Fibromyalgia disability process

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The Fibromyalgia disability process page house the information on the United States Social Security Insurance/Social Security Disability (SSI/SSD) and Long Term Disability (LTD) process for Fibromyalgia (FM/FMS) page. Information on this page may help patients in other countries. This page is for information purposes only. It is not legal advice and it should not be relied upon in taking steps to file for disability.

Preparing For Your Social Security Disability Hearing: What To Expect By Michles Booth (2015)

United States[edit | edit source]

Please Note: The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only the Social Security Administration (SSA) and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the US, SSI and SSD benefits are available for fibromyalgia. Generally, for SSI/SSD, notes and tests from a Primary Provider may be allowed for submission (if a specialist has reviewed the tests) but specialists] such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment, and completing SSI/SSD paperwork.[citation needed]

The SSA now accepts a Fibromyalgia#Diagnosis diagnosis of fibromyalgia with the 1990[1][2][3] or 2010[4][2]American College of Rheumatology (ACR) criteria.[5]

SSI/SSD information and help[edit | edit source]

One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

For documentation of symptoms and co-morbidities of an FM diagnosis, you and your doctor should consider the following examinations and tests:

Examinations and tests[edit | edit source]

Not every test will be recommended by your doctor or be necessary if patient is not exhibiting certain symptoms.
A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. Arthritis, avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.[6]
Bone Scan This video shows what people may experience when they are having a bones scan. By MFTNHS (2015)
Fibromyaglia diagnostic examination[edit | edit source]
  • Rheumatologist examination and diagnosis of FM.[7][8] (Consider having a rheumatologist order tests and coordinate referrals of other specialists for examinations and testing. Only specialists can complete Social Security paperwork. A primary doctor cannot complete disability paperwork but may be able to forward test results they have ordered if a specialist has reviewed them.)
Arthritis[edit | edit source]
  • Whole body bone scan (bone scintigraphy) to rule out treatable arthritis.
Blood tests[edit | edit source]
FM/a® blood test[edit | edit source]
  • FM/a® Test[9] is a blood test to diagnose Fibromyalgia
    EpicGenetics' FM/a® Test is an FDA-compliant blood test that has been in use since 2012 and has successfully diagnosed patients with fibromyalgia from around the world. This simple blood test recognizes the immune system’s multi-biomarkers which are unique to fibromyalgia.[9] 
  • Routine blood tests for diabetes[10] (fasting sugar/glucose, A1C) and a full thyroid disease[11] panel (TSH, T3, Free T3, T4, and Free T4).
Gastrointestinal[edit | edit source]
Mental health and cognition[edit | edit source]
Tilt Table Test This interactive video explains what you can expect during the tilt table test. By eMedTV (2009)
Orthostatic intolerance[edit | edit source]
Sleep dysfunction[edit | edit source]
Vestibular Tests: VNG - Boys Town National Research Hospital In our Vestibular Tests Video Series, Kristen Janky, Au.D, Ph.D., CCC-A, Vestibular Audiologist at Boys Town National Research Hospital, explains the VNG test. By BoysTownHospital (2015)
TMJ, tinnitus, vertigo, and dizziness[edit | edit source]

What to Expect at Your VNG/ENG Test[31]

Of course, a person can have arthritis, sleep apnea, chronic lyme disease or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.[36][37]

There have been cases of vitamin D deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed vitamin D treatments may alleviate this pain. However, it is possible to have both a vitamin D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.[38]

See also[edit | edit source]


Learn more[edit | edit source]

LTD claims[edit | edit source]

Fibromyalgia: Are Courts Starting To Favor Long Term Disability Claimants? By Disability Insurance Attorneys Dell & Schaefer (2017)

SSI/SSD legal process[edit | edit source]

Social Security Disability and Fibromyalgia: is there any Hope I can Win? By Social Security Disability videos (2014)
Fibromyalgia and Social Security Disability: Doctor's Advice By LawMed Disability Attorneys (2018)

References[edit | edit source]

