Fibromyalgia is often difficult to diagnose as the symptoms can manifest themselves over a period of several years. This can make it difficult, as illustrated by the case above, for fibromyalgia patients to receive Social Security disability benefits. That is why if you suffer from fibromyalgia, or any other severe medical impairment which prevents you from working, you speak with an experienced Chicago Social Security Disability attorney right away. Contact Pearson Disability Law, LLC, today if you need help dealing with Social Security.

Sources:

www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/symptoms/con-20019243

https://scholar.google.com/scholar_case?case=13655332564959458939&hl=en&as_sdt=6,47