Unfortunately, fibromyalgia is the type of medical condition that has been misunderstood by some Adjudicators at Disability Adjudication Services (DAS), as well as Administrative Law Judges (ALJs) at the Office of Disability Adjudication and Review (ODAR). Thankfully, there is Social Security Ruling (SSR) 12-2p, which brings much needed guidance for SSA evaluators of this debilitating condition.
Two to five percent of the American adult population is afflicted with fibromyalgia, according to Dr. Richard Podell, who addressed SSR 12-2p at a recent NOSSCR (National Association of Social Security Representatives) conference. Dr. Podell mentioned how scientific studies reveal that fibromyalgia results from abnormalities of the central nervous system. Fibromyalgia is defined, in SSR 12-2p, as pain in the joints, muscles, tendons, or nearby soft tissues that has persisted for at least 3 months.
For a finding of a “medically determinable impairment” of Fibromyalgia, SSR 12-2p requires diffuse chronic muscle pain affecting four quadrants of the body in addition to the spine.Testing for this condition by nurse practitioners, internists, rheumatologists, etc. may include the application of standard pressure to 18 tender points (see SSR 12-2p for locations). A diagnosis of fibromyalgia is reached when pain occurs at 11 or more tender points on the right and left side of the body, as well as above and below the waist.
Under SSR 12-2p, in addition to a history of diffuse chronic pain, a claimant must have repeated occurrence of six (6) or more fibromyalgia symptoms including but not limited to chronic fatigue syndrome, poor restorative sleep, trouble concentrating or remembering, anxiety, depression, temporal-mandibular joint dysfunction (TMD), chronic migraine or tension headaches, chest pain, irritable bladder, numbness or tingling, nausea, ringing in the ears, Reynaud’s phenomenon, loss of taste or change in taste, shortness of breath, interstitial cystitis, and irritable bowel syndrome.
Lastly, under SSR 12-2p, other disorders that could cause these repeated manifestations of symptoms or coexisting medical/mental conditions must be excluded. Adjudicators and ALJs should consider a longitudinal history of symptoms dating back at least 12 months before the date of the application.
SSR 12-2p further states that Adjudicators and ALJs must consider opinions of other acceptable medical sources such as psychologists and psychiatrists. Also, statements from laypersons such as family members, friends, past employers or SSA employees could be helpful in establishing symptoms and limitations of fibromyalgia according to SSR 12-2p. For additional information about how you can receive SSI, SSDI (DIB), DAC or Widow’s/Widower’s benefits for fibromyalgia, please contact the Law Offices of Kathleen M Flynn, LLC at 404-479-4431 or visit our website at www.kathleenflynnlaw.com.