Social Security Disability Benefits Can Be Awarded to Those with Fibromyalgia

Posted on August 3, 2010 by Editorial Board

The Social Security Administration provides financial support and medical benefits to individuals suffering from qualifying illnesses, injuries, and emotional problems.  These benefits are provided under two programs; Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  People suffering from chronic medical conditions such as fibromyalgia may be eligible for SSDI or SSI benefits.

A person’s work history generally determines whether they qualify for SSDI.  SSDI is intended for individuals who have paid a portion of their wages into the FICA tax fund.  SSI is need-based and provided to those who meet income guidelines, regardless of work history.

To qualify for benefits under either program, a person must prove that they cannot perform work for which they are suited.  The medical condition must be expected to last for a minimum of a year or be expected to cause death.

The Social Security Administration (SSA) has compiled a list of medical conditions so severe that they will most likely cause a person to be declared disabled.  If a person’s condition is not on the list, the SSA will determine whether it is severe enough to limit work enough to cause a disability.   Fibromyalgia is not on this list, but with proper documentation, fibromyalgia sufferers may still qualify by relating to fibromyalgia as a chronic fatigue syndrome.

Fibromyalgia is characterized by widespread pain of the muscles, ligaments, and tendons.  It is often characterized as a constant dull ache accompanied by fatigue, sleep disorders, and tenderness at multiple points on the body.  Many sufferers also have co-existing conditions such as Chronic Fatigue Syndrome, Lupus, or Rheumatoid Arthritis.  Depending on the severity of the symptoms, fibromyalgia can be a temporary or permanently disabling condition.

Fibromyalgia occurs in about 2 percent of the U.S. population, and is more common in women than in men.  Because the causes of fibromyalgia are unknown and the symptoms vary from person to person, diagnoses are sometimes inconclusive, and even controversial within the medical community.

People applying for Social Security benefits often have difficulty being approved with a diagnosis of Fibromyalgia.  SSA examiners will be more likely to approve cases in which fibromyalgia has been diagnosed in conjunction with another condition, such as rheumatoid arthritis.  Fibromyalgia diagnosed by an Orthopedist or Rheumatologist will likely carry more weight than a diagnosis by a general practitioner.  Good objective findings in your medical records, over and above the patient’s subjective complaints, will help the disability examiners see the severity of your condition.

The SSDI application process can seem long and overwhelming because the SSA is a slow moving governmental bureaucracy.  Though approximately 6.5 million people received Social Security benefits last year, many applicants were denied. The most common reason for denial is insufficient medical proof of a disabling condition.

To improve your chances of being approved for Social Security disability benefits, be sure to submit all available documentation, including detailed statements from your physician and specialists, complete medical records, and copies of all lab tests, including any new tests performed during your case review.  If you have been denied already you may consider getting help with your claim.  Disability law firms have the experience of knowing how to present cases that you can only get from doing it hundreds of times, they also know how to develop multiple ways to win a case, so you are not entirely reliant on just one theory as a way to win.

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Herniated Discs Can Become a Disabling Medical Condition

Posted on August 3, 2010 by Editorial Board

A person who suffers from a herniated disc that prevents them from working may be eligible for Social Security disability benefits.  If the back pain is so severe that it becomes a disabling medical condition that would inhibit one’s ability to work for a year or more then they may be able to get benefits if they apply.

There are two main types of Social Security disability payments. The first is Social Security Disability Insurance (SSDI), which an individual may qualify for if they have worked long enough to pay sufficient money to the Social Security trust fund through their taxes (these are known as FICA taxes). The other form of Social Security disability benefits is known as Supplemental Security Income (SSI). Disabled people who meet low income criteria may be eligible for SSI independent of any previous employment history.

The first step in receiving a Social Security disability payment is applying for benefits.  It usually takes a while to get awarded benefits so it’s best to apply early.  Even if a person has been told by their doctor that he or she shouldn’t work as a result of their condition, that doesn’t always mean that they will qualify for Social Security disability benefits. Social Security uses very strict guidelines regarding what they consider a disability.  The general idea is that you must be so severely disabled that you cannot work.

If a person is able to perform any type of regular work which meets SGA (substantial gainful activity) criteria, then they will not qualify for a Social Security disability payment.  To be disabled under Social Security’s rules, you must be found unable to work.

If a person’s back condition is severe enough that they are bedridden, or in such extreme pain that they can’t perform a light duty job, then it is possible that person may qualify for Social Security disability benefits.  The application process could be quite challenging, as many people suffering back problems find their claims are rejected. This is partly because “pain” is considered a subjective complaint, difficult to quantitatively determine, and so they may not always be taken seriously.

If your disability claim is denied, it is possible to appeal the decision.  If the disability is genuine, and the herniated disc causes severe pain and loss of physical mobility then you should try and get your doctor to document your medical records with proof of your condition.  When possible, document your limited strength or range of motion in medical exams, or if you can get CT scans or MRI imaging you may get more helpful evidence to use in your case.

