For years, fibromyalgia was a little understood disorder and some Social Security judges did not consider it to be a "medically determinable impairment," for purposes of disability benefits. Judges often ruled that disability could not be established merely on the basis of symptoms and that a medically determinable impairment must be deomonstrated by medical signs and laboratory findings. There is no laboratory test for fibromyalgia. It is usually diagnosed by exclusion of other disorders and by locating tender "trigger points." Many Social Security adjudicators simply did not believe that the disease existed - or if it did - it was not severe enough to cause disability.
In July 2012 Social Security issued Ruling SSR 12-2p on fibromyalgia. This ruling states that fibromyalgia may be a medically determinable impairment when established by appropriate medical evidence and it can be the basis for a finding of disability. Social Security has instructed all its administrative law judges and other adjudicators to follow SSR 96-7p to evaluate a claimant's statement about symptoms and functional limitations.
Step 2 in Social Security's sequential process for determining disability requires that the claimant have a severe impairment. Under SSR 12-2p, fibromyalgia may now satisfy the requirement of having a "serious, medically determinable impairment." The claimant must provide a diagnosis by a licensed physician. The diagnosis must satisfy the evidence criteria required by either the 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia or the 2010 American College of Rheumatology Preliminary Diagnostic Criteria. Also, a diagnosis alone is not enough. Social Security will review the doctor's treatment and the claimant's symptoms over time.
Once a medically determinable Impairment (MDI) has been established by a physician (MD or DO), as required under SSR 06-3p, then SSA will look at evidence from any treating source, including those which are not "acceptable medical sources" (non-doctors). Evidence may also include statements by family, friends, former employers, teachers, etc. to establish daily limitations of function over time. There still is no specific "listing" for fibromyalgia but it may equal another listing--such as 14.09D for inflammatory arthritis.
It is extremely important that the claimant provide Social Security with the full history of fibromyalgia symptoms and treatment over time. The SSA acknowledges that it is a disease that can "wax and wane."
At last, a Social Security ruling provides judges and other adjudicators with a framework to find that "widespread pain and other symptoms associated with fibromyalgia, such as fatigue, may result in functional limitations that prevent a person from doing the full range of unskilled work. Persons with fibromyalgia may also have non-exertional physical or mental limtiations because of pain or fatigue.
In short, SSR 12-2p may help individuals suffering from fibromyalgia to prove that it can be a disabling condition which qualifies for Social Security disability benefits.
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Sources: NOSSCR Social Security Forum, Vol. 34, No. 7, July, 2012.
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Learn more about NOSSCR
In July 2012 Social Security issued Ruling SSR 12-2p on fibromyalgia. This ruling states that fibromyalgia may be a medically determinable impairment when established by appropriate medical evidence and it can be the basis for a finding of disability. Social Security has instructed all its administrative law judges and other adjudicators to follow SSR 96-7p to evaluate a claimant's statement about symptoms and functional limitations.
Step 2 in Social Security's sequential process for determining disability requires that the claimant have a severe impairment. Under SSR 12-2p, fibromyalgia may now satisfy the requirement of having a "serious, medically determinable impairment." The claimant must provide a diagnosis by a licensed physician. The diagnosis must satisfy the evidence criteria required by either the 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia or the 2010 American College of Rheumatology Preliminary Diagnostic Criteria. Also, a diagnosis alone is not enough. Social Security will review the doctor's treatment and the claimant's symptoms over time.
Once a medically determinable Impairment (MDI) has been established by a physician (MD or DO), as required under SSR 06-3p, then SSA will look at evidence from any treating source, including those which are not "acceptable medical sources" (non-doctors). Evidence may also include statements by family, friends, former employers, teachers, etc. to establish daily limitations of function over time. There still is no specific "listing" for fibromyalgia but it may equal another listing--such as 14.09D for inflammatory arthritis.
It is extremely important that the claimant provide Social Security with the full history of fibromyalgia symptoms and treatment over time. The SSA acknowledges that it is a disease that can "wax and wane."
At last, a Social Security ruling provides judges and other adjudicators with a framework to find that "widespread pain and other symptoms associated with fibromyalgia, such as fatigue, may result in functional limitations that prevent a person from doing the full range of unskilled work. Persons with fibromyalgia may also have non-exertional physical or mental limtiations because of pain or fatigue.
In short, SSR 12-2p may help individuals suffering from fibromyalgia to prove that it can be a disabling condition which qualifies for Social Security disability benefits.
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Sources: NOSSCR Social Security Forum, Vol. 34, No. 7, July, 2012.
Contact an experienced Social Security disability advocate
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