It can be very difficult to win Social Security disability benefits based on fibromyalgia. However, it can be done!
While Social Security no longer considers fibromyalgia as a “imaginary” condition, or a “junk” diagnosis, you still need to make sure the diagnosis of fibromyalgia is backed up by medical findings.
I have reviewed many medical records which mention fibromyalgia, but don’t say how the doctor made the diagnosis. There is no mention of physical examinations or findings. Social Security may throw out the diagnosis because of a lack of medical support.
Without a diagnosis, all you have are symptoms and Social Security cannot approve disability benefits on symptoms alone.
This can stop a case dead in its tracks!
So, what do you need to properly diagnosis fibromyalgia?
The National Fibromyalgia Association provides an answer:
Currently there are no laboratory tests available for diagnosing fibromyalgia. Doctors must rely on patient histories, self-reported symptoms, a physical examination and an accurate manual tender point examination. This exam is based on the standardized American College of Rheumatology (ACR) criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.
To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:
Widespread pain in all four quadrants of the body for a minimum duration of three months
Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied
If you have fibromyalgia, and you are fighting for your Social Security disability benefits / SSI, ask your doctor if the basis for the diagnosis is documented in your file?
- Do your medical records show “widespread pain in all four quadrants of the body for a minimum duration of three months?”
- Do your medical records show, “tenderness or pain in at least 11 of the 18 tender points?”
Proper documentation is critical in a Social Security case. Make sure your records are complete.