Social Security disability cases based on fibromyalgia alone are generally difficult to win, and are always easier to win if other impairments are involved. (For more information, read our general article on getting disability for fibromyalgia.) Having said that, the outlook for fibromyalgia cases is starting to improve because more information is coming to light about the nature and causes of this illness.
Regardless of whether a claimant is applying for disability based solely on fibromyalgia or alleges several impairments, a case involving fibromyalgia can be strengthened by understanding how Social Security disability examiners consider medical evidence.
Tip 1: Make Sure a Fibromyalgia Diagnosis Is in Your Medical Records
If you allege fibromyalgia when you apply for disability, make sure you have an actual diagnosis of this in your medical records. It's happened more than once that a doctor has mentioned to a patient that they "might have fibromyalgia" without actually diagnosing this condition in their medical chart.
Tip 2: Try to Get a Referral to a Specialist
If your primary doctor (e.g., family doctor or internist) diagnoses you with fibromyalgia, try your best to be referred to a specialist, such as an orthopedist or a rheumatologist (or a chronic pain or fatigue specialist), who can give you the same diagnosis. Because so many family doctors hand out the fibromyalgia label when they can't otherwise diagnose a patient's complaints, the value of this diagnosis is somewhat diluted. It can be significantly strengthened, however, and taken more seriously, if the same conclusion is reached by a physician who specializes in bone or tissue disorders, or disorders that involve complaints of pain and fatigue.
Tip 3: Diagnoses by Mental Health Professionals Carry Less Weight
Although it may be impossible to do, try to avoid being diagnosed with fibromyalgia by a mental health professional. Why? Because the simple truth is this: in the same way that family doctors misdiagnose their patients and overuse the fibromyalgia diagnosis, so do psychiatrists. This is a regular occurrence, in fact, for patients who are being treated for depression.
It should not be surprising to anyone, of course, that a person who experiences continuous pain and/or fatigue might also have to deal with depression as a result. Nevertheless, a fibromyalgia diagnosis by a mental health practitioner is usually interpreted by a disability examiner to mean this: that the disability claimant's symptoms and complaints are psychosomatic in nature. In other words, all in their head.
Therefore, again, for the fibromyalgia sufferer who is trying to win disability benefits, it is always sound advice to seek a supporting diagnosis from a specialist. This becomes doubly important for the claimant who is also receiving mental health treatment.
Tip 4: Find Out What's in Your Medical Records
All Social Security disability cases are decided chiefly on the basis of a claimant's records. This is true at the intial application level, reconsideration level, and at the hearing level. Applying for disability without knowing what your records state about your condition is unwise, to say the least. Many claimants have been surprised to find that the doctor who claimed to support their case did not indicate the same level of support in his or her treatment notes that he or she submitted to the SSA.
By getting copies of your medical records before you apply, you can get a rough idea of how your case looks and decide if you need to switch to a different physician, one who is more capable concerning your treatment and more willing to support your disability case. The importance of this cannot be stressed enough.
Learn more about getting disability for fibromyalgia.
By: Tim Moore, former Social Security disability claims examiner