Living with fibromyalgia can make every day a challenge. Chronic pain and severe exhaustion are the two most common symptoms. However, people who suffer from the condition often experience other symptoms, like depression, headaches, memory loss, sleep disturbances, irritable bowel syndrome, and more. These can make it very difficult to go to work every day, which leaves many people wondering, “Is fibromyalgia a disability?” Depending on the situation, it can be, but it comes with some caveats. Read on for details about fibromyalgia disability benefits you may qualify for and how to apply for them.
Is fibromyalgia a disability?
When people ask if fibromyalgia is considered a disability, they’re typically referring to workplace accommodations under the Americans with Disabilities Act (ADA) or Social Security disability claims. Not that this post should not be taken as legal advice, as it only scratches the surface of what you should know when it comes to benefits, work status, and qualifications. You can read more about chronic pain and disability benefits here.
The ADA doesn’t maintain a list of medical conditions that constitute a disability. Instead, there is a general definition of disability that you must meet. According to the ADA, you must have a physical or mental impairment that substantially limits one or more major life activities. This includes people who have a record of impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability, but are regarded as having a disability.
The Social Security Administration (SSA), on the other hand, defines a disability as “a severe “medically determinable impairment,” also known as an MDI. We’ll discuss what qualifies as an MDI in further detail below.
Based on this information, the short answer is yes, fibromyalgia can be a disability in the way it affects your everyday life. But as for applying for and receiving Social Security benefits or ADA modifications, the answer will be based on factors related to your personal symptoms and overall health condition. While one person with fibromyalgia may be suffering with debilitating symptoms, another may find work and other daily activities more manageable. Fibromyalgia is a condition that can vary greatly from person to person, so the answer to the original question is also unique to that person.
Can you work if you have fibromyalgia?
Depending on the severity of your condition and the work you do, it may or may not be possible to work. Many people with fibromyalgia experience extreme tenderness when pressure is applied to the knees, thighs, hips, elbows, and neck.
For this reason, it is best to do a job that doesn’t require you to stay in one position for too long. Both standing and sitting for extended amounts of time can lead to more pain. Further, any job that requires heavy lifting or intense physical movement may also be too demanding in most cases.
If you wish to continue working, work with the Human Resources contact at your for the best methods on how to accommodate your fibromyalgia symptoms. Through ADA guidelines and recommendations, HR can work with you to offer several ways to make you more comfortable while you’re at work.
- Alternative lighting, flexible scheduling, or a modified break schedule for attentiveness/concentration issues
- Appropriate time off for treatments
- Chairs with head support, standing desks, or stand-lean stools for daily movement
- Reducing any physical requirements of the job
- Counseling, therapy, or even a support animal for stress management
- Walkers, scooters, or wheelchairs, as needed
This is just a sample of the many options that could allow you to continue working. Your HR team will determine the best solution on a case-by-case basis.
In order to make your condition best understood, you’ll need to provide a full explanation of your current diagnosis, symptoms, treatments, and limitations from your doctor. This documentation should be similar to what you’d provide in an application for disability.
Do fibromyalgia patients get disability benefits through Social Security?
The Social Security Administration maintains a list of adult impairments that may qualify for disability benefits. Unfortunately, fibromyalgia isn’t included. While it is one of the harder disability claims to win, it isn’t impossible. In order to qualify, you must prove to medical examiners that you’re suffering from a severe “medically determinable impairment,” also known as an MDI.
Social Security may consider fibromyalgia an MDI if both of these are true:
- You have evidence of widespread chronic pain that has lasted at least three months
- Laboratory testing, MRIs, and X-rays have ruled out other possible conditions
In addition, one of these must be present in your case:
- Ongoing occurrence of at least six fibromyalgia symptoms, such as fatigue, cognitive/memory issues (also known as fibro fog), waking up exhausted, irritable bowel syndrome, depression, and anxiety
- Positive tender point sites in at least 11 of 18 tested areas, above and below the waist and on both sides of the body
It’s important to note that even if you meet these requirements, you will still have to prove that you’re disabled. That means documenting reasons why you’re incapable of maintaining employment in any capacity, whether at your previous job or any other job.
How to apply for fibromyalgia disability benefits
The process of applying for fibromyalgia disability benefits is complex. Even if you are formally diagnosed, there are a number of factors you must be able to prove in order to qualify. This usually takes multiple visits with your doctor over a long period of time.
The following gives a brief overview of what you can expect, but it’s best to work with an attorney who is experienced with disability claims. They can give you exact guidance about how to apply for and receive benefits appropriate to your case.
Here’s what you can expect to do during the process.
Document your case
The more documentation you can gather about your medical history, the better your application will be. First, a confirmed diagnosis will be necessary. Due to the nature of fibromyalgia, which typically has no confirmed cause, doctors often diagnose it when they can’t find any other cause of your ongoing pain. This is why it’s important to have a specialist diagnose you based on lab tests and the current fibromyalgia diagnostic criteria.
