Proving a disability claim based on fibromyalgia requires extensive medical evidence. There must be evidence from an acceptable medical source. An acceptable medical source is a licensed physician, either a medical doctor (MD) or osteopathic doctor (DO).
Social Security published a ruling in July, 2012 setting forth policy on how to evaluate fibromyalgia for disability cases. This ruling is SSR 12-2p.
In order for SSR 12-2p to apply, there must be a medically determinable impairment of fibromyalgia. That is, there must be a diagnosis from a licensed physician that is not inconsistent with other evidence in the record.
The ruling explains that one way social security may find fibromyalgia is if there is a history of widespread pain in all quadrants of the body, at least 11 tender points on physical exam (the 11 tender points must be on both the left and right sides of the body and both above and below the waist), and other disorders that could cause the symptoms were excluded.
Solid medical evidence is critical and necessary in fibromyalgia, as in other cases. Additionally, evidence may come from non-medical sources as well, although such evidence cannot be the sole basis for determining disability.
Also, as in other cases, the severity of the disease and the functional limitations it causes must be considered on a case by case basis.
In sum, SSR 12-2p is an important regulation published in 2012 that gives policy guidance on how Social Security will review fibromyalgia claims.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.