TIPS TO WIN FIBROMYALGIA DISABILITY BENEFITS
HOW TO APPLY FOR SSD & SSI BENEFITS FOR FIBROMYALGIA
Fibromyalgia benefits are available from the SSA, if you cannot work for more than 12 months. If you suffer from fibromyalgia and can’t work, then you should apply for SSD benefits. You can apply for SSD & SSI benefits on the Social Security website.
For many years, the SSA did not recognize fibromyalgia as an illness. However, it was officially recognized by the SSA as a medical condition for which they would pay SSD Benefits in July 2012. That was over 10 years ago. However, many people still don’t know what to do in order to document fibromyalgia as a severe medical condition.
If you have fibromyalgia and are not working, then you can apply for Social Security benefits. However, in order to win SSD benefit, you will need the support of your doctor. It will increase your chances of winning benefits if your treating doctor describes your symptoms in the medical record. It is also helpful if you can find a doctor who is an expert in Fibromyalgia. Learn more about what you need from your doctor to improve your chances of winning benefits.
Our law firm can help you prove your case. However, in order to win benefits you will need the support of your doctor. Make sure the that you are seeing a doctor on a regular basis. That means at least once a month. You need to have ongoing treatment for your symptoms in order to receive SSD and SSI benefits. Learn more about the importance of medical records in your SSD case.
DO YOU NEED TO APPLY FOR SSD OR SSI BENEFITS?
If your fibromyalgia is going to keep your from working for over a year, then you should apply for benefits. You should also apply for benefits if you have a medical condition that is going to result in death. Even if you think you might eventually recover from fibromyalgia, you should apply for benefits as soon as you know that you cannot work.
Many people wait to apply for benefits because they think they will soon recover and be back to work. Unfortunately, some people even wait years to apply for benefits. By waiting, you may be creating a problem for yourself. For example, if you wait too long to apply after stopping work, you could end up with a date last insured problem (DLI).
If your DLI is in the past, then you must prove you were disabled prior to that date. This can be hard to do if your insurance ended or you were not going to the doctor prior to your DLI. Learn more about your date last insured and SSDI benefits.
You may not know how to prove you deserve benefits. Fortunately, we do. We have spent over 30 years helping clients apply for and win Social Security benefits. During that time, we have won over 20,000 SSDI and SSI cases. Filing for benefits with our help is simple. We will help you file your application for benefits online at the Social Security website.
APPLY FOR SSDI & SSI BENEFITS FOR FIBROMYALGIA
If you have fibromyalgia, then there are two types of benefits you can file for under the Social Security program: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. In order to receive benefits, you must first file an application. You can do this online at Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you cannot work:
SSDI benefits are for those who have worked in the recent past and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history.
To qualify for SSDI, you must have earned enough “work credits” to qualify. A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, you will only qualify for Supplemental Security Income benefits.
If you receive SSD benefits, then within 29 months of your onset date of disability, then you will also receive Medicare benefits. The 29 months includes your 5 month waiting period. Medicare benefits are a form of health insurance that pays for medical costs. Find out more about Medicare benefits.
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income. If you have a spouse who earns more than $4000 a month, for example, then that income will be the factor in whether you can receive SSI benefits. You cannot qualify for SSI benefits, no matter how severe your fibromyalgia symptoms, if you do not meet the income and asset rules for SSI.
SSI benefits are different from SSD benefits. However, SSI benefits can be more money on top a low monthly SSD benefit. In Utah for 2024, the monthly SSI benefit is $943 for an individual and $1,415 for a couple.
SSI benefits also come with Medicaid benefits to pay for medical bills. Medicaid is an insurance benefit that pays for visits to the doctor and other medical needs. Find more information about Medicaid.
WHAT IS FIBROYMYALGIA?
Fibromyalgia is a chronic condition that causes widespread body pain, fatigue, and other symptoms. It is an illness that is a collection of symptoms rather than a specific disease. People with fibromyalgia may have a bigger pain response to pressure and soft tissue pain. Also, other symptoms include sleep problems, cognitive issues (often called “fibro fog”), and trouble with memory. Some people also report restless legs syndrome. Additionally, you may have bowel or bladder problems.
Fibromyalgia can also link to Depression, Anxiety, and Post-Traumatic Stress Disorder. A medical doctor can tell you if you have fibromyalgia, after ruling out other potential causes of chronic body pain.
According to the CDC, almost 4 million adults in the United States have this disease. Fibromyalgia affects more women than men and tends to occur in people who are between the ages of 40 and 65.
You will need an attorney to help you prove you should receive SSD benefits. People who hire an attorney are 3 times more likely to win benefits.
SIGNS & SYMPTOMS OF FIBROMYALGIA
The SSA will consider your fibromyalgia to be a severe medical condition if your medical record shows a history of widespread pain that lasts for at least three months.
The pain may be intense one day and other days it may not be present. Nevertheless, the SSA must consider your ongoing pain. Additionally, the medical evidence must also show that other medical conditions which could cause the same symptoms have been excluded by your doctor. For example, your doctor may want to rule out other conditions that have similar symptoms. Your blood tests may include:
- Complete blood count
- Erythrocyte sed rate
- Cyclic peptide test
- Rheumatoid factor
- Thyroid function tests
- Anti-nuclear antibody
- Vitamin D
Also, if there is a chance that you may be suffering from sleep apnea, your doctor may recommend an overnight sleep study. Having these tests will demonstrate that you don’t have other reasons for your symptoms.
