Getting Disability for Fibromyalgia Brain Fog, or Fibro Fog

If you have "fibro fog" in addition to serious physical limitations, your chance of getting disability benefits increases.

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Brain fog due to fibromyalgia, also known as fibro fog, is a commonly reported symptom of fibromyalgia. Patients with fibromyalgia syndrome (FMS) often describe sensations of fatigue and listlessness combined with states of confusion, poor attention and concentration, and short-term memory problems.

How Common Is Fibro Fog?

According to a report in Clinical and Experimental Rheumatology, 50% to 80% of fibromyalgia patients report cognitive dysfunction, or "dyscognition." The cognitive issues people suffering from FMS most often complain of include:

  • inability to concentrate
  • short-term memory lapses
  • reduced ability to find words (verbal fluency)
  • forgetfulness, and
  • mental confusion.

The same report found that brain fog occurs 2.5 times more often in fibromyalgia patients than in patients with other rheumatologic disorders, such as arthritis, scleroderma, Crohn's disease, or polymyositis.

What Causes Fibro Fog?

Doctors don't agree on what causes the cognitive symptoms of FMS, and they don't have an explanation for why some FMS patients have cognitive symptoms and others don't. Sleep deprivation, and significant difficulty in getting maintaining deep level sleep, is one possible answer. It's at the deeper levels of sleep ("delta wave" sleep) that a person's mind conducts its internal "housekeeping." During the delta wave phase of sleep, the brain integrates newly acquired information. The inability to get enough restorative deep-level sleep may have a negative effect on an individual's ability to recall information or operate at a normal level of mental efficiency.

In addition, pain is known to interfere with cognitive functioning. When the brain is processing chronic pain, some neurologists believe the brain may have less ability, or less cerebral blood flow, to perform cognitive tasks.

Can I Get Disability Benefits for Fibro Fog?

For many fibromyalgia patients, fibro-fog can be more disturbing than the pain. Fibro fog can have a real impact on job performance, especially when coupled with chronic pain.

To qualify for disability benefits through the Social Security Administration (SSA), first you need to have a diagnosis of FMS from a rheumatologist. If the SSA agrees that your FMS is interfering with your ability to do work-related activities, it will look at your medical records to find out exactly how FMS limits you, and what you can still do. The SSA uses this information on your physical and mental abilities to come up with your residual functional capacity (RFC).

If you have fibro fog that affects your ability to concentrate or remember things, the SSA will give you a "mental RFC." Your mental RFC will rate your ability to do skilled work, semi-skilled work, or unskilled work. In developing your RFC, the agency will assess how well you can do things like:

  • understand and remember instructions and procedures
  • follow two-step instructions to perform a task
  • work at an appropriate and consistent pace
  • ignore or avoid distractions while working
  • complete tasks on time
  • work a full day without needing more or longer rest periods than given, and
  • sustain regular attendance at work.

If you're only moderately limited in these areas, the SSA might say you can do unskilled work, meaning that there are plenty of jobs that you could do. But if the SSA finds that you're severely limited in several of these areas, you might be unable to do even unskilled work.

But what if you have fibro fog and physical problems, as many disability applicants do? When you have severe pain that limits you from certain activities in addition to moderate cognitive dysfunction, your combined issues will make it hard for the SSA to name any jobs you can do. For instance, say the SSA gives you:

  • a mental RFC for unskilled work because of poor concentration and a diminished ability to follow instructions, and
  • a physical RFC that allows you to do only desk jobs because of severe fatigue.

In this case, the SSA might agree that there are few jobs you can do. For more information on how the SSA makes these determinations, see our section on getting disability with an RFC.

Getting Help Applying for Disability When You Have Fibro Fog

One way to apply for Social Security disability benefits on your own is to file your claim online at www.ssa.gov/applyfordisability. You can also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information on applying, please see our article about filing for Social Security disability benefits.

If you have trouble getting started, you're having trouble getting through the questions, or you have questions about the application, you may want to get some legal help. Fibromyalgia is a difficult condition to get benefits for, even without the fibro fog. (Read more about why in our general article on fibromyalgia disability.)

Hiring a legal representative before you apply can:

  • walk you through all the steps in the process
  • help you avoid mistakes in the initial application
  • help you fill out all the required forms
  • make sure you cover all the criteria and have medical evidence to support your claim, and
  • handle the filing for you.

If this sounds like it would be helpful for you, click for a free case evaluation with a legal professional to get a sense of your chances of qualifying for benefits.

Updated December 20, 2021

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