Getting a disability claim approved for fibromyalgia can be difficult as initial claims are often denied. Fibromyalgia claims were traditionally denied by disability claims examiners if fibromyalgia was the only diagnosis. However, due to legislation in the past few years, the criteria for a fibromyalgia claim has changed. An experienced Chicago Social Security attorney can provide answers to questions, especially if an application has been previously denied.

What is Fibromyalgia?

Fibromyalgia is a common disorder. Historically, fibromyalgia was a sort of “catch-all” diagnosis. If musculoskeletal complaints were causing pain for no specific reason, fibromyalgia (FM) was often the diagnosis.

In 1990, the diagnosis of FM was formalized by the American College of Rheumatology. Various points on the body were chosen. A physician would manually press on a point using a force of 9 pounds. If at least 11 tender spots were found, FM could be diagnosed.

18 points were chosen, nine on each side of the body. These pressure points include the:

  • Base of the skull
  • Back and side of the neck
  • Shoulder muscles and muscle near shoulder blade
  • Second rib from the top of the rib cage
  • Top of the buttock and below the hip
  • Outside of the elbow or inner side of the knee

What New Criteria are in Place?

Fibromyalgia was not traditionally accepted as a disorder requiring Social Security benefits until recently. Many claims were initially denied. Patients may have been forced to work while suffering severe, painful symptoms.

In 2012, a new ruling by the Social Security Administration provided new criteria for disability adjudicators and judges. This decision provided clear guidelines for FM, much to the relief of patients.

Fibromyalgia can be the basis of disability when established with medical evidence. A licensed physician must document the person’s symptoms and conduct a complete medical exam. Medical history and treatment notes must also be provided. The physician will establish the person’s functional abilities over time, indicating if symptoms improve or worsen, and how they respond to treatment.

What if a Claim is Initially Denied?

If a claim is denied, it is important to seek the counsel of an experienced Chicago Social Security attorney. An attorney can examine the medical history of the claimant to determine if a proper diagnosis has been made and what treatment options have been used. It is important to understand why these claims are denied when pursuing an appeal.