Fibromyalgia

Friday, July 17th, 2009

Disability benefits adjudicators are averse to approving claims based upon fibromyalgia. Fibromyalgia claims are frequently denied for allegedly lacking objective evidence. I represent a 37 year old banker with fibromyalgia whose application for Social Security Disability (“SSD”) benefits was approved in only three months.

To ensure that there was no mistaking the severity of the claimant’s fibromyalgia, I submitted functionality assessments from two rheumatologists and an infectious disease specialist. Based upon their examinations and review of the medical records, each specialist concluded the claimant was unable to do sedentary work on a full time basis.

The rheumatologists’ opinions are particularly important because the only accepted standard for diagnosing fibromyalgia is the criteria from the American College of Rheumatology (the “ACR”). The rheumatologists specified that their diagnosis and opinions regarding the severity of the claimant’ fibromyalgia was based on strict adherence to the ACR criteria. All three specialists explained why the claimant’s fibromyalgia was severe enough to preclude her from working, and those opinions were buttressed by a report that a vocational consultant prepared.

Fibromyalgia claims not only need longitudinal treatment records showing complaints and diagnoses of fibromyalgia, but also multiple expert opinions regarding the severity of the claimant’s condition to have any chance of being approved.

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