Fibromyalgia Disability Benefits
One of the fiercest battles for me personally has been the disability benefits process. I have to say this up front — once you make a decision to apply and fight for disability benefits, be prepared! It is not for the faint of heart.
I gave it a go for the first time 10 years ago when I was divorced, a single mom and solely responsible for my adolescent son. I followed the procedure to a tee — that meant no attempt to work during the months the case was being reviewed.
As most of you know, the first time to apply is almost always denied. Such was my case. I don’t tell you this to discourage you in any way, but to actually prepare you and encourage you to muster up that warrior side of you.
At that time in life, I had to make a decision not to continue the fight because of the responsibility I had as a single parent. I chose rather to find alternative means of making a living that would allow me to have a more flexible schedule.
To make money from home, I worked at home as a web administrator, executive assistant and bookkeeper, taking on freelance jobs as I was able.
In the years that followed, I returned to the public sector workforce to better provide and for my son and myself. I went through what so many of us do in trying to maintain a regular routine and schedule.
I went through three more jobs to finally come to the conclusion that it was time to pursue the disability process again. I simply was unable to maintain a nine-to-five schedule consistently.
I was hurting my health more than I was helping, and worsening my financial situation as I had to go to the doctor more frequently, to therapy, and to specialists for accelerated conditions.
The Decision Process
Once you decide applying and fighting for disability benefits is the route you should take, it is most important to have a thorough understanding of what is required, what is needed and what will occur along the way.
Please understand that it is a slow process and can take months up to a couple of years, depending on your local administration’s case loads. As I share step by step with you, I want to let you know that I have come out on the other end of the tunnel and won!
So be brave, be patient with yourself and others, and realize that the decision to follow it through to the end can be rewarding if you don’t give up.
While there are no guarantees, I knew for me it was important to give it my best and fight it all the way through to the end, knowing that I had done everything possible to bring about a change that would give me some relief and flexibility in my life.
Through the Eyes of the Social Security Administration
One thing that is important to know at the outset of your disability application process is that Social Security does not look solely at medical condition, but rather “functionality.”
They do not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible.
For this reason, some with fibromyalgia may be deemed disabled and others not. What does this mean? The definition given by SSA defines disability as follows:
- "The inability to do any substantial gainful activity due to your medical or mental problem." In addition, your condition must interfere with basic work-related activities. If it doesn't, your claim won't be considered.
- The combined effect of having multiple impairments is taken into account. That can be important for many people with fibromyalgia.
- You must be unable to do your previous work or any other substantial gainful activity. Your age and education are considered, as well as your remaining abilities and your work experience.
Of course the first step is indeed proving you have a severe physical impairment, and then proving it limits your functional ability.
When determining physical impairment, the Social Security Administration requires that your health care provider has ruled out other conditions through physical exams and blood tests. For this reason, it is imperative that you and your doctor have thoroughly done your homework before applying.
Proper notation of your condition and health diagnosis is mandatory. Be certain that you have a doctor who is in full support of your decision and one that properly notates their findings and agreement in your medical records.
Schedule frequent visits with your doctor in order to maintain proper care as well as evidence for your claim.
Note: There are some physicians who do not participate in the disability process for various reasons. It is wise to speak with your doctor early on to see if they support disability applications or not so if you have to change doctors, you can do so sooner rather than later.
Medical Determination
Your medical file must contain a diagnosis of fibromyalgia, trigger point testing results, and documentation of your medications, treatment, response to treatment, and limitations. The SS Administration specifically requires objective medical evidence to establish the presence of an MDI (medically determinable impairment.)
When a person alleges fibro, longitudinal records reflecting ongoing medical evaluation and treatment from acceptable medical sources are especially helpful in establishing both the existence and severity of the impairment. In cases involving fibro, as in any case, they will make every reasonable effort to obtain all available, relevant evidence to ensure appropriate and thorough evaluation.
Also, they request evidence for the 12-month period before the date of application unless they have reason to believe that they need evidence from an earlier period, or unless the alleged onset of disability is less than 12 months before the date of application.
