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Fibromyalgia and Social Security Disability: Can You Still Win?

Posted Apr 21 2014 10:07pm

Social Security disability judges are increasingly reluctant to award benefits to fibromyalgia claimants unless these claims meet a certain profile.  Let me tell you about this profile – what is currently working for me in disability hearings I try here in the Atlanta area hearing offices.

I first started seeing disability claims based on “multiple myalgias” or “fibromyalgia” around 10 years ago.  Back then, many disability judges had never heard of this condition and they struggled with how to approach claims where claimants seemed credible and treating doctors offered written support, yet there were no diagnostic tests that confirmed that this widespread pain condition actually existed.

Back then it was common for judges to call psychiatrists as expert witnesses at hearings and they would approve or deny based on a mental health interpretation of fibromyalgia.

Around 6 or 7 years ago, FMS (fibromyalgia syndrome) became more mainstream and judges seemed more comfortable concluding that this syndrome was real and that high achieving 40 to 50 year old females would not give up solid careers as professionals or executives to wait 2 years to collect $2,000 in disability benefits.

Within the last 2 to 3 years the trend has shifted back to again make it more difficult for a fibro patient to win disability.  This is because the FMS diagnosis has been overused, especially by family doctors who have perhaps been too quick to slap a fibromyalgia diagnosis on patients who complain of widespread pain but who have not confirmed their diagnoses with a rheumatologist.

In addition, Social Security judicial supervisors continue to encourage judges to only approve cases where there is strong medical evidentiary support.

You can still win a fibromyalgia disability case but, as I point out in this video, your claim file needs to meet a certain profile.  Here is what I am telling my clients:

  1. If you have other diagnoses that lend themselves to objective testing, it may be better to base your claim on other conditions like irritable bowel syndrome, depression, inflammatory arthritis, etc.
  2. Seek treatment from a rheumatologist who evaluates you using criteria set out by the American College of Rheumatology.  It is no longer sufficient to rely on a FMS diagnosis from your family physician.
  3. Try to work if you can and remain compliant with medications and treatment protocols.  Failed work attempts can be very compelling evidence.
  4. Demonstrate your intent to fight the label of disabled by seeking treatment consistently and not resigning yourself to permanent incapacity.

Please let me know if you have questions about how to approach your FMS disability claim.

You can also read more about how I approach these cases here – http://bit.ly/fibroclaims .

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