Fibromyalgia is a chronic condition causing widespread pain, fatigue, and other debilitating symptoms. Securing disability benefits can be a challenging process, but understanding the requirements and building a strong case significantly increases your chances of success. This guide will walk you through the key steps to winning a fibromyalgia disability case.
What is Considered Disability for Fibromyalgia?
The Social Security Administration (SSA) defines disability as the inability to engage in any substantial gainful activity (SGA) due to a medically determinable impairment(s) that has lasted or is expected to last for at least 12 months or result in death. For fibromyalgia, this means demonstrating that your symptoms are so severe they prevent you from performing even simple work tasks. This isn't just about pain; it encompasses the impact of fatigue, sleep disturbances, cognitive difficulties (fibro fog), and other symptoms on your daily functioning.
How to Prove Your Disability Due to Fibromyalgia
Proving disability requires comprehensive documentation and a strategic approach. Here's a breakdown of essential steps:
1. Thorough Medical Documentation: The Cornerstone of Your Case
This is the most critical aspect. Your medical records must clearly and consistently document the severity of your symptoms and their impact on your ability to work. This includes:
- Detailed medical history: A complete record from your doctors, specialists (rheumatologists are key), and therapists, detailing your diagnosis, symptoms, treatment attempts, and their effectiveness or lack thereof.
- Objective findings: While fibromyalgia lacks definitive objective markers, your doctor should document findings that support your subjective complaints. This might include tender points, limitations in range of motion, or abnormalities on other tests.
- Treatment records: Comprehensive documentation of all treatments, including medications (and their side effects), physical therapy, occupational therapy, and other interventions. Note the success or failure of these treatments.
- Functional limitations: Your doctor needs to detail the specific tasks you can no longer perform due to your symptoms. This could include lifting, carrying, standing, sitting, walking, concentrating, remembering, and more. These functional limitations should be clearly linked to your fibromyalgia.
2. Consistent Reporting of Symptoms: Maintaining a Detailed Diary
Maintain a detailed daily diary documenting your symptoms, their severity, and how they affect your daily activities. This includes pain levels, fatigue levels, sleep disturbances, cognitive issues, and any other relevant symptoms. This diary provides crucial supplementary evidence, corroborating your medical records.
3. Third-Party Evidence: Strengthening Your Claim
Supplement your medical and diary evidence with statements from family, friends, or caregivers who can attest to the severity of your symptoms and their impact on your daily life. These statements provide valuable corroboration.
4. Functional Capacity Evaluation (FCE): Objective Assessment of Abilities
An FCE is a comprehensive assessment by a qualified professional, evaluating your physical abilities and limitations. This objective assessment provides valuable evidence to support your claim and contrast subjective reports.
5. Seeking Expert Medical Opinion: Navigating Complex Cases
If your initial application is denied, consider getting a second opinion from a specialist knowledgeable about fibromyalgia and disability evaluations. Their report can strengthen your appeal.
Frequently Asked Questions (FAQs)
What are the common reasons for denial of fibromyalgia disability claims?
Common reasons for denial include insufficient medical evidence demonstrating the severity of symptoms and their impact on work abilities, inconsistent reporting of symptoms, and a lack of objective findings.
How long does a fibromyalgia disability case usually take?
The process can take several months or even years, depending on the complexity of the case and the appeals process.
Can I work part-time if I have fibromyalgia and am applying for disability?
This depends on your individual circumstances and the severity of your symptoms. You may need to demonstrate that even part-time work is impossible due to your condition.
What if my doctor doesn't believe my fibromyalgia is disabling?
Seek a second opinion from a specialist experienced in fibromyalgia. A comprehensive evaluation from a specialist who understands the complexities of the condition is crucial.
What type of lawyer should I hire for a fibromyalgia disability case?
Seek an attorney specializing in Social Security Disability (SSD) claims, preferably one with experience handling fibromyalgia cases.
Conclusion: Persistence and Preparation are Key
Winning a fibromyalgia disability case requires meticulous preparation, comprehensive documentation, and persistence. By diligently following these steps and gathering compelling evidence, you significantly increase your chances of success. Remember, your claim should be supported by consistent medical evidence, accurately reflecting the severity and impact of your fibromyalgia on your ability to work. Seeking professional legal assistance is often advisable to navigate the complexities of the disability process. Don't hesitate to seek help from advocacy groups or support networks for emotional and practical support throughout the process.
