Question: What is your experience with fibromyalgia disability cases?
I have a lot of experience with fibromyalgia cases in the twenty-three years I have been handling Social Security Disability Law. Fibromyalgia, in these past years, has come along as a very common cause of disability because of the nature of the symptoms that this disorder creates. The symptoms are very disabling, as anyone who suffers from fibromyalgia can tell you. The Social Security Administration has really come to recognize this, thank goodness, and in 2012 they issued a new regulation that really helped people with fibromyalgia. This regulation recognizes that your treating doctor can diagnose the disorder and it does not have to be treated by a rheumatologist. This has really helped applicants with fibromyalgia because they no longer have to automatically see a rheumatologist. I still recommend seeing one, because a rheumatologist is the optimal person to diagnose and treat these symptoms, but this regulation has nonetheless made fibromyalgia cases easier for applicants to win.
The key symptoms that need to be recognized and documented in the records in order to win a fibromyalgia case are the tender points. At least eleven tender points need to be documented in the record, and preferably checked at least once per year or every six months. If those tender points are not documented in the record, the diagnosis is not going to be considered valid by the Social Security Administration. Those tender points are part of American College of Rheumatology’s requirements for a true fibromyalgia diagnosis. Additionally, unrefreshed sleep should be something that your doctor is documenting and that you should be explaining to them, if applicable. Unrefreshed sleep is the experience of sleeping a lot without ever feeling rested. Widespread pain is another symptom that applicants should document with their doctor. This is the symptom that most fibromyalgia patients are good at communicating. It is very important that these symptoms are all documented in the records in order to meet the American College of Rheumatology definitions. When it comes to winning a fibromyalgia case, a very important aspect of actually winning in front of the Social Security Administration is to document any mental aspects of the case. Fibromyalgia has physical impacts, of course, but the mental results of those physical symptoms are a major reason people cannot perform any work. Getting documentation of that mental result can really have a big impact on winning a case. This means getting appropriate mental health treatment directly, or at least having your physical doctor document any problems you are having with concentration, follow-through, or confusion. Social Security cases put huge emphasis on a person’s mental function. Social Security will often order a mental evaluation with a specialist to evaluate how a person is functioning mentally. People with fibromyalgia should not fight that process, but rather they should embrace it and cooperate in order to have documentation of their mental symptoms. These are some of the key details in many fibromyalgia cases.