I regularly receive calls from prospective clients who are applying for Social Security disability based on fibromyalgia. For those not familiar with this condition, it produces symptoms of pain, joint discomfort, fatigue, intestinal discomfort, issues with balance, and confusion (fibro fog).
Fibromyalgia is recognized by the CDC and American College of Rheumatology, which has set out specific diagnostic criteria (widespread pain of at least 3 months duration + tenderness in 11 of 18 pressure points).
In my experience, fibromyalgia generally affects women over the age of 40 with a “type A” personality. Within a matter of months, a fibromyalgia patient can go from a fulfilling, productive lifestyle to an existence of chronic pain, fatigue and confusion.
North Carolina Social Security judges do recognize fibromyalgia as a disabling condition. However, this was not always the case. Ten years ago, for example, many Social Security judges had never heard of this condition and at that time there was not a consensus among medical professionals about whether fibromyalgia actually existed. Fibromyalgia cannot be seen on an x-ray or MRI and at this point in time there is no definitive blood or other diagnostic test for it.
In 2011, all of the Social Security judges you will encounter in North Carolina have considered numerous fibromyalgia cases and they all recognize that this syndrome can produce significant work limitations. At the same time, your Social Security judge will expect more than a passing reference to “fibromyalgia” or “myalgia” in your internist’s notes.
Here is what I look for when reviewing a potential fibromyalgia client:
- does the client experience the classic symptoms of fibromyalgia – pain at trigger points, myofasical pain (i.e. pain at even the lightest skin touch), digestive upset, balance issues, extreme fatigue, confusion and memory issues?
- has my client sought treatment with multiple physicians – frequently my fibromyalgia clients bring me thick notebooks with neatly labeled and tagged copies of medical records
- does the pain move around my client’s body – fibromyalgia pain usually does not stay in the same place
- is there an extensive medical record – because fibromyalgia cannot be identified by a diagnostic test, judges expect you to seek ongoing treatment with a variety of doctors
- does the client fit the profile – is she a high achieving, type “A” female with a long work history at a challenging job?
- is the file free of “drug seeking behavior” and references to “malingering?” As fibromyalgia has become more well known, judges sometimes see claimants who claim disability based on fibromyalgia despite an absence of the typical symptoms.
Social Security judges know that fibromyalgia is not a medical condition that your doctor will identify immediately. Often you you will seek help from your internist when you experience unexplained symptoms of pain or discomfort. Over time, your symptoms will often change and become more intense and your doctor will begin to rule out a variety of other ailments. Perhaps you will be referred to one or more specialists. Your fibromyalgia may not be diagnosed for six months, a year or longer.
Further, your symptoms must interfere with your capacity to perform even a simple, entry level job. If your doctor will note specific activity limitations in your medical record, you have a better chance at winning.
When I am representing a fibromyalgia client, I will encourage your doctor or doctors to complete a checklist form that tracks both your symptoms and your activity limitations. When I go to court, my goal is to present a complete and comprehensive medical record detailing your struggle for a cure, and to prepare you to answer questions about reliability problems.
If you have been diagnosed with fibromyalgia and you have questions about the Social Security disability process, please email me or call 866-674-8810.