Fibromyalgia Syndrome (FMS) is a leading cause of Social Security Disability and Long Term Disability Insurance Claims. Anyone who comes in contact with patients with FMS knows its disabling effects. However, much about the disease remains unknown. One Social Security Judge referred to it as a “pervading mystery – its cause, duration and functional limitations.” These cases can be won if the symptoms and the functional effects are made clear to the social security judge or the disability insurance company.
While the disease is identifiable medically, it can be difficult to prove legally in a Social Security Disability case
Fibromyalgia cannot be established by an objective test such as X-ray, CT Scan or MRI. There is no lab test to demonstrate it, though there are promising breakthroughs on brain imaging. FMS is only diagnosed by documenting the patient’s pain at certain “tender points” on the body, and correlating this information with reports of depression and sleeplessness. It is important to record how this debilitating disease impacts the ability to perform ordinary tasks.
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Even within the medical community, there are questions as to whether Fibromyalgia should be treated as a mental or physical impairment. This confusion causes a lot of trouble in the legal world of a Social Security claim; cases are often denied unless they fit easily into definitions set out in government regulations.
Psychological problems are entangled with physical pain for these patients. The pain can cause depression, and a vicious cycle is formed where the depression intensifies the pain.
For a Social Security case, any claim based on pain must be proven by demonstrating some definable underlying cause. Therefore, on a physical basis, these cases become difficult to win.
Rheumatologists with expertise in this illness can often diagnose the syndrome, but the problem is that pain itself is the condition. The pain cannot be legally proven by objective means, although it may be clear enough for a medical diagnosis. Careful notes from a treating rheumatologist can be key to winning a claim.
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The pain of Firbomyalgia can sometimes be quantified and proven with psychological assessments. This can demonstrate pain by scoring on specific tests. While some Fibromyalgia claimants may be offended by the suggestion that there is a psychogenic aspect to their conditions, they need to understand that social security considers pain under psychological rather than physical criteria. This does not mean the physical pain is not present, just that this is the way to present it clearly to the judge.
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Diagnosises of depression and possibly of somatoform disorder are concepts that do fit into social security’s listings of Impairments, and judges can recognize these diagnoses. Such functional impairments as decreased concentration, impaired memory, diminished social functioning and deterioration in work settings all need to be carefully documented to prove the cases. Marc Whitehead & Associates represents disabled claimants in their Social Security Disability, Long Term Disability Insurance and Veterans Disability Claims. To learn more, please read our free Social Security Disability E-book, and visit our website at disabilitydenials.com.
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