New Social Security Disability Ruling on Fibromyalgia

By Douglas I. Friedman of Friedman Law Firm, P.C.

SSA has issued a ruling effective immediately on the evaluation of fibromyalgia in Social Security Disability claims. The ruling states that fibromyalgia can be the basis for a finding of disability when it is established by appropriate medical evidence. A claimant who claims disability based on fibromyalgia must have a diagnosis by a licensed physician (medical or osteopathic doctor) and evidence of the criteria from either “the 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia” or “the 2010 American College of Rheumatology Preliminary Diagnostic Criteria.”

Recognizing that the symptoms and signs of fibromyalgia may vary in severity over time and may even be absent on some days, SSA will look at all of the medical records to see how a claimant’s symptoms may change over time, and how the doctors treated them.

The Social Security Administration has awarded Social Security Disability cases based on the limitations caused by fibromyalgia for several decades now. This recent ruling seems to just formalize how SSA wants these cases evaluated. For example, trigger point testing is accepted as a consideration in diagnosing fibromyalgia by SSA. In cases where the doctor’s records indicate that trigger point testing was completed, the records will have a greater effect on the decision.

However, doctors may not always conduct an examination during each office visit that meets the stated criteria, or if they do, they may not always describe the examination in detail in their treatment notes. In those cases SSA may not give as much weight to the doctor’s opinions. In order to obtain a favorable disability decision, it is often better if the treating physician describes in the medical records exactly what is done every time the physician examines the claimant.

You can read this ruling by clicking here.