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
- 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
What Benefits Can You Get With Fibromyalgia?
If you meet the SSA’s requirements, there are two kinds of disability benefits you can get: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
SSDI are for disabled people who have paid social security taxes and have earned enough work credits.
To qualify for SSDI, you must have at least 40 work credits. Though you can still claim benefits even with lesser work credits if your disability started at a young age.
How much work credits you’ll earn will depend on your income. For 2023, every $1,640 in covered earnings per year earns you one work credit. You can only earn up to 4 work credits per year.
The SSA uses a complicated formula to calculate SSDI benefits. But in general, SSDI beneficiaries can receive anywhere from $800 to $1,800 per month. Though people with higher income before their disability can receive up to $3,345.
If you haven’t worked in jobs that pay social security taxes, you can still claim SSI. This is a needs-based benefit intended for people from low income backgrounds.
To qualify for SSI, you must:
- be disabled, blind, or aged 65 and above
- have limited income and resources
- be a U.S. citizen or national or a lawfully permitted alien who meet the additional requirements
- reside in one of the 50 states, the District of Columbia, or the Northern Mariana Islands
For 2023, you must not earn more than $914 per month ($1,371 if you have an eligible spouse) to claim SSI. How much you’ll get will depend on your income. If your countable income exceeds the threshold, the SSA will deduct the excess amount from your monthly SSI check.
Do You Need a Lawyer?
Strictly speaking, you don’t need a lawyer to apply for disability benefits. However, having an experienced social security disability lawyer like Victor Malca can increase your chances of getting approved.
For the past 27 years, Atty. Victor Malca had been helping disabled workers in Florida get the benefits they rightfully deserve. He knows the SSA’s rules and regulations like the back of his hand. So he can help you identify and gather the right evidence to support your claim. Call us now for a free consultation.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.