  1. Wolfe, Frederick; Smythe, Hugh; Yunus, Muhammad; Bennett, Robert; Bombardier, Claire; Goldenberg, Don; Tugwell, Peter; Campbell, Stephen (1990). Micha Abeles; Patricia Clark; Adel Fam; Stephen Farber; Justus Fiechtner; Michael Franklin; Robert Gatter; Daniel Hamaty; James Lessard; Alan Lightbroun; Alfonse Masi; Glenn McCain, W. John Reynolds; Thomas Romano; Jon Russell; Robert Sheon. "The American College of Rheumatology Criteria for the Classification of Fibromyalgia" (PDF). Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 33 (2): 160–172.
  2. 2.02.1 Wolfe, Frederick; Clauw, Daniel; Fitzcharles, Mary Ann; Goldenberg, Don; Katz, Robert; Mease, Phillip; Russell, Anthony; Russell, Jon; Winfield, John; Yunus, Muhammad (2010). "The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity" (PDF). Arthritis Care & Research. American College of Rheumatology. 62 (5): 600–610.
  3. "2010 Fibromyalgia Diagnostic Criteria - Excerpt" (PDF). American College of Rheumatology. 2010. p. 2.
  4. "American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia" (PDF). fibroknowledge.com (PDF). 2010.
  5. 5.05.1 ORDP; OPPS (July 25, 2012). "Social Security Ruling: SSR 12-2p". www.ssa.gov. Retrieved August 9, 2018.
  6. Krans, Brian (December 13, 2017). "Bone Scan: Purpose, Procedure, and Risks". Healthline. Retrieved August 21, 2018.
  7. "Finding a Fibromyalgia Specialist: Rheumatologists". Fibromyalgia-Symptoms.org. Retrieved February 2, 2019.
  8. "Rheumatologist Fibromyalgia: Do Rheumatologists Treat Fibromyalgia?". NewLifeOutlook | Fibromyalgia. December 31, 2013. Retrieved February 2, 2019.
  9. 9.09.1 "Home". EpicGenetics' FM/a® Test is FDA-compliant and has successfully diagnosed patients with fibromyalgia since 2012. Retrieved February 2, 2019.
  10. "Chronic Fatigue, Fibromyalgia and Diabetes". ADW Diabetes. September 1, 2015. Retrieved February 2, 2019.
  11. Fogoros, Richard N.; Shomon, Mary (January 22, 2019). "The Connection Between Hypothyroidism and Fibromyalgia". Verywell Health. Retrieved February 2, 2019.
  12. "How Is Fibromyalgia Diagnosed?". WebMD. Retrieved August 12, 2018.
  13. 13.013.1 Mandal, Ananya (June 25, 2013). "Common Conditions that Mimic Fibromyalgia". News-Medical.net. Retrieved February 2, 2019.
  14. Hughes, Grant; MD (November 16, 2018). "Can B12 Help With Fibromyalgia and Chronic Fatigue Syndrome?". Verywell Health. Retrieved February 2, 2019.
  15. Dix, Robin (February 10, 2017). "Vitamin B12 Deficiency Could Affect Your Fibromyalgia". Fibromyalgia News Today. Retrieved February 2, 2019.
  16. "Vitamin D and fibromyalgia". Vitamin D Council. Retrieved February 2, 2019.
  17. Tweed, Katherine (October 17, 2017). "Fibromyalgia and Small Intestinal Bacterial Overgrowth (SIBO)". News-Medical.net. Retrieved February 2, 2019.
  18. Mandal, Ananya (March 19, 2013). "Irritable Bowel Syndrome (IBS) and Fibromyalgia". News-Medical.net. Retrieved February 2, 2019.
  19. Hughes, Grant; MD (June 8, 2018). "Gluten Intolerance in Fibromyalgia & Chronic Fatigue Syndrome". Verywell Health. Retrieved February 2, 2019.
  20. Garcia-Leiva, Juan Miguel (August 15, 2014). "Celiac Symptoms in Fibromyalgia Patients". Prohealth. Retrieved February 2, 2019.
  21. Thomas, Liji (October 17, 2017). "Fibromyalgia and Small Intestinal Bacterial Overgrowth (SIBO)". News-Medical.net. Retrieved February 2, 2019.
  22. "Fibromyalgia and Depression". WebMD. Retrieved February 2, 2019.
  23. 23.023.1 "Fibromyalgia". Anxiety and Depression Association of America, ADAA. Retrieved February 2, 2019.
  24. Sher, Daniel. "How Are Anxiety and Fibromyalgia Connected?". www.calmclinic.com. Retrieved February 2, 2019.
  25. Mandal, Ananya (June 3, 2013). "What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction". News-Medical.net. Retrieved February 2, 2019.
  26. Dix, Robin (June 20, 2017). "Fibromyalgia, Fibro Fog and Cognitive Dysfunction". Fibromyalgia News Today. Retrieved February 2, 2019.
  27. Zamunér, Antonio Roberto; Porta, Alberto; Andrade, Carolina Pieroni; Forti, Meire; Marchi, Andrea; Furlan, Raffaello; Barbic, Franca; Catai, Aparecida Maria; Silva, Ester (2017). "The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients". PloS One. 12 (6): e0179500. doi:10.1371/journal.pone.0179500. ISSN 1932-6203. PMC 5470709. PMID 28614420.
  28. Yun, Dong Joo; Choi, Han Na; Oh, Gun-Sei (July 2013). "A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia". The Korean Journal of Pain. 26 (3): 303–306. doi:10.3344/kjp.2013.26.3.303. ISSN 2005-9159. PMC 3710947. PMID 23862007.
  29. Dellwo, Adrienne (November 16, 2018). "Living With Both Restless Legs Syndrome in Fibromyalgia". Verywell Health. Retrieved February 2, 2019.
  30. "Fibromyalgia and Sleep". www.sleepfoundation.org. Retrieved February 2, 2019.
  31. Banks, Lindsey (February 11, 2017). "What to Expect at Your VNG/ENG Test". Everyday Hearing. Retrieved February 2, 2019.
  32. "Fibromyalgia - Symptoms and causes". Mayo Clinic. Retrieved February 2, 2019.
  33. Dellwo, Adrienne (February 13, 2018). "Swollen Glands With Fibromyalgia & Chronic Fatigue Syndrome". Verywell Health. Retrieved February 2, 2019.
  34. Iikuni, Fusako; Nomura, Yasuyuki; Goto, Fumiyuki; Murakami, Masato; Shigihara, Shuntaro; Ikeda, Minoru (October 2013). "Why do patients with fibromyalgia complain of ear-related symptoms? Ear-related symptoms and otological findings in patients with fibromyalgia". Clinical Rheumatology. 32 (10): 1437–1441. doi:10.1007/s10067-013-2287-2. ISSN 1434-9949. PMID 23700040.
  35. Rana, M G. "» 10 Tips To Stop Fibromyalgia Dizziness and Balancing". Retrieved February 2, 2019.
  36. "Common Misdiagnoses of Fibromyalgia". WebMD. Retrieved August 9, 2018.
  37. "When Fibromyalgia Is More than Pain - Prohealth". Prohealth. January 8, 2016. Retrieved August 9, 2018.
  38. Shaw, Gina. "Does Vitamin D Deficiency Cause Chronic Pain?". WebMD. Retrieved August 9, 2018.
  39. Tillman, Adrienne (June 4, 2018). "Victory for ME Disability Claim - U.S. Court Upholds Plaintiff's Lawsuit After Being Denied Disability". #MEAction. Retrieved February 2, 2019.
  40. Silver, Lily (April 17, 2017). "The Sleepy Girl Guide to Social Security Disability (U.S.) | #MEAction". MEAction. Retrieved August 9, 2018.
  41. Skelton Preston, Patty (March 20, 2017). "How Patty's Lawyer Never Told Her What She Needed to Know". How to Get On. Retrieved August 9, 2018.
  42. "21 Sample Doctor Letters for Disability". How to Get On. May 1, 2017. Retrieved August 9, 2018.
  43. Dell, George; Jessup, Stephen (March 15, 2017). "Fibromyalgia: Are Courts Starting To Favor Long Term Disability Claimants?". YouTube. Disability Insurance Attorneys Dell & Schaefer.
  44. Ginsburg, Jonathan (April 21, 2014). "Social Security Disability and Fibromyalgia: is there any Hope I can Win?". YouTube. Social Security Disability videos.
  45. Bohan, Anthony (March 23, 2018). "Fibromyalgia and Social Security Disability: Doctor's Advice". YouTube. LawMed Disability Attorneys.

