Can You Get Disability with Fibromyalgia?

Yes, you can get disability benefits for fibromyalgia. As long as your condition meets the SSA’s definition of disability, it’s possible to qualify for benefits.

The tricky part, however, is proving to the SSA that your fibromyalgia is disabling enough to warrant benefits.

You see, despite several research studies about it, there are still a lot of things we don’t understand about fibromyalgia. Even experts cannot agree on what’s really causing it. Plus, the symptoms are often self-reported and thus cannot be reliably determined.

It’s no wonder, then, that getting disability benefits for fibromyalgia can be tricky. For some types of disabilities, a medical diagnosis would usually suffice. But for fibromyalgia, it may not always be enough.

If you’re suffering from fibromyalgia and are planning to apply for disability benefits, here’s everything you need to know.

When is Fibromyalgia a Disability?

According to the SSA, a medical condition can be considered a disability if:

• it prevents you from working or engaging in any substantial gainful activity
• it prevents you from doing the work you previously did or adjusting to other types of work
• it has lasted or is expected to last for at least a year or result in death

For Fibromyalgia, the SSA uses the 1990 ACR Criteria for the Classification of Fibromyalgia and the 2010 ACR Preliminary Diagnostic Criteria.

Based on the 1990 version, you can have a medically determinable impairment (MDI) if you can prove all of the following:

• a history of widespread pain that lasts for at least 3 months and affects most parts of the body,  including:
  – thoracic spine
  – lower back
  – anterior chest
  – cervical spine
  – left, right, upper, and lower sides of the body

• At least 11 positive tender points in the physical examination. They must be found bilaterally on either side of the body at any of these sites:
  – the base of the skull
  – the muscles at the shoulder and near the shoulder blade
  – back and side of the neck
  – gluteal muscles at the top of the buttocks
  – the outer aspect of the elbow
  – below the hip
  the inner part of the knee
• evidence that other disorders that could cause similar symptoms have been excluded from the diagnosis

In addition to the above, the 2010 ACR Diagnostic Criteria added that a patient must show repeated manifestations of six or more symptoms, including:

• manifestations of fatigue, cognitive or memory problems,
• anxiety disorder
• depression
• irritable bowel syndrome
• waking unrefreshed

To prove the above, the SSA may require you to provide:

• medical evidence for at least 12 months before the date you applied for benefits
• psychologist evaluation
• other medical evidence to prove the severity and functional effects of the impairment
• statements proving the disability from relatives, friends, neighbors, past employers, and the SSA personnel who conducted the interview, among others