Tuesday, January 1, 2008

Applying for Disability with Fibromyalgia

http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html

"Unfortunately, when an Examiner receives a case in which the only allegation (reason for disability) is Fibromyalgia, the outlook for approval is not good. In fact, Social Security Disability will generally give little weight to such a claim unless another condition is involved, such as arthritis or degenerative disc disease.  Why is this? Part of the problem has to do with the nature of Fibromyalgia itself. Fibromyalgia is an impairment whose causes are not fully understood. And though it may be a legitimate disability in and of itself, because it's symptoms and speculated causes vary so much from one person to the next, disability Examiners are never sure how to classify such cases."

"Obviously, this is not the fault of the disability claimant who is suffering from Fibromyalgia and is struggling to get their case approved. But it is helpful to understand how the disability process works in this regard and to consider how Social Security Examiners sometimes view applications where this illness is alleged."

"Find out what's in your medical records. The importance of this cannot be stressed enough. All Social Security Disability cases are decided chiefly on the basis of a claimant's records. This is true at the intial application level, reconsideration level, and at the Administrative Law Judge hearing level where a claimant is generally represented by an attorney, or non-attorney disabilty representative.  Applying for disability without knowing what your records state about your condition is unwise, to say the least. And many claimants have been surprised to find that the doctor who claimed to support their case did not indicate the same level of support in his or her treatment notes."


That's very true.  One of my doctors, who had no idea how CFS is diagnosed, put information in my medical records that has continued to affect my application.  To my face, he said "I want to help you", but the way he wrote my medical records shows that that was the very last thing he wanted to do.  I was tested for things that need to be ruled out in order to confirm the problem was CFS and not some other condition that causes fatigue, and those test results were negative, which should have proven that my prior CFS diagnosis was correct.  Instead, he worded it as if those negative tests proved that I did not have CFS.

At this point, 6 or 8 other doctors (including specialists) have diagnosed CFS, some have added fibromyalgia, and tests that should be abnormal have been done, and were abnormal (including one described to me as "off the charts").  The judge ignores all that information supporting my claim and keeps going back to the uninformed doctor's false assertion that negative tests for thyroid, diabetes, anemia, etc., mean that I don't have CFS.  But it gives the judge one doctor who says what the judge wants to hear.

It's tough enough to win a disability case for an "invisible" impairment like CFS or fibromyalgia.  Make sure your doctors aren't sabotaging you to make it even harder.

The decision is supposed to be made only on a Functional Capacity Evaluation, i.e., what you can do and how much.  Unfortunately, when it comes to CFS and fibromyalgia, the decision on whether you get SSDI is often made on prejudgment that CFS/fibro are all in your head, and not on the only facts that should be considered: the ability to work successfully.  (see list below)

Work Feasibility Evaluation Checklist

Program in Occupational Therapy

Washington University School of Medicine

Section 1 - PRODUCTIVITY

Quantity - amount of dependable work output

Quality - quality of dependable work output

Attendance - reporting to work on assigned days

Workplace Tolerance - remaining in the workplace for the assigned duration

Timeliness - Reporting to work and returning from breaks on time

Work Task Instructability - ability to perceive, understand, and follow work instructions

Work Task Memory - ability to remember instructions, procedures and rules

Concentration - ability to focus attention on assigned tasks

2 comments:

Anonymous said...

The other problem is that there's a lot of abuse of the diagnosis. Apparently, a lot of medical professionals (esp those that work in hospital emergency rooms) see people claiming fibromyalgia as a way to get drugs. Don't you love when people intent on fraud screw it up for honest folks?

Anonymous said...

"Don't you love when people intent on fraud screw it up for honest folks?"

Ain't it the truth.

Now that there's Lyrica for fibro, I'm guessing that there will be fewer "party pills" handed out for fibro in ERs.

Speaking of which, we've been discussing in support group that with the Lyrica ads stressing "fibro is real", people (and doctors) are starting to accept it as real.  Erik suggested we need to create a CFS drug (irrespective of whether it works well or not) and market it just as heavily; when there's a drug for a disease, doctors magically change their minds about the validity of the disease.  He points out RLS was also "all in your head" till they came out with a drug, and suddenly it was accepted as real because there was a drug for it.

He and I (as the old-timers in the group, Erik since the original 1984 epidemic, me since 1987) are looking forward with glee to the earthquake that will result when millions of doctors are forced to do a 180 on the legitimacy of CFS because suddenly there's a pill for it.  (Cross fingers that Montoya gets his anti-viral treatment recognized so that happens ASAP.)