Furthermore, a Residual Functional Capacity (RFC) about your impairments is necessary for a thorough application. This is an overall evaluation of your capacity to complete certain job-related activities, including your ability to:
- Lift or carry weight, and how often you’re able to do so
- Stand, walk, or sit during a normal eight-hour work day, and how long you’re able to do so
- Climb stairs, kneel, crouch, or crawl
- Use fine motor skills (such as typing or using a computer mouse)
- Reach for objects, especially those overhead
- See, hear, and speak clearly
- Withstand environmental conditions, such as extreme cold or heat, smells, and noise
Gather supporting information
In addition to a formal application, your diagnosis, and an RFC, there may be a few other things that will be critical to your success. You may need to include:
- Contact information for all of your doctors, as well as the dates of your appointments, treatments, or hospitalizations
- Health records of lab tests, psychological evaluations, and prescribed medications
- A summary of your job history
The Social Security Administration will take everything you provide into consideration, so provide a very clear picture of your day-to-day challenges. A journal (paper or mobile-app based) is a great way to do this. Spend time each day jotting down how you felt and how symptoms limited your activities. This can help you paint a picture of what you’re coping with on a daily basis.
File your application
After you’ve gathered all of your materials, there are a few ways to file your application:
- In person at your local social security office
- By phone at 1-800-772-1213 -or- TTY 1-800-325-0778 if you are deaf or hard of hearing
On average, it can take three to five months to hear back regarding disability benefit claims. In some cases, you may have to supply additional evidence or documentation.
During the application process, a team of doctors for the Social Security Administration will do a thorough review of your application. A psychologist on this team may also evaluate whether your case of fibromyalgia has resulted in any mental impairments. These are based on:
- Speed of information processing
Once they’ve reviewed your application, they’ll determine if you receive disability benefits or not. You can typically appeal this decision, if they’ve denied your claim. An appeal is an additionally complex process, on top of an already complicated task. Work with your local health advocates or an attorney when undergoing an appeal.
Is fibromyalgia considered a long-term disability?
Much like the other disability benefits we’ve discussed, fibromyalgia long-term disability benefits can be difficult to obtain. Most long-term disability insurance companies deny or limit these requests since the condition is usually based on self-reported symptoms. Many insurance companies specifically exclude fibromyalgia from coverage. Others consider it a mental disorder in order to limit payments to one or two years. Examine your policy carefully to understand if it is possible to receive benefits for fibromyalgia, and for how long. Work with your Human Resources team if you’re unsure about any of the language or policy coverage.
As previously discussed, if you plan to apply for these types of benefits, you will need to be prepared with as much documentation as possible. You should be seeking medical treatment from a specialist and keeping a detailed record of your symptoms. It will also help to have written opinions from your doctors regarding your limitations and current condition.
What else do I need to know?
Only you and your medical team can determine if seeking disability benefits is the right course of action for you. These are a few questions you should ask yourself before seeking fibromyalgia disability benefits.
Will I be able to maintain my lifestyle?
Before applying for disability, it’s important to take a look at your finances. Allsup provides a free online calculator to estimate how much you may receive on disability.
Ask yourself if you’re comfortable with this amount of monthly income. Will it be enough for you to continue living in the same home? Will you have enough for groceries, a car payment, and any other monthly costs? Evaluate whether it’s financially possible for you to leave your job.
Am I emotionally and mentally prepared to be on disability?
A job provides much more than just a paycheck. It often gives us a sense of purpose and fulfillment. It’s even a form of socialization. Co-workers become friends that you confide in and enjoy spending your days with.
Some people are surprised by the fact that they feel lonely and bored when they stop working. Others need the time and space to focus on healing.
What are my job options?
Perhaps you would like to continue working, but can’t continue doing your current job because of physical or mental limitations. What are your other job options?
Take a look at your skillset and capabilities and research what else is out there. Ask your employer about other opportunities within the company, workplace accommodations they can make, or search for new jobs that allow you to work from home.
Are there treatment options I haven’t explored?
If you’re eager to continue working, there are treatment options that could give you the relief you need to do so. From chiropractic care to physical therapy, there are non-invasive options that can improve your comfort level.
If these remedies don’t work, there are currently three medications approved by the Food and Drug Administration. Lyrica, Cymbalta, and Savella may reduce pain and improve function in some people with fibromyalgia. Talk to your doctor about all of your treatment options.
Who can help me?
Social Security benefits can be complicated. For this reason, it’s often beneficial to hire a disability attorney who can help you file the right forms and gather the information for your case. A skilled attorney who specializes in disability and other insurance benefits will be able to guide you through the process of completing applications. If your initial case is denied, your lawyer will be able to prepare you for an appeal that may require you to go before a judge.
For ADA accommodations, you’ll likely have to work closely with your company’s Human Resources team to create the best plan moving forward. While companies look to the guidance provided through federal resources, they will still have their own unique set of rules and regulations to work from.
Not sure where to start? Working with a pain specialist is a great first step. Having someone who is experienced at helping patients prepare for disability claims can be one of the best ways to get the information you need, when you need it. You can find a pain doctor in your area by clicking the button below or using the tips here.