Fibromyalgia affects about 4 million US adults, about 2% of the adult population. Fibromyalgia can cause pain, disability, and lower quality of life.
WHAT IS FIBROMYALGIA?
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Fibromyalgia is a chronic long-term illness. It causes all-over muscle pain, joint pain, and fatigue. The pain may come and go.
In most cases, symptoms often begin after an incident, such as physical trauma, surgery, infections or physiological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
There are no known cures, but medications, lifestyle changes, and therapies offer relief.
SOME IMPORTANT FACTS AND STATISTICS ON FIBROMYALGIA IN THE COUNTRY
• Two-thirds of cases with fibromyalgia are misdiagnosed.
• Women are twice as likely to have fibromyalgia as men.
• 28% of physicians who treat fibromyalgia patients don’t take it as a legitimate disease.
• 74% of fibromyalgia patients spend more than $100 per month on OTC medications.
• Fibromyalgia patients have a higher chance of becoming overweight.
• Fibromyalgia patients are 10 times more likely to commit suicide.
• 24.6% of fibromyalgia patients see more than 6 health professionals before reaching their diagnosis.
• 20 to 36% of patients with migraines also suffer from fibromyalgia.
• 2 to 6% of school-aged children suffer from fibromyalgia.
• More than half of all fibromyalgia patients will experience Major Depressive Disorder (MDD) at some point.
Fibromyalgia is one of the harder conditions to get approved for as a disability in the country. As its symptoms are self-reported, you will require extensive medical documentation and your treating doctor to support your case.
Fibromyalgia is diagnosed using the patients’ history, physical examination, X-rays, and blood work.
SOCIAL SECURITY ADMINISTRATION (SSA)
The Social Security Administration (SSA) is an independent agency of the US Federal government. It administers Social Security benefits and has a budget of over a trillion dollars. It employs more than 60,000 individuals.
The SSA is responsible for evaluating all disability applications. While reviewing your case, the SSA will determine if you have a “medically determinable impairment” (MDI) of fibromyalgia.
DEFINITION OF DISABILITY
Disability is defined as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which is expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
The SSA considers you disabled under Social Security rules if all the following conditions are fulfilled:
• You cannot do the work that you did earlier because of your medical condition.
• You are unable to adjust to other work because of your medical condition.
• Your disability has lasted or is expected to last for at least one year or will result in death.
The criteria and requirements for claiming disability due to fibromyalgia are extensive, they include:
• Symptoms of pain in joints, muscles, and surrounding tissues must be severe and present for three months.
• Documented evidence that rules out any other condition.
• Statements from you and others supporting any restrictions on, or inabilities, to perform, your daily activities.
• Whether fibromyalgia prevents you from working.
• 6 or more ongoing signs or symptoms of fibromyalgia.
SYMPTOMS OF FIBROMYALGIA
• Fatigue and tiredness.
• Headaches including migraines.
• Pain and stiffness all over the body.
• Problems with memory and cognition, also known as fibro fog.
• Irritable Bowel Syndrome (IBS).
• Depression and anxiety.
• Waking up exhausted.
• Tingling or numbness in the hands and feet.
• Pain in the face or jaw (temporomandibular joint syndrome, also known as TMJ).
Although the SSA already requires a doctors’ diagnosis, they will still evaluate your history of symptoms to determine whether you are capable of work.
ELIGIBILITY TO RECEIVE SOCIAL SECURITY DISABILITY INSURANCE BENEFITS FOR FIBROMYALGIA
The Social Security Administration (SSA) does not have a separate listing for fibromyalgia in its impairment listings manual or ‘Blue Book’. Earlier, most applicants who applied for social security benefits based on fibromyalgia got denied. The main reason for this was due to the nature of fibromyalgia.
Fibromyalgia symptoms are largely subjective and its causes are unknown and not understood. Because its symptoms vary from person to person, and because the medical profession has not figured out its causes, disability examiners at the SSA were not sure how to classify fibromyalgia cases.
The SSA has, however, published a ruling giving guidance to disability claims examiners and Administrative Law Judges as to how to assess fibromyalgia cases.
MEDICALLY DETERMINABLE IMPAIRMENT (MDI)
The first test you must pass when applying for fibromyalgia-based disability benefits is that you should have a medically determinable impairment (MDI) that has been established by medical evidence such as laboratory tests and medical signs of the illness or disease. The ruling of the SSA directs disability claims examiners and judges to rely on criteria issued by the American College of Rheumatology (ACR).
