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Fibromyalgia and Disability Claims

Why does fibromyalgia still present problems when it comes to disability claims? For those who aren’t entirely aware, fibromyalgia has many characteristics, but receiving a definitive diagnosis is difficult. There are many beliefs around the symptoms of fibromyalgia, but it affects the body on a widespread basis.

Many doctors will only provide a fibromyalgia diagnosis after excluding all other possibilities. Because of the diagnosis method of exclusion, fibromyalgia is under a lot of speculation with disability claims.

Struggles for SSA and Fibromyalgia Claims

In July of 2012, the SSA or Social Security Administration took a new stance on handling fibromyalgia disability claims. The evaluation of fibromyalgia is now acceptable within the medical community and has objective measures. Although the method of diagnosis has not primarily changed enough objective proof is in place to show that the disorder is real.

Before 2012, people often struggled to show that they suffered from something that caused them constant pain. The biggest signifier of fibromyalgia is ongoing pain. This pain usually has accompanying symptoms such as fatigue and difficulty focusing. Unfortunately, when first describing these symptoms to a doctor, it sounds like, “I hurt everywhere and am tired all the time. I can’t concentrate.”

A doctor will hear that and understand that these three things could be symptoms of a number of issues. However, the SSA’s initial reaction was to deny claims for fibromyalgia widely.

Ongoing Issues – Particularly with MDI

MDI is the Medical Determinable Impairment, and it’s a precursor to all SSDI claims. However, when it comes to most applications, the impairment is evident. Someone who is on SSDI for family leave is impaired from returning to work. Alternatively, someone undergoing surgery is impaired for however long the doctor determines.

When it comes to fibromyalgia, the SSA insists that everyone involved take another look. To have a successful MDI in your claim, you’ll need a few key things to prove your diagnosis.

Initially, you’ll need a medical diagnosis from a doctor. Meaning that a nurse practitioner, chiropractor, or physician’s assistant is not capable of making that diagnosis. Your doctor must be the one to note the diagnosis as well. They must have clear notes that show strong support for a fibromyalgia diagnosis.

After your diagnosis, you need the following in your treatment notes:

  • Proof that other possible diagnoses were ruled out such as rheumatoid arthritis or lupus.
  • General and widespread pain for over three months.
  • Eleven tender points or at least six repeated additional symptoms.

Of the many additional symptoms, the most common are fatigue and cognitive problems or trouble focusing. Other symptoms, less frequently heard of include depression, irritable bowel syndrome, anxiety, waking without feeling as if you slept, and memory problems.

Only after the MDI comes back with a positive review can the claim go to an evaluation. After you submit a claim, it’s almost that the MDI process is a step backward. Your application will go through the SSA, and they will decide on whether the fibromyalgia is preventing you from working.

An SSDI Lawyer Can Offer More Insight

The struggle for many fibromyalgia patients going through the SSDI process is step three. In this step, they will evaluate if your impairments meet the listing of impairments, they use to guide their decision. Fibromyalgia will not win on this step.

Because there are clear hurdles that are nearly impossible for fibromyalgia patients to pass, they need legal guidance. A local SSDI lawyer can help you understand how to explain best and present your claim. That may mean citing medical records or showing that you were unable to continue at your most recent job.

Most likely, you will at least go through to the appeals process. During that phase, you will have more access to actual people on your case. Additionally, you can begin your argument a different way than how it appears on paper. Fibromyalgia cases will often see success when the claim evaluates the loss of productivity and cognitive problems.

Contact a Disability Law Attorney in Milwaukee Now

There are many disability lawyers in Milwaukee. However, you want someone familiar with fighting the SSA on their determinations and taking cases all the way through to an Administrative Law Judge. When you’re dealing with a fibromyalgia evaluation, it may seem like there is not much hope.

At Tabak Law, we put our focus on ensuring you have the best chance possible for a favorable outcome. When it comes to handling fibromyalgia cases, our top legal staff stay on top of recent updates within Wisconsin’s rulings and with the entirety of the SSA.

Contact Tabak Law for a case review now. Learn what opportunities are available to you, given your circumstances.

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