Sometimes, you can benefit from the experience of a Social Security disability attorney, who can help in gathering the right evidence from medical professionals, and who can assist in the Social Security dispute process. Nearly 65% of all Social Security disability claims are initially rejected, so filing appeals is not an uncommon situation.  Managing your appeal deadlines becomes an important part of keeping your case alive after an initial denial.  Nearly all attorneys who work in this area can easily help you navigate these rules.

Spinal conditions like a herniated disc are among the listed medical conditions which Social Security deems severe enough that individuals suffering at the level detailed in the listing book will qualify for Social Security disability benefits without further examination of work history.  A herniated disc also known as a herniated nucleus pulposus, is listed in Social Security’s “Blue Book” of medical conditions, and to meet the listing you will need medical proof that you suffer from this condition.  Typically an MRI or CT imaging scan are the best ways to have evidence of a herniated disc and related nerve damage.

Posted in Bone & Joint Problems | 1 Comment

Winning Social Security Disability with Depression Disorder

Posted on August 3, 2010 by Editorial Board

Depression can affect your disability application and disability determination in various ways. On the one hand, it is not uncommon for disability applicants to feel depressed because of their inability to continue working and provide for their families, particularly after many months of unemployment.

Under this scenario, the applicant’s depression is an ancillary element to the primary cause of disability—which could be any other ailment or combination of ailments. When the depression is added to the primary disability-causing ailment, it is important to note how the depression also affects the applicant’s ability to sustain work overall. Depending on the severity of the depression that the applicant experiences, non-severe depression or untreated depression will not, standing alone, usually result in a disability finding.

Depression for some individuals, without the addition of other ailments, can be severe enough to allow a finding of disability. In order to allow such a disability finding, the applicant must first of all be in treatment for their depression. This will require review of the treatment records including medications and analysis of the treating doctor’s assessments regarding the severity of the depression, and more importantly, the work-related limitations that result from the diagnosis.

If an individual meets or equals a Social Security listed impairment, then they are considered to be disabled. Listing 12.04 is for Affective Disorders, which according to Social Security are characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Additionally, mood refers to a prolonged emotion that colors the whole psychic life and it generally involves either depression or elation.

Under this listing, the applicant’s various symptoms will be matched up with the listed symptoms of 12.04A1, and will be required to show at least four of the following, including: anhedonia, appetite disturbance with change in weight; sleep disturbance; psychomotor agitation; decreased energy, feelings of guilt or worthlessness; difficulty concentrating or thinking; thoughts of suicide; or hallucinations, delusions, or paranoid thinking.

The applicant who is able to show four of the symptoms listed above must also show at least two of the following (also known as the B criteria): marked restriction of activities of daily living, marked difficulties in maintaining social functioning, marked difficulties in maintaining concentration, persistence or pace, or repeated episodes of decompensation, each of extended duration. Where the applicant is unable to meet the B criteria, he or she can still meet or equal the listing by establishing the C criteria which is medically documented history of a chronic affective disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support.

The C criteria also requires one of the following: repeated episodes of decompensation, each of extended duration; or  residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Social Security Disability applicants should understand the difference between establishing depression as the primary disability impairment versus it being an element that adds to other impairments.  If you need help deciding strategy or legal theories in your case consider getting a disability attorney to help out, as they will be experienced in these rules and be able to provide advice that can give you a better chance to win your case.

Posted in Mental Conditions, The Listings (Step 3), Winning Disability Benefits | 1 Comment

Mental Retardation Can be a Disabling Medical Condition

Posted on August 3, 2010 by Editorial Board

The Social Security Administration (SSA) maintains a listing that describes the impairments that the SSA considers severe enough to qualify someone for disability benefits. This list is known as the Blue Book, and mental retardation is among the impairments listed. The SSA provides specific criteria to help you determine whether the mental retardation of an adult or child meets their definition of a disabling medical condition: a condition that renders a person incapable of work and is expected to last one year or more, or result in death.

The Blue Book defines mental retardation in adults as below average intellectual functioning beginning before the age of 22. If you wish to apply for disability benefits due to a decrease in intellectual functioning that occurred after the age of 22, you would want to see the criteria listed under “organic mental disorder,” rather than mental retardation. In order for mental retardation to qualify as a disabling medical condition, a person must have an IQ of 70 or below. An IQ of 59 or below is itself severe enough to qualify as mental retardation; if IQ is between 60 and 70, additional conditions must be met as well. In cases where someone is unable to follow directions well enough to have their IQ evaluated, that person meets the criteria for severe mental retardation if they are dependent on others for basic personal needs such as dressing and eating. The criteria is the same for children, with additional ways to qualify based on lack of age-appropriate abilities.

Claims for disability benefits based on a mental disorder are often denied at first, but they can still be worth pursuing. Mental retardation has the advantage of being one of the easier mental disorders to prove, as a valid IQ test provides an objective measure of severity. Even if your claim is initially denied, if you have comprehensive medical records you have a good chance of being awarded Social Security benefits at a disability hearing. Often the most difficult part is proving that the onset of mental retardation occurred before the age of 22. The best evidence would be an IQ test taken at a young age, but records of special education classes or learning disabilities can also help establish your case. If you can’t prove the age of onset, be sure to check the other entries in the Blue Book under “mental disorders” to see if another mental condition is a better fit.

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