supplementary security income (SSI) - United States government disability benefit for those who have not enough work history to claim SSD, including children. Provides payments to adults and children with a disability. Means tested. (Learn more: me-pedia.org)

social security disability (SSD) - United States government disability benefits. Used for those who have previously paid tax and is not means tested. (Learn more: me-pedia.org)

Social Security Administration (SSA) - SSA is the United States government department for disability benefits, unemployment, and social security/welfare that handles SSD and SSI disability payments.

supplementary security income (SSI) - United States government disability benefit for those who have not enough work history to claim SSD, including children. Provides payments to adults and children with a disability. Means tested. (Learn more: me-pedia.org)

social security disability (SSD) - United States government disability benefits. Used for those who have previously paid tax and is not means tested. (Learn more: me-pedia.org)

cognition Thought processes, including attention, reasoning, and memory.

tilt table test A diagnostic test to determine orthostatic intolerance or other forms of dysautonomia. The patient is strapped to a table and the table is tilted while the patient is monitored.

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

Canadian Consensus Criteria (CCC) - A set of diagnostic criteria used to diagnose ME/CFS, developed by a group of practicing ME/CFS clinicians in 2003. The CCC is often considered to be the most complex criteria, but possibly the most accurate, with the lowest number of patients meeting the criteria. Led to the development of the International Consensus Criteria (ICC) in 2011.

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.