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What Is Fibromyalgia Disability, and How Can It Be Diagnosed?


Obtaining long-term disability insurance benefits for fibromyalgia can be an arduous task. Here at Mehr Fairbanks Trial Lawyers, we will walk you through the process of proving your case to reverse your denied claim. The simplest definition of fibromyalgia is that it is a condition that causes people to feel ongoing pain and tenderness throughout their body, and doctors are unable to connect this pain to other medical issues. Of course, if you’re going to qualify for long term fibromyalgia disability benefits, there are a number of more specific criteria that need to be met.

  • The chronic, widespread pain you are feeling must be ongoing for at least three months at the same general level of discomfort.
  • The pain has to have occurred within the past week.
  • You have to feel it in four bodily quadrants.
  • Tenderness must be felt in at least 11 of the 18 anatomical “tender points” that have been medically defined.
  • You need to be experiencing fatigue.
  • You have to wake up feeling unrefreshed.
  • You need to have problems remembering things or putting together coherent thoughts.
  • Other physical symptoms must exist.
  • Your doctor has not been able to identify any specific causes or abnormalities that would explain these symptoms, and therefore cannot provide objective testing or treatment.

Fibromyalgia as a Medically Determinable Severe Impairment

You must have a medically determinable impairment that is severe. A medically determinable severe impairment must be established through medically acceptable clinical and laboratory diagnostic techniques. Generally, to establish fibromyalgia as a medically determinable severe impairment, you must show:

  • Widespread pain for at least three months.
  • Pain on palpation in at least 11 of the 18 tender point sites (as identified by the American College of Rheumatology).
  • Morning stiffness or stiffness after sitting for a short period of time.
  • Fatigue

Careful Documentation Is Required in Cases of Fibromyalgia and Long-Term Disability

In order to qualify for disability benefits, someone suffering from fibromyalgia needs to provide “Objective Evidence of Disability.” Unfortunately, by its very nature, fibromyalgia eludes objective tests. How then do you prove it?

It’s not easy. A well-documented and extensive medical history showing your struggles with the condition is a must, and you may wish to undergo physical examination and testing to elaborate on your work restrictions as well.

One path that is potentially available is to show that you are not actually suffering from small-fiber polyneuropathy, a condition with symptoms very similar to fibromyalgia that can be diagnosed with objective tests and sometimes even treated.

This condition occurs when peripheral small-fiber neurons degenerate and stop functioning correctly, and your insurer may attempt to fight your claim of fibromyalgia long term disability by saying that you actually have SFPN. Testing yourself for this condition first can take the wind out of their sails and further your claim for fibromyalgia.

Attorney Help with Long-Term Fibromyalgia Disability Insurance Benefits

Our disability insurance lawyers at Mehr Fairbanks Trial Lawyers have helped many LTD claimants that have been unable to work as a result of suffering fibromyalgia. If your claim has been denied, we are here to assist you and make the claim process as easy as possible for you. Please give a call toll free at 800-249-3731.

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