Chronic Fatigue Syndrome

Social Security Disability cases based on Fibromyalgia alone are generally difficult to win, and are always easier to win if other impairments are involved.

But having said that, it should be be noted that the outlook for such cases is starting to improve because more information is coming to light about the nature and causes of this illness. Check Our Tip List

Here is an explanation of Social Security's five-step process to determine if fibromyalgia qualifies for Social Security Disability Insurance:

STEP ONE simply determines if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $860 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

STEP TWO implies that the fibromyalgia disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling

STEP THREE has no medical listing for fibromyalgia. At this level of consideration the adjudicator is required to consider “equating” a medical listing. To establish fibromyalgia as a medically determinable severe impairment there must be evidence of widespread pain present for at least three months. There must be pain present on palpation in at least 11 of the 18 tender point sites as identified by the American College of Rheumatology and the Centers for Disease Control. There must be evidence of morning stiffness and/or stiffness after sitting for a short period of time. Fatigue is to be present. To equate a medical listing, the signs, symptoms and laboratory findings must be equivalent to an established listing. In most claims with a diagnosis of fibromyalgia a finding of disabled is usually at Step 5, i.e., functional limitations so significantly erode the occupational base for sedentary work that a finding of disabled is warranted.

STEP FOUR explores the ability of an individual to perform work he has done in the past despite his fibromyalgia disability. If SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

STEP FIVE looks at age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine fibromyalgia disability, SSA enlists vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of fibromyalgia, unable to perform what SSA calls sedentary work, then SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to his fibromyalgia disability, limited to performing sedentary work but has no work-related skills that allow him to do so, SSA will reach a determination of disabled.

Over age 60 and, due to his fibromyalgia disability, unable to perform any of the jobs he performed in the last 15 years, SSA will likely reach a determination of disabled.

Any age and, because of fibromyalgia, has a psychological impairment that prevents even simple, unskilled work, SSA will reach a determination of fibromyalgia disabled.

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