Fibromyalgia

Disability benefits adjudicators are averse to approving claims based upon fibromyalgia. Fibromyalgia claims are usually denied for allegedly lacking objective evidence. However, I represent a 32 year old who had worked at odd jobs until 1993, whose fibromyalgia claim was denied on the grounds that it was not severe.

The claimant retained me after an administrative law judge (“ALJ”) denied her third application claim for Social Security Disability (“SSD”) benefits. I persuaded the Appeals Council to remand the case for another hearing, and I made a motion that reopened the claimant’s prior applications. Today I received a fully favorable decision that found she became disabled because of her fibromyalgia as of 1991.

After the remand, I subpoenaed medical records that showed the claimant had been diagnosed and treated for fibromyalgia as of 1991. However, the ALJ had to be convinced that the claimant’s fibromyalgia was severe enough to prevent her from being able to do even sedentary work all the way back to 1991.

To ensure that there was no mistaking the severity of the claimant’s fibromyalgia, I submitted reports from three treating specialists. Based upon their review of the medical records, each specialist specified a retrospective onset date that predated their treatment.

The first doctor was the rheumatologist. The rheumatologist is important because the accepted objective evidence for fibromyalgia is the criteria from the American College of Rheumatology. The second doctor was the internist. ALJ’s usually overlook internists because they are considered more of a generalist. However, their opinions are particularly important when, as here, they have been treating a relatively long time. The third doctor was the neurologist. Her opinion corroborated the other two opinions. The new reports made it easy for the ALJ to conclude that the medical evidence now showed she could not work.