Patients with fibromyalgia have had trouble getting SSDI (Social Security Disability Income) benefits in the past. Most applicants who applied primarily based on having fibromyalgia were denied. The problem was that they didn’t have a disability “listing” for the condition. It is more likely to be accepted if there are multiple conditions other than fibromyalgia present. Fibromyalgia is not considered a MDI (medically determinable impairment). Symptoms are subjective and vary from person to person. It is hard to prove to anyone that you have the disorder. To fix the problem, the Social Security Administration ruled in 2012 to give claim examiners and law judges guidance on how to help patients appeal their case and win.
Some people think that they can’t apply for disability if they are still working part-time. As of 2017, if you are earning less than $1,170 per month you can be considered. The less hours worked the greater the chance of getting it. Also, you don’t have to wait 12 months after you quit to file for disability, either.
Here are just a few things you need to know to help your chances of getting accepted for benefits. (Proving you have have fibromyalgia)
- Evidence of chronic widespread pain, including back, neck and chest (records from the doctor)
- Doctor rules out other diseases (such as lupus, hypothyroidism, MS) through labs or x-rays
- Tender points in 11 of the 18 total tender points on the body
- Repeated occurrences of six of more fibro symptoms (fatigue, memory problems, sleep issues, depression, muscle weakness, IBS, headache or dizziness)
How do you apply? You can apply online: ssa.gov or apply in person by calling to make an appt.: 1-800-772-1213. You can print and review the Adult Disability Checklist to help you gather the information you need. Then complete the disability benefit application. You will need to get doctor’s notes, medical test results, work information such as paystubs, list of past jobs, ss statement, and w-2 forms.
Tips on applying:
- Make sure you get a diagnosis from a specialist such as a rheumatologist (it is more credible)
- Make sure fibromyalgia is the DIAGNOSIS in your medical records
- Get a copy of your records to see what they put in there.
- Get a statement from your work of any missed days due to your disability
- Provide as much info as possible to help your case
After you’ve applied then what happens? The examiner will review your medical records to see if they include evidence of a disability. They may ask the doctor questions on the extent and duration of your impairments, and what treatments you have tried. Evaluation is not over there. They develop a RFC (residual functional capacity) to see how much work you can do at your job. They will ask your doctor their opinion on how long you can sit, stand, walk and lift. They may even ask family members questions too. They will compare the job you do with jobs available for someone with your RFC level and limitations. If they rule out all jobs, they will find you disabled.
How long will you have to wait to get an answer? It generally takes 3-5 months for disability claims to be processed.
How much can you receive? It is not based on how severe your disability is or how much you make. Most recipients receive between $700 and $1,700 a month. The average for 2017 is $1,171. If you receive disability payments from other sources, your payment may be reduced. It is to your benefit to apply for disability since most people with fibromyalgia miss work and the average cost for annual fibromyalgia treatment is $5,945 per person. It will also be to your advantage to get help from a professional disability lawyer.