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Does fibromyalgia qualify for Social Security Disability (SSD)? 

Many people suffer from a condition called fibromyalgia.  As a complex medical condition, it has numerous symptoms which can make it difficult to diagnose. It is characterized by diffuse pain throughout the body, including the sufferer’s joints, tendons, muscles, and surrounding soft tissue, and it can be quite debilitating. 

Because it can be difficult to diagnose, proving that you are disabled due to fibromyalgia can be complicated.

What does it take to convince SSA that you have fibromyalgia?

The Social Security Administration (SSA) gave a policy interpretation ruling with SSR 12-2p: Titles II and XVI, which details the evidence necessary to qualify for benefits based on fibromyalgia.  The qualifying factors come in three categories: history, testing and examination:

  • History: SSA wants to see a medical history of widespread fibromyalgia pain, and how the condition has changed over time. Your physicians’ notes are key to demonstrate how the condition has persisted or worsened over time.
  • Testing: SSA also is looking to rule out other medical conditions. A history of medical tests should be included in your medical records that rule out any other potential diagnoses for your pain.
  • Examination: A fibromyalgia can include 18 possible points of tenderness on the human body. SSA is looking for documentation that includes at least 11 of these points.

In addition, your medical records should indicate what treatments your doctors have recommended you try to control your condition and the efforts you have made to follow the treatment plans by your doctors.

If you are wondering if your fibromyalgia diagnosis qualifies for SSD, you’ll be glad to know that numerous people with fibromyalgia have successfully applied and received benefits. If your Social Security Disability application has been denied, it may be time to explore all your options. An experienced advocate can help you understand more. 

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