Have you been diagnosed with fibromyalgia and wonder if you can collect Social Security disability benefits?
Fibromyalgia can cause a significant amount of pain, keeping you from performing your job and earning for a living.
However, since this chronic illness is one of those “invisible” conditions—only a few symptoms are observable—it can be hard to prove you have it.
The Social Security Administration (SSA) has rigorous eligibility criteria that applicants must meet to access benefits. Failing to prove you have a qualifying condition can quickly compromise your case.
If you have fibromyalgia and meet the SSA criteria, building a solid case is your best chance to secure the monthly payments and medical assistance you deserve.
In this article, our Indianapolis disability law firm will share valuable information regardless of fibromyalgia disability cases (based on our professional experience). Besides, we’ll provide 6 tips to strengthen your case and get you one step closer to securing the benefits you deserve.
Is Fibromyalgia a Qualifying Disability?
Fibromyalgia is considered a disability; therefore, if you have this condition, you could get Social Security disability benefits if it prevents you from working.
However, there are 8 types of fibromyalgia, and not all of them qualify for disability benefits.
Understanding the SSA eligibility criteria before applying is essential to ensure you meet the requirements and build a successful case.
How Does The SSA Define Fibromyalgia?
Fibromyalgia is not listed in the SSA’s “Blue Book, ” leading many people to believe it doesn’t qualify for Social Security Disability Insurance (SSDI).
While not officially in the book of disabilities, fibromyalgia is eligible for benefits. The SSA places this condition between a musculoskeletal disorder and an immune system disorder.
Fibromyalgia is a chronic condition whose cause remains unknown. There are different types of fibromyalgia, and patients are likely to go through all of them during the course of the disease.
The most common symptoms include:
- Pain all over the body
- Muscle pain
- Joint stiffness
- Fatigue
- Insomnia
- Headaches
- Trouble concentrating
While there’s still no cure, there are effective treatments to control and manage the symptoms.
Can You Get Social Security Disability Benefits for Fibromyalgia?
You can secure disability benefits for fibromyalgia if your symptoms are severe enough to stop you from engaging in a substantial gainful activity.
However, despite this condition technically qualifying, applying for and obtaining the benefits is no less challenging.
Claimants must meet strict criteria and prove their symptoms prevent them from working. Fibromyalgia is not easy to prove, and if you don’t build a solid case, the process can take months or even years.
While fibromyalgia is eligible for SSDI, it’s much easier to secure disability benefits if you have another impairment alongside it. Fibromyalgia usually comes paired with other health conditions, which you can use to enhance your case:
- Depression
- Anxiety
- Arthritis
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome (IBS)
- Postural tachycardia syndrome (POTS)
- Migraines
SSA Eligibility Criteria for SSDI Fibromyalgia
To obtain Social Security Disability benefits, you must prove you have a qualifying condition hindering your work capacity.
Each impairment has its own criteria, but the general SSDI eligibility requirements encompass the following:
- You have a qualifying disability.
- Your disability is preventing you from working and earning enough money to support yourself.
- The impairment or disease is expected to last at least 12 months.
- You have collected enough work credits through your taxes.
These are some of the criteria the SSA will consider when evaluating your fibromyalgia claim:
Trigger Point Score
Medical evidence, such as tests, scans, diagnoses, and medical history reports, are the cornerstone of your disability case. One of the most common tests to confirm fibromyalgia is the trigger point test.
You need at least 11 out of the 18 pain points to qualify for SSDI. The higher the score, the more chances you have of securing the benefits.
Main Symptoms
To qualify, you must have the following symptoms:
- Pain in joints, muscles, and surrounding tissues for at least three months.
- The pain stops you from performing daily or work activities.
- You have at least six or more secondary symptoms.
Secondary Symptoms
These are some of the secondary fibromyalgia symptoms you must experience to be eligible for SSDI:
- Fatigue
- Depression
- Anxiety
- Memory loss
- Irritable Bowel Syndrome
- Sleep disruptions
- Headaches
- Hair Loss
- Blurred vision
- Bruises
Rule Our Other Conditions
The SSA will ask to provide medical tests and imaging to rule out other diseases that could cause the same symptoms, such as lupus, multiple sclerosis, or hypothyroidism.
SSDI or SSI: Which Benefit Can You Get for Fibromyalgia?
If you have fibromyalgia, you can apply for two SSA disability benefits: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Each program has its own eligibility criteria, but both require you to have a long-term impairment that stops you from working.
SSDI is meant for disabled individuals who have enough working credits to qualify.
SSI was designed to aid low-income individuals who don’t have sufficient work credits to meet SSDI requirements.
In some rare circumstances, you can apply for both benefits. We wrote an article about the difference between SSI and SSD – you can check it to learn which benefit you should apply for.
Steps for Applying for Disability Benefits for SSDI Fibromyalgia
If you think your fibromyalgia meets the SSA criteria, now it’s time to apply for the benefits.
Like with any SSDI case, you must file a claim for the SSA to evaluate your condition and determine if you are eligible.
These are the steps to file SSDI fibromyalgia disability claims:
1. Confirm Your Diagnosis
The first step of the process is to prove you are suffering from the symptoms of fibromyalgia. We advise you to seek medical treatment from a professional physician or rheumatologist.
