Sorting Out Fibromyalgia Intricacies to Prove Disability - Part 3


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Sorting Through the Intricacies of Fibromyalgia to Prove Disability, Part 3

Published on July 5th, 2020 by Eric Slepian

Chronic, intense joint and muscle pain. Overwhelming fatigue. Painful and disruptive digestive problems. Difficulty concentrating and processing instructions. These and many more are symptoms of fibromyalgia, a sometimes misunderstood and potentially devastating disease.

In parts 1 and 2 of this post, we talked about fibromyalgia (FM) and why it can be challenging to win a claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) based on fibromyalgia. Today we continue our discussion about how the Social Security Administration (SSA) analyzes a disability claim involving FM as Social Security Ruling 12-2p dictates.

Analyzing the Credibility of the Claimant’s Subjective Complaints of Pain and Other Symptoms

Once the SSA establishes that a claimant’s FM is a medically determinable impairment (MDI), the agency must evaluate the “intensity and persistence” of pain and other symptoms and how they limit work.

First, the agency looks at the objective medical evidence (OME) of FM and any other impairments. If the OME does not support the extent of symptoms alleged, the SSA must consider other evidence that might support the subjective complaints the claimant alleges – evidence like limits on activities, medication and treatment, attempts to get treatment for symptoms and other people’s statements about the claimant’s symptoms.

Determining Whether FM is Disabling

The SSA uses a five-step process in an SSDI or SSI claim to determine whether a claimant is disabled from working. If the agency finds that the claimant is not working and has a severe impairment, it goes to step three: whether the impairment meets or equals a listing in the official Listing of Impairments. Because FM is not a listed impairment, the question is whether the person’s FM “equals” the severity of a listed impairment such as the listing for inflammatory arthritis that has similar symptoms, according to the SSR.

Assessing Residual Functional Capacity

If the fibromyalgia does not equal a listing, the agency determines the claimant’s residual functional capacity, which is basically the person’s capacity for work after accounting for the limitations from FM and other impairments. Notably, the SSR requires a “longitudinal” look at the FM symptoms – in other words, an analysis of symptoms over time because the SSA recognizes that FM symptoms “wax and wane,” and there are both good and bad days.

Considering the person’s RFC, the agency at step four looks at whether the claimant could return to past work. If not, step five asks whether the claimant could perform other available work according to complex regulations that consider RFC, age, education and work history in the context of disability from working.

Importantly though, the SSR requires consideration of the limitations from subjective FM symptoms like pain, fatigue, mental health problems, environmental sensitivities and others that can limit the ability to perform work activities.

An SSDI or SSI attorney serving Mesa, AZ can be a tremendous help to an SSDI or SSI claimant with fibromyalgia since the application and appeal process can be complex and arduous at times. But the effort is certainly worth it when the claimant is ultimately eligible for disability benefits.

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