Fibromyalgia is a condition marked by pain that is present throughout the body. Other symptoms may accompany the condition, all of which can be debilitating. When a severe medical condition prevents you working, you may apply for Social Security disability benefits.
One of the requirements is that it falls under Social Security Administration’s (SSA) listing of impairments. Although fibromyalgia doesn’t, it is still possible to receive benefits if it meets the criteria of “medically determinable impairment” (MDI).
Fibromyalgia Based on Medically Determinable Impairment
An MDI is a mental or physical impairment caused by physiological, psychological or anatomical abnormalities established by medically acceptable lab or clinical diagnostic techniques. It’s not enough that a patient states that he is experiencing symptoms; a doctor must diagnose the condition and claims require support by evidence.
SSA has indicated there are two circumstances under which fibromyalgia may qualify for benefits based on MDI. The first set of circumstances is when all of the following are present:
- widespread pain in all quadrants of the body for at least three months (above and below the waist, and on both sides of the body);
- proof that conditions with similar symptoms have been ruled out; and
- at least 11 of the 18 tender points on the body experience pain when a doctor palpitates the area (using a certain amount of force, presses the tender point with his finger).
The second set of circumstances that could allow for disability benefits is when the first two factors are present (widespread pain in all quadrants and proof that other conditions have been ruled out), but other symptoms replace the last criteria. There must be recurring episodes of six or more co-occurring conditions, signs or symptoms.
In particular, the following symptoms would apply:
- anxiety disorder;
- memory/cognitive problems;
- irritable bowel syndrome;
- waking from sleep still tired; and
However, it’s possible that other symptoms would also qualify: such as muscle weakness, headache, dizziness, pain in upper abdomen, seizures and many more.
Obtaining Social Security Disability Benefits for Fibromyalgia
Although the aforementioned criteria are necessary in establishing that fibromyalgia is an MDI, it is not the only requirement that claimants must meet. SSA doesn’t provide benefits for those with short-term disability or partial disability; only those who are totally disabled.
The following are other requirements that claimants must meet to qualify for Social Security disability benefits:
- the disability is expected to last or has lasted at least 12 months (or result in death);
- unable to perform work that was previously done; and
- SSA determines the medical condition prevents the individual from adjusting to other work.
Additionally, the person must have worked recently enough and long enough to qualify. This is based on the number of credits earned each year. Meeting the many requirements is difficult enough, without the challenges of proving eligibility. Markhoff & Millman, P.C. help disabled individuals in New York City and the nearby communities with their Social Security disability claims, so call today: (866) 205-2415.