The Social Security Administration (SSA) doesn’t always make it easy for those with fibromyalgia (FMS) to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve. Many claims are denied because SSA says:
(1) Your FMS won’t keep you out of work for at least a year,
(2) Your FMS isn’t severe,
(3) You can return to the lightest job you held in the 15 years before you became disabled, or
(4) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
Not all cases of FMS are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with FMS. She works to overcome the claims denial by working closely with you and your physician by showing that:
Ms. Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
FMS, whose cause is unknown, causes severe joint and body pain and fatigue that is not improved with rest. There is no gold standard test for fibromyalgia; the diagnosis is based, in part, on subjective complaints.
The American College of Rheumatology has developed criteria for the diagnosis of FMS that includes: widespread pain in all four quadrants of the body that have lasted at least three months, and 11 out of 18 positive trigger points over various parts of the body.
Other criteria were passed by The American College of Rheumatology in 2010 that include widespread pain and the use of a scale to measure the severity of the symptoms. Making a diagnosis, physicians can use one or both tests.
FMS is not a listed condition that automatically would qualify you for Social Security Disability benefits. You must have proof of the basis of the diagnosis; many Administrative Law Judges are skeptical about FMS and discount the impact of symptoms on your ability to work.
That is why it is crucial that you have an attorney who understands fibromyalgia and knows how to gather the medical and vocational evidence that is required to approve a claim.
FMS is a poorly understood medical condition that doctors once thought was “all in the heads” of patients. The general symptoms of FMS can include:
It is crucial that your medical records show that you meet the criteria for a diagnosis of FMS and that your symptoms did not begin before the onset of your FMS. You must submit medical records that date back to when your symptoms began and should include the results of lab work, hospitalizations, doctor visits and medication history, including side effects of your medication.
Abnormal sleep studies, exercise stress tests and neurocognitive testing are helpful to document the basis of the FMS diagnosis and your limitations.
Because there is no listing for FMS, SSA will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.
You must prove that you:
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your FMS.
The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that explain:
This is not an exhaustive list of all of the questions on a FMS or mental impairment RFC form. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.
Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
FMS can interfere not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:
The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by experienced Social Security Disability attorney Nancy Cavey.
You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits for FMS. Call our Florida social security disability lawyer today for a free consultation at 727-894-3188.[/vc_column_text][/vc_column][/vc_row]