Social Security doesn’t have a specific impairment listing for fibromyalgia, but that doesn’t mean you can’t get benefits for fibromyalgia.
Social Security may approve disability benefits when your fibromyalgia symptoms are severe enough that you cannot work any significant amount for at least a year.
Fibromyalgia is usually diagnosed based on symptoms like:
- Widespread pain
- Fatigue that does not improve with rest
- Sleep problems
- Cognitive issues (“fibro fog”)
- Sensitivity to touch, light or temperature
- Flare-ups of symptoms that come and go
The challenge with fibromyalgia disability claims is that Social Security wants to see more than a diagnosis. They want proof that your condition is serious, ongoing and limiting.
In general, there are two big questions Social Security is trying to answer:
- Do you have medically documented fibromyalgia?
- Does fibromyalgia keep you from working full time?
Here are the most important factors of a strong fibromyalgia claim.
1) A clear medical record of fibromyalgia symptoms
Fibromyalgia is diagnosed clinically. That means your medical records need to show consistent reports of symptoms over time.
Helpful documentation often includes:
- Records showing pain lasting at least three months
- Notes describing tender points or pain patterns
- Repeated symptoms like fatigue, unrefreshing sleep and cognitive problems
- Treatment notes that explain what doctors have tried and what has helped and not helped
Social Security also expects doctors to rule out other causes that could explain your symptoms. But if you have other conditions in addition to fibromyalgia, you should include those in your disability claim, too, because they can strengthen your case.
2) Consistent treatment
Social Security is more likely to take a fibromyalgia claim seriously when they see regular medical care. Your file should reflect ongoing treatment and follow-up. It shows that your condition is severe and that you are seriously trying to feel better.
These are the kinds of treatments you can document for your disability claim:
- Regular visits with a primary doctor
- Rheumatology or pain management care
- Physical therapy
- Medications
- Sleep treatment
- Mental health therapy if anxiety, depression or other mental health issues are involved
3) Proof that fibromyalgia limits your ability to work
This may be the most important part of the claim. Social Security ultimately is not deciding whether fibromyalgia is real. They are deciding whether your symptoms make it impossible to work reliably.
They want to know whether you can:
- Stay on task
- Concentrate and follow instructions
- Sit or stand for long periods
- Lift, carry, and move throughout the day
- Maintain attendance
- Finish a normal workday without needing excess breaks, rest or time lying down
Fibromyalgia disability claims are often won or lost based on how clearly you can document limitations like these.
4) Support from your doctors
Social Security gives weight to medical evidence from your treating providers. That includes notes that clearly describe what your symptoms look like in real life and how those symptoms limit you.
It also helps if your providers document:
- Frequency and severity of flare-ups
- Fatigue levels
- Concentration and memory problems
- Functional limitations in movement, posture and stamina
- Reasons you cannot maintain a normal schedule
Doctors don’t always write down the day-to-day limitations unless they are asked. Working with a disability advocate can help you get the information you need from your health care providers in the form that works for Social Security Disability.
Start with a FREE disability claim consultation from Mathis Disability Advocates.
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