The SSA must find medical signs of an impairment that could reasonably be expected to produce symptoms. The applicant is required to provide extensive evidence of chronic widespread pain, including pain in the back, neck, or chest, and a doctor must have ruled out other diseases such as lupus, hypothyroidism, or multiple sclerosis through the use of laboratory tests or X-rays. In addition, the applicant must have one of the following:
• Tender points in at least 11 out of the 18 tender point areas of the body.
• Repeated occurrences of six or more fibromyalgia symptoms, particularly fatigue, memory or cognitive problems, non-restorative sleep, depression, etc.
Other symptoms include dizziness, seizures, headaches, muscle weakness, Raynaud’s phenomenon.
The claim examiner will then examine and review your medical records and study your doctor’s notes on your complaints of pain, fatigue, and cognitive difficulties and will determine if you have a Medically Determinable Impairment (MDI).
RESIDUAL FUNCTIONAL CAPACITY (RFC)
Once the SSA has determined that you have an MDI, it will prepare a residual functional capacity (RFC) assessment to determine if your fibromyalgia permits you to do any work.
An RFC is an evaluation of your ability to perform various levels of work. The SSA determines your RCF based on your medical records, opinions from doctors and specialists, and statements made by you, friends, family members, and co-workers.
In preparing your RFC, the SSA will rely on your doctor’s findings and opinion with regard to your abilities, such as:
• How long you can sit or walk.
• How much can you lift.
• How well you can focus.
• How well you can remember instructions.
The SSA will compare your RFC with your previous job, and the types of jobs available for someone with your RFC levels and limitations. If the RFC rules out all jobs, you will be found disabled.
INITIATING A DISABILITY CLAIM IN NORTH CAROLINA IF YOU ARE SUFFERING FROM FIBROMYALGIA
In order to file a disability claim through the SSA, you are required to fill out an application and provide medical documentation of your medical impairment/s that restrict you from working. You may be also required to sign release forms to allow the SSA to request any additional records that they might need in order to process and review your claim.
Application forms once properly completed, can be filed online, by mail, or in-person. Many SSA offices are located throughout North Carolina.
If your application is denied at the initial stage or after it was reconsidered, then you will have to request a hearing likely at one of the four Office of Hearings Operations located in Charlotte, Fayetteville, Greensboro, or Raleigh.
THE IMPORTANCE OF HAVING A SKILLED NORTH CAROLINA DISABILITY ATTORNEY
Attorney Charlie Hall has successfully handled many Fibromyalgia and similar cases throughout his long disability career and understands the rules required to be met to win a Fibromyalgia case. Currently, he sits on the Social Security Disability Specialization Committee that reviews attorney applicants for board certification in Social Security Disability Law. Over the last decade, he has trained other attorneys in how to practice in Social Security Disability law and how to handle Fibromyalgia and similar cases.
CONTACT A NORTH CAROLINA SOCIAL SECURITY DISABILITY ATTORNEY
At the Law Office of Charles F. Hall, IV, we provide genuine support and compassion for each and every claimant who is seeking disability benefits. We know how stressful being disabled can be – many of us, including Attorney Charlie Hall, have disabled loved ones who are in the same situation. Attorney Charlie Hall founded his law firm on July 4, 2016, to meet a growing need in the market of a client-focused law firm that treats disabled clients with superior customer service and zealous advocacy. For us, disability advocacy is who we are and our clients are more than just a number.
Social Security Disability Lawyer Charles Hall has examined, prepared, and presented complicated and complex medical evidence and advocated for disabled clients throughout North Carolina, and early in his career throughout the United States.
Call experienced Social Security Disability Attorney Charlie Hall for a free case evaluation right away. If you or your loved one is currently unable to work due to fibromyalgia in North Carolina, talk to our North Carolina Social Security disability attorney to learn more about qualifying and applying for Social Security Disability. If you have been denied, give us a call so we can help. We are located in Winston-Salem, North Carolina and represent clients throughout North Carolina, including Charlotte, Lexington, Mt. Airy, Greensboro, Winston-Salem, Statesville, Asheville, and Raleigh areas. You will not pay a penny until we have won your case.