It can be very difficult to win Social Security disability benefits based on fibromyalgia. However,  it can be done!

While Social Security no longer considers fibromyalgia as a “imaginary” condition, or a “junk” diagnosis, you still need to make sure the diagnosis of fibromyalgia is backed up by medical findings.

I have reviewed many medical records which mention fibromyalgia, but don’t say how the doctor made the diagnosis. There is no mention of physical examinations or findings.  Social Security may throw out the diagnosis because of a lack of medical support.

Without a diagnosis, all you have are symptoms and Social Security cannot approve disability benefits on symptoms alone.

This can stop a case dead in its tracks!

So, what do you need to properly diagnosis fibromyalgia?

The National Fibromyalgia Association provides an answer:

Currently there are no laboratory tests available for diagnosing fibromyalgia. Doctors must rely on patient histories, self-reported symptoms, a physical examination and an accurate manual tender point examination. This exam is based on the standardized American College of Rheumatology (ACR) criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.

To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:

• Widespread pain in all four quadrants of the body for a minimum duration of three months
• Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied

If you have fibromyalgia, and you are fighting for your Social Security disability benefits / SSI, ask your doctor if the basis for the diagnosis is documented in your file?

Do your medical records show “widespread pain in all four quadrants of the body for a minimum duration of three months?”

Do your medical records show, “tenderness or pain in at least 11 of the 18 tender points?”

Proper documentation is critical in a Social Security case. Make sure your records are complete.

eNewsMediaMagazine has some tips on building a strong Social Security disabilty claim:

Tip #1: Choose the right doctor(s).

Regardless of your specific disability, you will need medical documentation. The only way to do this is to visit at least one physician. Ideally, that would be an experienced, respected doctor in the field of your disability. The more specific the doctor to your disability, the more credibility he or she will have. For instance, if you claim to have back problems, but only see an MD for treatment, your records will probably not contain much useful information other than pain medication.

There is nothing wrong with this tip. However, for many people choosing which doctor they see, just is not an option.

If you are treating through a community health center, you are lucky to see a doctor for more than a few minutes, let alone choosing which doctor you see.

Many clinics which serve the poor, low income, and indigent “don’t want to get involved with the disability system.” This means that the only doctor you can see, may not want to fill out a residual functional capacity form for you.

Well, isn’t that just great!  The only doctor you can afford to see does not want to help you get your Social Security and Medicare/Medicaid which might actually help you get the care you need!  If you are in this position, sometimes you just have to shake the tree a bit to get some results.

Look the doctor in the eye and ask if he thinks you can work?

If the doctor answers, “no,” tell the doctor that without his or her help, you will probably be denied (which is true if you are unable to document the limitations caused by your disabilities).

Sometimes, a bit of brutal honesty helps shake a bit of humanity out of the bureaucracy many clinics are mired in. 

Read the rest of the article here. March 2, 2009 update: Sorry, the linked article is no longer available.

Have you had good or bad experiences dealing with your doctors?  Share your experiences in the comments.