To confirm you have fibromyalgia, you need a doctor’s diagnosis that shows you:
- Have had body pain for at least the last 3 months (and the rest of the symptoms listed above).
- Don’t have any other medical condition that could cause those symptoms.
2. Gather Medical Evidence
Before applying, you must collect enough medical proof to support your condition.
The SSA will base its decision on the evidence you submit. This is a critical step, so take your time and do your homework.
You will need to include the following evidence in your claim:
- Medical evidence from physicians (tests, diagnoses, treatment history, valuations, and more).
- Proof from other medical sources. For example, diagnosis from healthcare professionals if you suffer from anxiety or depression.
- Nonmedical evidence, such as testimonials from family, friends, and coworkers.
3. File An SSDI Claim
The last step of the application process is filing an SSDI fibromyalgia claim.
You can apply in person at any Social Security office, online, or over the phone.
For this step, you must submit medical and nonmedical evidence and fill out some forms. Make sure to answer every question, no matter how vain they may seem, and to be detailed but concise.
4. Next Steps: What To Do After Filing Your Claim
After filing your Social Security claim, you must wait for a verdict from the SSA.
How long will it take? The SSA receives thousands of applications each month, so reviewing your case may take a while. On average, claimants get a decision about 5 months after submitting the claim.
During that time, maintain regular communication with the SSA, and don’t neglect your medical treatment or doctors’ appointments.
Securing Your Benefits: 6 Knowledgeable Tips to Build a Winning Case
Do you want to enhance your chances of securing disability payments?
The secret is not leaving anything to chance. These are 6 knowledgeable tips for building a solid case and acquiring the benefits you deserve:
Collect Enough Medical Evidence to Support Your Case
Fibromyalgia claims are not easy to win. This condition can be challenging to prove; the more medical evidence you submit, the better your chances of winning your case.
Start collecting medical records as soon as you get the fibromyalgia disability diagnosis. Document the progress of your illness, stating how much it affects your daily activities and ability to work.
From test results and treatments to doctors’ notes and medical exams ruling out other conditions, put forth effort to gather all relevant information about your medical history.
Show Initiative in Improving Your Condition
It’s also crucial to show the SSA you are doing everything possible to improve your health.
That includes proving you are pursuing every available treatment for fibromyalgia, such as physical therapy, medication treatment, or seeing a mental health professional if you have anxiety or depression.
If you haven’t exhausted the treatments suggested by your physician, the SSA may reject your claim until such therapies have been pursued.
Be Extra Careful When Filling out the Paperwork
Filling out an SSDI application involves a substantial amount of paperwork. When applying, you must complete a lengthy questionnaire with personal and condition-related inquiries.
It’s important to reply to every question, even those that might seem irrelevant. The process is strict, and leaving a question blank can cost you your benefits.
Use this opportunity to provide insightful information about your condition. Try not to overlook any details.
Be concise but thorough; explain your fibromyalgia pain, the symptoms you have, and how this condition prevents you from working.
Remember not to exaggerate your symptoms (the SSA can verify them through your medical records).
Don’t Miss Deadlines – Avoid Giving the SSA Any Chances to Reject your Claim
Just as not filling out the application paperwork correctly, missing deadlines also can hinder your case.
For example, if your application gets denied in the first instance, you can request an appeal. After getting rejected, you have a specific time frame for filing an appeal.
Mark all important dates on your calendar or schedule reminders on your phone so you don’t miss any deadlines.
Request a Recommendation Letter from Your Physician
A letter from your physician or a rheumatologist can tip the scale in your favor.
However, for it to be efficient, the letter must be well-written and persuasive. You can request it from a licensed healthcare professional; if they specialize in your condition, that is even better.
Additionally, letters from family and friends describing how your impairment has impacted your daily life can strengthen your case.
All the letters you submit must be consistent with your illness and the medical records you provided.
In some cases, the content of nonprofessional letters can weigh down your case, so we advise you to consult with an attorney before including additional information on your application.
Hire A Professional Disability Attorney to do The Heavy Work for You
The journey of claiming disability benefits for fibromyalgia can be lengthy and stressful; thankfully, you don’t have to walk this path alone.
Professional disability attorneys have the resources and experience to help you build a winning case. They can take the stress out of your hand and help you with crucial tasks, such as:
- Gather medical evidence.
- Paperwork submission.
- Maintaining direct communication with the SSA.
- Represent you at a hearing, if necessary.
Improving your chances of winning disability with a lawyer is a wise decision with impairments that are difficult to prove, such as fibromyalgia. Such cases need a solid case without flaws.
Having an experienced disability lawyer by your side can be the breaking point between getting rejected or obtaining monthly disability paychecks.
Get in Touch With a Reliable Indianapolis Disability Law Firm
Navigating the turbulent waters of SSDI fibromyalgia can be stressful and time-consuming.
However, putting the effort into building a persuasive case is your best bet to secure disability benefits. Use the insight from his article as your base to start working on your claim.
Do you need advice on your fibromyalgia disability case? Don’t hesitate to contact our disability law firm.
Our dedicated attorneys are ready to answer your questions, tell you if you qualify for SSDI fibromyalgia, and assist you with your case. We’ll deal with the heavy work so you can enjoy peace of mind and secure the benefits you deserve.
