About Fibromyalgia
Fibromyalgia is a chronic disorder characterized by widespread muscle pain, tenderness, fatigue, and other physical and cognitive symptoms. The condition can significantly interfere with daily activities, concentration, sleep, and the ability to work.
For some individuals, fibromyalgia symptoms begin suddenly after a surgery, infection, injury, or traumatic event. For others, symptoms develop gradually and worsen over time.
Although fibromyalgia cannot currently be cured, treatments and lifestyle changes may help manage symptoms and improve quality of life.
Symptoms of Fibromyalgia
Symptoms of fibromyalgia can vary widely from person to person. Common symptoms may include:
Widespread muscle pain
Fatigue
Disturbed or non-restorative sleep
Sensitive skin
Sensitivity to light and sound
Sensitivity to temperature
Difficulty concentrating or memory problems (“fibro fog”)
Irritable bowel syndrome (IBS)
Joint stiffness
Headaches
Abdominal cramping
Many individuals with fibromyalgia also experience co-occurring mental health conditions such as:
Depression
Anxiety
Post-traumatic stress disorder (PTSD)
Causes and Treatment of Fibromyalgia
The exact cause of fibromyalgia remains unknown. The condition affects women far more often than men.
Treatment typically focuses on symptom management and may include:
Medications
Physical exercise
Physical therapy
Stress management techniques
Counseling or therapy
Sleep management
Healthy dietary habits
Qualifying for Social Security Disability with Fibromyalgia
For many years, fibromyalgia claims were difficult to approve because the Social Security Administration (SSA) did not have official evaluation guidelines for the condition.
In July 2012, the SSA introduced Social Security Ruling (SSR) 12-2p, which explains how fibromyalgia claims are evaluated for disability benefits.
SSR 12-2p – Evaluation of Fibromyalgia
To qualify under SSR 12-2p, an applicant generally must satisfy either Requirement A or Requirement B with proper medical documentation.
Requirement A
The applicant must have all of the following:
History of Widespread Pain
Pain affecting all quadrants of the body and axial skeletal pain lasting at least three months.
Positive Tender Points
At least 11 positive tender points identified during a physical examination.
Exclusion of Other Disorders
Medical evidence showing that other conditions capable of causing the symptoms have been ruled out.
Requirement B
The applicant must have all of the following:
History of Widespread Pain
Persistent widespread pain lasting at least three months.
Repeated Fibromyalgia Symptoms
Repeated manifestations of at least six fibromyalgia symptoms, signs, or co-occurring conditions such as:
Fatigue
Cognitive problems (“fibro fog”)
Depression
Anxiety
Irritable bowel syndrome
Exclusion of Other Disorders
Medical evidence confirming that other possible causes of the symptoms were excluded.
Medical-Vocational Allowance
Even if an applicant does not fully meet the requirements of SSR 12-2p, they may still qualify for disability benefits through a medical-vocational allowance.
Under this evaluation, the SSA considers whether the condition prevents the individual from performing unskilled work activities on a sustained basis.
Unskilled work generally refers to jobs requiring little training or education.
The SSA evaluates factors such as:
Chronic pain
Fatigue
Concentration problems
Physical limitations
Ability to remain productive throughout the workday
Residual Functional Capacity (RFC)
Residual Functional Capacity (RFC) assessments are often important in fibromyalgia disability claims.
An RFC form explains what an individual can still do despite their condition and limitations.
There are two primary types of RFC evaluations:
Physical RFC
Mental RFC
Physical RFC
A physical RFC may evaluate a person’s ability to:
Sit
Stand
Walk
Lift and carry objects
Use their hands and arms
Maintain physical activity throughout the day
Mental RFC
A mental RFC may evaluate:
Concentration and focus
Memory
Ability to complete tasks
Ability to handle stress
Social functioning
Consistency and productivity
Medical Evidence for a Fibromyalgia Disability Claim
Strong medical evidence is critical in fibromyalgia disability cases. Helpful documentation may include:
Rheumatology treatment records
Tender point examinations
Physical examinations
Treatment history
Mental health records
Imaging or laboratory testing used to rule out other disorders
Statements from treating physicians
RFC assessments
The SSA evaluates how fibromyalgia symptoms affect a person’s ability to function consistently in everyday life and within a work environment.