The interplay between fibromyalgia and Social Security Disability

After years of being considered by many physicians as a “made-up” condition or one that was “all in the head” of sufferers, fibromyalgia has finally been legitimized and accepted by the medical community. To that end, it has also been recognized as a debilitating condition that might – pursuant to the criteria established by the Social Security Administration (SSA) in Policy Interpretation Ruling SSR 12-2P – qualify for disability benefits under the Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI) programs.

What is fibromyalgia?

Fibromyalgia is a disorder characterized by widespread chronic pain and fatigue. Memory and concentration issues, poor sleep (including insomnia, not sleeping enough, and not getting enough “restful” sleep), depression, anxiety and gastrointestinal issues like Irritable Bowel Syndrome are also commonly seen in fibromyalgia sufferers.

How is it diagnosed?

There is no single diagnostic test that can recognize fibromyalgia, and patients often bounce from specialist to specialist before they are finally diagnosed. The diagnostic process can take years, something that is stressful and frustrating for patients. However, there are methods that can help medical professionals identify fibromyalgia, including:

  • Examining the patient to check for pain and tenderness in at least 11 of the 18 recognized “tender spots” on the body
  • Learning about the extent of the patient’s symptoms, and confirming that the patient reports widespread pain throughout the body for at least three months
  • Ruling out other conditions causing pain or fatigue (rheumatoid arthritis, lupus, Lyme disease, chronic fatigue syndrome, and more)
  • Checking the patient’s inflammation levels
  • Checking for thyroid malfunction or disease

It is possible that a blood test may be able to one day identify fibromyalgia based on unique concentrations of particular molecules in a blood sample. A recent study showed promising results on a small scale, but there are no plans at this time for the study’s authors to perform additional research.

How the SSA views fibromyalgia

Since July of 2012, when SSR 12-2P was issued, the SSA has had in place a specific guideline for awarding DIB or SSI benefits to a patient with fibromyalgia. When making a determination about whether to award DIB or SSI disability benefits to a fibromyalgia patient, the SSA will look not only at medical evidence to back up the diagnosis, but also the treatment protocols that the patient has tried prior to the application.

If a patient has only tried a single medication, with no medical evidence of additional pain and fatigue management methods that might allow he or she to perform job duties, the SSA might deny the application or delay consideration of it until the applicant can undergo additional treatments that might prove effective. The more varied a care approach is, the more likely the SSA is to award benefits if the patient, after multiple courses of treatment, is still so debilitated by fibromyalgia symptoms that he or she cannot work.

Recognized treatments

Pharmaceutical advances and the acceptance of alternative medical options to treat fibromyalgia have both made life easier for thousands of the estimated five million Americans dealing with the disease. The pain medication Lyrica is FDA-approved to treat the chronic pain associated with fibromyalgia and has helped many living with the condition feel better. Similarly, antidepressant medications like Cymbalta, and drugs like Neurontin that help suppress nerve pain have brought relief for some patients. Supplements featuring vitamins B and D, as well as magnesium might also help.

Sometimes if a patient’s symptoms are not totally managed with a prescription medication or supplement, a more holistic approach is needed. This can involve the use of physical therapy to build muscle tone, a course of medication, stress management techniques, meditation, yoga or Pilates to stretch strained muscles, alternative treatments (acupuncture and acupressure, in particular), massage and cognitive behavioral therapy.

Exploring disability options

Have you been diagnosed with fibromyalgia? Has the pain and fatigue become so severe that you can no longer work? Want more information about DIB and SSI benefits for fibromyalgia sufferers? If so, then speak with an experienced disability attorney in your area today.