Can people in Minnesota with fibromyalgia qualify for SSDI?

Provided they have received a diagnosis and meet the specified criteria, people in Minnesota with fibromyalgia may qualify for SSDI.

A condition affecting people in Minnesota, and throughout the U.S., fibromyalgia is a disorder with potentially devastating effects. For many, the symptoms of this ailment may make it difficult, or even impossible, for them to work. Consequently, they may be faced with additional challenges, including concerns over how they will deal with their loss of income and how they will afford their medical treatments. However, some who are diagnosed with fibromyalgia may be eligible to receive Social Security Disability Insurance.

Causes and symptoms of fibromyalgia

Primarily affecting the musculoskeletal system, the exact etiology of fibromyalgia is unknown. More common in women, symptoms of the disorder often present following an infection, surgery, or a physical or psychological trauma.

Characterized by widespread pain throughout the body, fibromyalgia may cause a range of symptoms, including stiffness, tiredness, fatigue, sleep problems, headaches, and depression and anxiety. Some people with this condition may also experience digestive problems, numbness or tingling in the feet and hands, and cognitive and memory issues.

Evaluating fibromyalgia for SSDI benefits

In order to qualify for SSDI based on fibromyalgia, there are certain requirements that people must meet. Applicants must have been diagnosed with the condition by a licensed physician, as well as meet certain criteria. Social Security reviews their medical history and treatment records to confirm the diagnosis, and determine whether the applicant's symptoms have improved, stayed stable or worsened. Based on this information, the agency will make a determination regarding the claim.

Beyond receiving a diagnosis, Social Security has two sets of qualifying criteria for fibromyalgia. Applicants must either meet the 2010 or the 1990 criteria. Under the 2010 criteria, people must meet the following:

  • Evidence other conditions that might cause the symptoms have been ruled out
  • Recurrent manifestations of at least six signs, symptoms or co-occurring conditions
  • A history of pain throughout the body

The 1990 criteria, on the other hand, specifies that people must have a history of widespread pain, proof that other possible conditions have been ruled out through testing, and at least 11 positive tender points above and below the waist and on both sides of the body.

Providing supporting documentation

Social Security requires that people submit certain documentation with their claims, which is used to help make determinations on their claims. This includes medical records for the previous 12-months from an approved health care provider. These records should show they been receiving evaluations and treatments relating to their conditions. Social Security may also ask for supporting evidence from other medical professionals, such as psychologists or therapists, to further document the severity of the applicant's disorder, as well as the functional limitations it has caused.

In addition to submitting their medical records, some may be asked to also provide documentation from other sources. Family members, friends, neighbors, clergy, former employers or coworkers, and others may be asked to speak to the impact that fibromyalgia has had on the applicant's life. When Social Security cannot reach a determination based on the documentation and evidence provided, it may request a consultative evaluation.

Working with a lawyer

Even with a proper diagnosis and the necessary supporting documentation, people throughout Minnesota commonly have their SSDI claims denied. For many, this increases the devastating impact their conditions have on them, as well as their families. Thus, it may be helpful for those pursuing Social Security benefits to obtain legal counsel. An attorney may explain their rights and options and guide them through each stage of the process.