Can you receive social security disability benefits for fibromyalgia

Can You Receive Social Security Disability Benefits for Fibromyalgia?

The SSA conducts a thorough medical records review to evaluate the extent of an applicant’s disability and treatment to determine the severity of his/her disability.

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In every social security disability case, medical records are the prime focus. The SSA (Social Security Administration) conducts a thorough medical records review to evaluate the extent of the applicant’s treatment to determine the severity of his/her disability. Among the many impairments that prevent a person from engaging in regular gainful work, fibromyalgia is a serious and painful condition. Social Security does not have a disability listing for this condition but the Administration has published a ruling giving guidance to disability claims examiners and administrative law judges (ALJs) on how to evaluate fibromyalgia cases. It is expected that this ruling will help reduce the number of fibromyalgia claimants who are often denied during the initial application stage but go on to win the benefits at the appeal stage. Even so, there are many fibromyalgia patients who are denied benefits.

Why Fibromyalgia May Not Qualify for Benefits Fibromyalgia by itself is not given the due importance it deserves, unless another condition such as degenerative disc disease or arthritis is involved. Moreover, it is a disability the symptoms of which are for the most part subjective, and its causes are not fully understood.

As a result, disability examiners have never been sure about classifying fibromyalgia cases.

Another thing that works against fibromyalgia patients is the fact that family doctors who are unable to identify reasons for certain types of pain their patients experience would diagnose fibromyalgia as the cause, which lacked credibility.

The SSD Ruling a Great Relief With the publication of the above mentioned ruling in which Social Security clarified that fibromyalgia should be found as an MDI (medically determinable impairment), applicants with this condition have new hope. Claims examiners and judges are directed to rely on criteria issued by the American College of Rheumatology (ACR) to determine whether an applicant has fibromyalgia.

The claims examiner will review all relevant medical records of the applicant to see if they include evidence of the required criteria. 

Applicants applying for disability should ensure that they have an actual diagnosis of fibromyalgia in their medical records.

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The diagnosis of fibromyalgia made by a family doctor can be strengthened if the same diagnosis is made by a specialist such as an orthopedist or a rheumatologist.

www.mosmedicalrecordreview.com

(800) 670 2809

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Once the severe medical impairment of fibromyalgia has been established, it is important to prove that the claimant is doing all that is possible to treat the condition.

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Apart from the medical records of the claimant from the treating doctor, the SSA may also require records from physical therapists and psychologists the claimant may have consulted.

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In the absence of sufficient information to make a decision, the SSA may send the claimant to a consultative exam, where he/she will be examined by a doctor who is paid by the SSA and will determine whether the claimant has fibromyalgia, its duration and severity, and how it limits the claimant functionally.

Solid Medical Evidence Helps Build the Case Judges prefer to approve disability claims for conditions/diseases that can be identified via diagnostic tests such as CT scan, MRI, EMG and so on. Medical record review for attorneys handling cases of fibromyalgia claimants, who also have another condition that can be confirmed via radiography, would therefore focus on that condition with the objective evidence. To win a case based on the fibromyalgia condition alone, lawyers require the right kind of evidence. This evidence comprises long-term treatment notes from a pain management specialist or rheumatologist; a statement that the patient’s condition meets the criteria required by the American College of Rheumatology; and proof from medical records

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Social Security disability cases are decided primarily on the basis of a claimant’s medical records, and these documents are of prime significance at the initial application level, reconsideration level, and at the hearing level. This makes medical review services a great support for attorneys handling such cases. Applicants would be well advised to obtain copies of their medical records before they apply for disability benefits. A careful perusal of the records would give a fairly good idea of how the case looks, and help the claimant decide whether he/she needs to consult another physician who is more efficient as regards the treatment provided and more willing to support the claimant’s disability case.

www.mosmedicalrecordreview.com

(800) 670 2809