Social Security Administration Issues Guidance on Fibromyalgia

When a person is suffering from an injury or illness that makes working impossible, quite often the condition is easy to see. However, not every injury or illness is easy to diagnose, and this can make it extremely challenging for individuals with these illnesses to make ends meet.

When a person applies for Social Security Disability benefits, the Social Security Administration requires that very detailed medical information accompany the applications. Failing to include this may cause applications to be rejected. The SSA carefully lists the information that is necessary to establish evidence of the condition for many illnesses and injuries.

One condition that is proving to be very challenging for the agency is fibromyalgia. This is a particularly painful condition that can cause exhausting pain. Those suffering often experience many other related symptoms, including depression or chronic fatigue.

Since fibromyalgia can have so many different symptoms or manifest itself in many different ways, the SSA has issued some guidance on what must accompany SSD requests.

Individuals must submit evidence from a licensed physician that states they have the condition. Additionally, the agency requires the physician to provide information that demonstrates why this diagnosis was made, which include requirements discussing pain that is impacting the individual.

The SSA states that it may decide a person has fibromyalgia if there specific criteria are met: first, the person has a history of widespread pain; second, that there are six or more symptoms of fibromyalgia present; and lastly, that other potential causes have been excluded.

Many first-time applications for SSD benefits are denied. It is important to understand that while frustrating, a denial of benefits is not the last step. Individuals may appeal the SSA’s decision, but this could add time to the process.

Source: The Federal Register, July 25, 2012.