Applying for Disability based on Fibromyalgia (by Tim Moore)

Hello Everyone,

The following article was written by Tim Moore. Tim is a former medicaid-disability caseworker and a former disability claims examiner for the social security administration's DDS, or disability determination services. Thank you Tim!


Applying for Disability based on Fibromyalgia

SSDI (Social security disability insurance) and SSI disability claims that are filed on the basis of fibromyalgia will come up against the same problems as other disability cases, including:

1. High denial rates at the disability application and first appeal levels (the first appeal is the request for reconsideration).

2. Very long waiting periods for decisions at all steps in the system.

3. Incredibly long waits for disability hearings to be scheduled (a problem that has intensified in recent years and may only get worse).

and, finally,

4. A system that, on its face, can not only appear complex and confusing, but almost designed to result in financial disaster for most claimants.

Unfortunately, disability claims for which fibromyalgia is a primary allegation have their own specific problems, problems that are somewhat unique. One of those particular difficulties is that a claimant with this condition can find it difficult to obtain needed support from their treating physician. This can be due to a host of reasons, including, unfortunately, the fact that many doctors do not find it worth their time to provide documentary support for a patient's disability claim, but also the fact that a certain percentage of physicians are not in support of fibromyaliga as a valid diagnosis (this despite the fact that medications are currently being approved by the FDA for the treatment of fibromyalgia).

The other problem, of course, is the fact that SSA does not expend much effort in recognizing fibromyalgia as a condition in its own right. Though there have been policy pronouncements regarding FMS, fibromyalgia still does not have a separate listing in the blue book, the social security administration's impairment listing manual that is published under the name "Disability Evaluation under Social Security".

Is a claim for disability benefits based on fibromyalgia an uphill climb? To some extent, it may be. However, the fact is that seventy percent of all social security disability claims that are filed with the social security administration are initially denied, regardless of the impairment. Those same claimants, if they pursue the appeals process to the level of an administrative law judge hearing and have able representation, will stand a better than sixty percent chance of being awarded benefits. Therefore, the best advice for any claimant is simply not to give up on a claim. If the initial claim is denied, file a request for reconsideration appeal. If this appeal is denied, file a request for a hearing.

What do judges look for when they hear cases based on fibromyalgia? As with all cases, the judge will look for evidence of physical or mental limitations that rule out the ability of the claimant to return to their past work. The judge will also examine whether or not these limitations rule out the ability of the claimant to perform some other type of work that might seem suitable based on the claimant's condition, age, education, and work experience.

However, with regard to claims predicated on fibromyalgia, disability judges will also give more credence to medical evidence that emanates from specific types of treating sources. In other words, medical records obtained from a pain treatment specialist can often offer more validity than records from an internist. Likewise, a diagnosis either obtained from, or corroborated by, a rheumatologist may carry substantially more weight than a diagnosis obtained from a family physician who has no specialization in fibromyalgia or conditions involving pain or fatigue.

The author of this article is Tim Moore, a former medicaid-disability caseworker and a former disability claims examiner for the social security administration's DDS, or disability determination services. Tim Moore is the publisher of The Social Security and Disability Resource Center.

I hope and pray everyone has experienced less pain and fatigue today.

Just a note-found a site on "Disability"

Hello Everyone,

I am sorry I have not written anything lately. However, I was notified about a blog site that offers information on disability and the site includes questions and answers on Social Security SSI Questions and Answers. I hope this site helps you! Just click check out my blogroll list.

I was just asked about the site, sorry for not adding a link. Here it is: Disabled Not Mislabeled

Here is another disability blog site: My Disability Blog

Thank you for asking about the site Cheryl:)

Soft hugs and God Bless!

Fibro Viv

Obtaining Disability

I was let go with a group of people that were laid off at my place of employment. I know it was because of my illness, but I was in denial and did not want to stop working. I was also the only good source of income because my husband is disabled. I wish I had filed for short and long term disability when I was working. I was filled with too much pride and wanted to continue working.

I finally applied for disability online and I was denied. I gave up and prayed daily. Soon after a lawyer's assistant called me and said I had called their office about disability. I did not remember doing that..Fibro fog! Anyway, I told him I was denied, he said they could help me. So I let them take the case and I finally won. It was not easy because you have to still fill out paperwork, answer questions, etc. Fortunately, I had taken medical leave and my doctor referred me to a Pain Management Specialist who in turn enrolled me at St. David's Rehabilitation Program for people with FMS/CFIDS. That experience was hard but helped me. I felt so good I returned to work too early. I lied to my PCP and had him sign a release form so I could go back to work, we needed the money. Bad choice because I transferred to another area of the company and that manager did not know me or my background. So I ultimately got laid off. I was in denial and did not want to file against the company. Anyway, I did hire that lawyer (no upfront fees) and now receive disability.

These are some of the things I did and the paperwork I added to my claim:

1). Hire a lawyer
2). I saw my PCP on a regular basis.
3). I continued to see the Pain Management Doctor.
4). I told my lawyer about the different doctor's I had seen and the Rehabilitation Program I had used.
5). I had my sister write a letter describing me, how I had changed socially, physically and mentally. It hurt her to write it and it hurt me to read it, but it helped.
6). I had a friend that worked for me and helped me when I first started having symptoms write a letter. I was an IT Project Manager. She wrote down what she saw and how she helped me along the way. I thank God for her help and for her letter. She described how I used to work and how I went down. It hurt to read it and it hurt her to write it, but I needed it to help me get my disability.
7). I had my sister write a letter that I tried to dictate to her about how I felt, my pain, fatigue and how I tried to keep working.
8). I wrote a letter to my congressman and explained my situation, illness, financial problems, etc. because it was taking so long to get an answer from Social Security. It is a long wait, so it helps to write your congressman. If he is a good man, he will write a letter on your behalf asking about the progress of your claim. He cannot write about you, but he can ask about the progress and time it takes to get disability.
9). I attached my resume, educational background and comments on how I was not able to function in that capacity or any for that matter. Why? Because of the amount of time I required sleep in order to even feel human. I was sleeping 22 hours a day! No exaggeration. My Mother was afraid I was going to die in my sleep. My husband and I tried to explain to her that I was weak, required sleep and was in a lot of pain. Sometimes I could not sleep at all. I could not function, sleep or no sleep. I could not even remember words, what a cup was, I had to point to things I wanted. It was terrible. I described my grief, my inability to function as I used to, the person I was and how I missed work. I still have some days like that.
10). I also informed my lawyer of the different Fibromyalgia studies I had enrolled in for help.
11). I also had other health problems, I listed them all.
12). Keep records of your work habits and how they have changed overtime due to your illness and have another work colleague document it.

The key is not to leave anything out, even if it hurts. The first time I was turned down, they felt I could work part-time. I wish I could, I would not make a good employee right now or then. They look at the whole picture and your education to see if you can do some type of stationary work. If you cannot function mentally and concentrate, stationary work does not make a difference.

I hope and pray this information helps someone today.

Fibro Viv

A Place to find Legal Documents

Here is a place to find legal documents that might be of assistance to you. I know when I tried to figure out how to get disability and other types of forms, is was helpful to find some type of resource.

I will add tips on disability write-ups and where I found tips soon.

I hope and pray this post has helped someone today.