Is Fibromyalgia A Disability?

Yes, fibromyalgia can be considered a disability. While the severity and impact of fibromyalgia can vary among individuals, it can significantly affect a person’s ability to perform daily activities and maintain employment. Not all types of fibromyalgia qualify for disability. Therefore, the applicant must take care of the eligibility requirements of the SSA.

An applicant can be eligible for Social Security Disability Insurance and Supplemental Security Income benefits the SSA provides. The Social Security Administration’s “Blue Book” of impairments includes a specific disability listing for fibromyalgia under Section 14.09 Inflammatory Arthritis, which can be used as a reference for evaluating fibromyalgia claims.

The claimant must have comprehensive medical documentation that supports their claim to be eligible for the benefits. This may include records of doctor visits, diagnostic tests, treatment history, and detailed descriptions of your symptoms and their impact on your daily functioning. 

Can You Get Disability Benefits For Fibromyalgia?

Yes, it is possible to pursue disability for fibromyalgia. The process of applying for and obtaining disability benefits can be complex and time-consuming. It is important to be patient and seek professional assistance to navigate through the system. 

It is crucial to demonstrate that your fibromyalgia symptoms significantly limit your ability to work and perform regular activities for at least 12 months. To qualify for disability benefits, you need to demonstrate that your fibromyalgia symptoms are severe enough to significantly impact your ability to work and engage in substantial gainful activity.

The following are some common qualifying conditions you may experience alongside fibromyalgia:

• Anxiety
• Depression
• Irritable Bowel Syndrome
• Chronic pain disability
• Serious and persistent back pain
• Postural tachycardia syndrome (POTS)
• Migraines or other types of headaches
• Interstitial cystitis (painful bladder syndrome)

How Does The SSA Define Fibromyalgia?

The Social Security Administration recognizes fibromyalgia as a medically determinable impairment. According to the SSA, fibromyalgia is characterized by widespread pain and tenderness, along with symptoms such as fatigue, sleep disturbances, cognitive difficulties, and mood disorders. 

People with fibromyalgia often experience pain throughout their body, including areas such as the neck, shoulders, back, hips, and limbs. Although fibromyalgia is a chronic condition that can be challenging to manage, various treatment approaches, including medication, exercise, stress management, and lifestyle modifications, can help alleviate symptoms and improve the quality of life for individuals with fibromyalgia.

What Are The Symptoms Of Fibromyalgia?

The symptoms of fibromyalgia can vary among individuals, but the most common symptoms include:

• Fatigue: Many individuals with fibromyalgia experience persistent fatigue, even after getting sufficient rest. This fatigue can interfere with daily activities and may be accompanied by reduced stamina.
• Sleep disturbances: Fibromyalgia often disrupts sleep, leading to difficulties in falling asleep, staying asleep, or achieving restorative sleep. Individuals with fibromyalgia may wake up feeling tired or unrefreshed.
• Cognitive difficulties: Commonly referred to as “fibro fog,” fibromyalgia can cause cognitive impairments such as memory problems, difficulty concentrating, and decreased mental clarity.
• Mood disturbances: Depression, anxiety, and mood swings are frequently associated with fibromyalgia. Chronic pain and other symptoms can significantly impact an individual’s emotional well-being.
• Sensitivity to stimuli: Many people with fibromyalgia experience heightened sensitivity to various stimuli, including touch, temperature, noise, and light. This sensitivity can intensify pain and discomfort.

Eligibility Criteria For Getting Disability With Fibromyalgia

To qualify for disability benefits with fibromyalgia, you must meet the criteria outlined by the Social Security Administration. The criteria include the following:

• Medically Determinable Impairment: You must have a diagnosis of fibromyalgia from an authorized medical source. This may include a rheumatologist, neurologist, or other qualified healthcare professional.
• Widespread Pain: You should experience widespread pain that has lasted for at least three months. This pain should be present on both sides of the body, above and below the waist, and in the axial skeleton (e.g., spine, chest, and neck).
• Tender Points: You must have at least 11 out of 18 specific tender points upon palpation. These tender points are specific areas on the body that elicit pain when pressure is applied.
• Exclusion of Other Conditions: The SSA will evaluate your medical records to ensure that other potential causes of your symptoms have been ruled out.

Questions To Ask Yourself Before Applying For Fibromyalgia

Before applying for the disability benefits, you must ask yourself the following questions:

• Do you face conditions such as depression and other mental illnesses?
• Is your fibromyalgia consistent?
• Is your trigger point or tender point test above 14 or not?
• Am I sleeping for more than 18 hours per day?
• Have you met the doctor multiple times along with your primary care provider?

What Type Of Benefits Should I Apply For?

As you will research more about disability benefits, you will get to know that there are two main types of benefits to which you can apply:

• Social Security Disability Insurance (SSDI) is more favorable if you have been working and have paid your social security taxes. 
• Supplemental Security Income (SSI) is helpful for those who have low income and low assets.

Both programs offer support for those claimants who have filed a disability claim if they are unable to do work. 

What Happens If Your Fibromyalgia Meets The Criteria Of The SSA?

The next step after meeting the eligibility criteria of the SSA is to apply for the benefits. Applying for disability benefits involves several steps. Some of them are as follows:

• Obtain a proper diagnosis: It is essential to have a formal diagnosis of fibromyalgia from a qualified healthcare professional. Ensure your medical records include detailed information about your symptoms, physical examinations, and any diagnostic tests conducted to support the diagnosis.
• Review eligibility criteria: A claimant must meet all the eligibility requirements, including limitations on work activities and the severity of the condition.
• Gather medical evidence: Compile comprehensive medical records that document your fibromyalgia symptoms, treatments, and their impact on your ability to work. 
• Complete the application: Obtain the necessary application forms for disability benefits. Fill out the forms accurately and thoroughly, providing all the requested information about your medical condition, work history, and daily activities. Be sure to include the medical evidence you have gathered.
• Submit the application: Follow the instructions provided and submit your completed application along with all supporting documentation.

What Happens If Your Fibromyalgia Does Not Meet The Criteria Of The SSA?

If your Fibromyalgia does not meet the eligibility criteria of the SSA, you must not get discouraged. You may consider applying even after not meeting the SSA’s criteria. However, you must be honest in filling out your application form. Consider taking help from a disability attorney who can help you in filing an appeal. 

80% of the applicants get rejected in their initial application phase meaning only 20% get approved in their first instance. Therefore, you may file an appeal and submit all the missing evidence related to your disability claim in the appeal process.

How Much Is a Disability Check For Fibromyalgia?

The maximum possible disability benefit for fibromyalgia in 2024 is $942 per month for SSI and about $3,822 per month for SSDI. These maximums apply regardless of the condition you are suffering from, the severity of the condition, or other qualifying conditions. 

The amount an applicant may receive will depend on your specific circumstances. For Social Security Disability Insurance benefits, the amount will vary based on your work and tax history. For Supplemental Security Income benefits, the amount will vary based on your other sources of income. If the applicant is a child who is below 18 years old, the income of parents and other financial support will also be considered as the income of the child. 

Disability Benefits Denied? Contact An Experienced Lawyer

If your disability benefits have been denied, it can be a frustrating and disheartening experience. Contacting experienced Social Security disability lawyers can make a significant difference in your case. (Learn more on what disability attorneys can do)

They have the knowledge, expertise, and resources to navigate the complex legal system, gather additional evidence, and present a strong appeal on your behalf.