SSA’S LIST OF FIBROMYALGIA TENDER POINTS
In order for your fibromyalgia to be severe medical condition, the SSA requires your doctor to document the following tender points. Your doctor must find at least 11 tender points on a physical exam OR repeated manifestations of six or more fibromyalgia symptoms including:
- memory problems (often called “fibro fog”)
- irritable bowel syndrome
- muscle pain
- muscle weakness
- headache pain or cramps in the abdomen
- Raynaud’s phenomenon
- hives or welts
- blurred vision
- oral ulcers
- loss of taste or change in taste
- dry eyes
- shortness of breath
- no desire to eat food
- hearing problems
- easy bruising
- hair loss
- frequent urination or bladder spasms
You can learn more about how to prove your fibromyalgia meets SSA’s rules.
YOU MUST BE UNABLE TO WORK FOR MORE THAN 12 MONTHS DUE TO FIBROMYALGIA
In order to win SSD benefits, your fibromyalgia must keep you from working for 12 months or more. This is a “durational” rule. The reason for this rule is that most medical conditions don’t last for 12 months.
For example, think about breaking your leg. If you break your leg, then you might not be able to walk for 12 weeks. You might even have to lie down for a number of weeks. But, it will usually not keep you off work for a whole year.
Similarly, even a serious back surgery won’t keep you off of work for more than one year. Obviously, this depends on any problems you have after surgery and the kind of work you do. However, most of the time after back surgery you can return to work in a few months.
In order to win benefits, you must show you have ongoing fibromyalgia symptoms while you have been unable to work. This mean that you must have medical records that document the above list of symptoms. For example, your primary care doctor should have progress notes that show you have dry eyes, trouble breathing, and blurred vision. Additionally, you might have notes from a counselor showing that you have brain fog, chronic pain, and trouble sleeping. All of these records are important to submit to the SSA.
FIBROMYALGIA AND YOUR RESIDUAL FUNCTIONAL CAPACITY (RFC)
The SSA will also consider the functional limits that are caused by fibromyalgia. This is called your residual functional capacity. You should provide medical evidence showing how your symptoms significantly impact your ability to perform daily activities, work tasks, or other activities, like your hobbies. You may be asked questions at the hearing about what you do all day. Learn more about possible trick questions at your SSA hearing.
When the SSA decides your RFC, they use your statements on the forms you fill out for them. For example, when you fill out forms about your past work, you state how much you had to lift on the job and how also tell them how much you stood or sat during a work day. They will also look at the form where you write about what you can do during the day. They will decide how much you can lift and if you need to lie down during the day due to your fatigue. Therefore, your answers on these forms are often some of the most important statements you make.
The SSA may require you to see a medical expert in fibromyalgia to tell them about your condition. If the SSA orders you to see one of their doctors, then they will pay for the exam. The SSA doctor will provide an opinion regarding your pain and how it limits your ability to work.
TREATMENT FOR FIBROMYALGIA
The treatment for fibromyalgia usually requires that your doctor tailor treatment to your symptoms and needs. For example, it may include a combination of medication, diet and exercise changes, and therapy.
Medications for pain relief are commonly used to manage pain and improve sleep. Changes can also involve regular exercise, stress management, getting better sleep, and eating a healthy diet. Other forms of therapy, like massage and yoga may also help. Other doctors may tell you to go to talk therapy to help you manage your pain and stress. There is talk therapy that specifically focuses on pain management.
Support groups and education about your condition can also provide help when you are living with fibromyalgia. It’s important to remember that symptoms vary from person to person. Treatment plans may need to change over time based on your response to treatment and changing symptoms. Therefore, consult with your doctor.
WHAT WE DO TO HELP YOU WIN FIBROMYALGIA BENEFITS
You do not need to try to win SSDI and SSI benefits by yourself. We can help file your SSD application. Also, we can help you appeal every SSA denial. That way, you can focus on your health. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSD and SSI benefits
- Inform the SSA that they should pay your benefits under the Compassionate Allowance Rules
- Request an appeal if you receive an initial denial from DDS
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing and question the expert witnesses
- Read more about job experts
- Learn more about medical expert testimony
- Request review of a decision at the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. Send it in quickly.
Additionally, once you receive a denial, you have 60 days to file an appeal. You must also meet the time limit set by the SSA. If you do not, then you will have to start the process over again. That means you will lose any benefits you could receive on any prior application.
CONTACT US AND WE WILL TELL YOU IF YOU QUALIFY FOR FIBROMYALGIA BENEFITS
Our attorneys practice in Utah, California, and Nevada. We also represent clients in Idaho, Arizona, Washington, and other states. Find out more information about Utah SSD benefits. Read here for more information about Nevada SSDI benefits. We have helped many clients win benefits who have fibromyalgia and chronic fatigue syndrome.
Our main office is in Salt Lake City, Utah. However, there are also hearing offices in Las Vegas, San Francisco, Oakland. Learn more information about California SSD benefits. Idaho SSD benefit information is also available. In order to become our client all you need to do is give us a call.
We are also familiar with the Social Security laws where you live. Additionally, we understand the medical evidence the judge needs to see will help you win your case. It also helps us present the best arguments in court. If we accept your case, we will drive or fly to the SSA hearing office nearest you. Therefore, we can help you no matter where you live. If you need to apply for SSD benefits, then contact us.
If you have further questions about filing for SSDI and SSI benefits, then contact Cannon Disability Law. There is no charge to call our office. We will give you a free review of your case. Because we examine the merits of your case, we can often tell you over the phone if we can help you. Call today and let us help you win fibromyalgia benefits.