Archive for the ‘Social Security Disability FAQ’ Category

Can I get Social Security Disability for Fibromyalgia?

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Does Social Security Disability Recognize Fibromyalgia as a Real Condition?

Fibromyalgia is a frequently misunderstood and very real medical condition that affects a person with widespread pain throughout their body. It took the Social Security Administration a very long time to believe that statement.

Only in 2012 did Social Security issue guidelines for how they will evaluate fibromyalgia when someone applies for Social Security Disability. Yet, the condition was first identified in 1904 by Sir William Gowers. The modern definition was outlined in 1972 by Dr. Hugh Smythe.

Forty years later, Social Security caught up with modern medicine. With Social Security Ruling 12-2p, the regulations for evaluating fibromyalgia as a disability were set.

How Do I Get Social Security Disability for Fibromyalgia?

With the establishment of SSR 12-2p, Social Security outlined exactly what you have to prove in order to win your claim for disability. It’s no surprise that the majority of the evidence that Social Security will require must come from a doctor.

How much weight the doctor’s opinion is given in your case can be affected by what kind of doctor makes the diagnosis. For example, a family doctor who makes an official diagnosis of fibromyalgia may not be considered the same way as a rheumatologist who makes that same diagnosis. That’s because a rheumatologist is an expert in systemic (whole body) musculoskeletal diseases and autoimmune conditions such as fibromyalgia.

Social Security will also consider other information that you provide, such as statements from your spouse or family about how your condition has affected you. The condition itself has to have lasted for 12 months or has to be expected to last for twelve months – usually not a problem for someone with a diagnosis of fibromyalgia.

If Social Security isn’t clear about your diagnosis, they can also send you to a doctor they choose, often called a Consultative Examination. Social Security pays for this evaluation and if you get scheduled for one, it’s very important that you attend and that you tell the doctor everything that is wrong with you.

What If I Have Other Conditions Along With My Fibromyalgia?

More often than not, it’s been my experience that people who are affected by fibromyalgia are also suffering from other conditions. For example frequently clients will have several conditions which affect their entire body like Chronic Fatigue Syndrome — which is NOT the same thing as fibromyalgia! — and Chronic Pain Syndrome.

Our clients will be on many different medications to try to control their pain and those medications can cause their own problems. It’s important then to make sure that when Social Security is given information about a client’s condition that the entire disability picture is presented.
We make sure to get records from every treating source and to get the information from our clients to be able to demonstrate to Social Security the full impact of disability on their lives.

Fibromyalgia is a very real condition that affects more than 5 million people What causes fibromyalgia isn’t yet known, but we do know how it affects people. Symptoms include pain, stiffness, tenderness, headaches, numbness, tingling, real fatigue, confusion, problems with memory and more.
It is a condition that is hard to treat and frequently requires a team of doctors and professionals to address the condition to just allow the patient to function.

If fibromyalgia has taken away your ability to work and you’re applying for Social Security Disability, or if you’ve been denied and turned down for Social Security Disability for fibromyalgia, feel free to call our office for help. We understand your frustration, and we would be happy to help you.

What happens at a Social Security Disability pre-hearing conference

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As we’ve explained here before, most people who apply for Social Security Disability are initially denied benefits. Many applicants must submit go through several appeals, waiting years and dealing with miles of red tape, before they get to the point where they can argue their case before a judge.

If you are denied initially, your best chance at being approved for disability benefits is during one of these hearings before an administrative law judge who works for the Social Security Administration. I think applicants who have an attorney represent them are much more likely to win benefits than those who do not.

The Office of Disability Adjudication and Review, ODAR for short, is the part of the Social Security Administration that holds hearings for those who have been denied Social Security disability benefits. Many people who have to go to a hearing are represented by an attorney, who helps gather evidence, explain the law and issues to you, and present the law and facts of your case to the judge.

But there are some applicants who do not have an attorney at this stage. The local ODAR, including ours in Greensboro, will sometimes schedule pre-hearing conferences for people who don’t have representation. If you get a notice of a pre-hearing conference, do not ignore it.  We also strongly recommend that you seek the representation of a qualified attorney who can help you prepare the strongest case possible.

At a pre-hearing conference, you will be asked about the medical treatment you have been receiving.  The burden to provide evidence to support your disability is on you, and so it is up to you to provide the medical evidence about your mental and physical conditions that keep you from being able to work.

ODAR will sometimes try to obtain these records itself, but in my experience, they often leave out important records.

During the conference, Social Security will also inform you of your right to be represented at your hearing.

Your representative does not have to be an attorney, but I always recommend that people get an attorney to represent them. Attorneys better understand the law and the regulations, in my experience, and can do the best job analyzing and presenting your case to the judge.

If your Social Security Disabilty claim has been denied and you are waiting for a pre-hearing conference or a conference, contact our office to find out how we can help.

Social Security Disability – Spotlight on Osteoarthritis

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I have been asked several times recently, “Can I be approved for Social Security Disability based on osteoarthritis?”

The answer is that many people are approved for Social Security Disability and Supplemental Security income based solely on osteoarthritis. However, like almost all medical conditions that can form a basis for a Social Security Disability claim, the diagnosis of osteoarthritis alone is not enough.

The most important factors are

  • where you have the osteoarthritis
  • how severe it is
  • how well you have responded to treatment
  • how severely it affects what you are able to do.

Osteoarthritis is very common, especially as we age. It can affect many different joints in the body, but the joints that I see most often in connection with disability cases are the knees and the hips.

It makes sense because knees and hips are some of the joints that help us stand, walk, stoop, and generally help us get around, which are functions important to most jobs. Fortunately medical treatment can often alleviate or at least improve symptoms of osteoarthritis, but this is not true for everyone.

In addition to medications and lifestyle changes (such as losing weight) sometimes surgery can improve your ability to function, such as artificial joint replacements.

When it comes to Social Security disability, how severe your osteoarthritis is, how well it has responded to treatment, and how it affects what you are able to do on a daily basis are some of the most important factors that the Social Security Administration will consider.

If you are unable to work because of osteoarthritis and are considering applying for Social Security Disability, it is very important that you are getting medical treatment to document the nature and extent of your osteoarthritis, and to hopefully get you some relief from your symptoms.

The Social Security administration will consider what you say about how your osteoarthritis affects you, but they often give more weight to what your doctor says about the nature and severity of your medical problems.

North Carolina disability denial rates

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When it comes to your chances of getting approved for Social Security Disability Benefits initially, or upon the first appeal (called “reconsideration”), the state you live in makes a difference.  

Charles Hall’s excellent Social Security blog posted some interesting statistics about initial and reconsideration denial rates last August, which he got from NOSSCR, the National Organization of Social Secuirty Claimants’ Representatives. 

The stats show in Fiscal Year 2013,  72.2 percent of disability claims in North Carolina were denied initially. This is higher than the national average of 67 percent of claims denied initially.  

At the reconsideration level, in North Carolina 90.4o percent of claims are denied.  This is again higher than the national average of 88.6 percent denied at reconsideration.

Due to these high denial rates many claimants in North Carolina have to appeal their reconsideration denial by requesting a hearing before an administrative law judge.

Unfortunately, due to Social Security disability backlogs the wait time (which varies by hearing office) to get a hearing is quite long. The good news? The denial rate at the hearing level is much lower than it is at initial or reconsideration, both in North Carolina and nationally.  

The vast majority of Social Security disability cases that I win are at the hearing level.

Given the backlogs and the number of times most people are denied Social Security Disability benefits, it’s best to get a lawyer who understands the law and the process. 

An attorney can help prepare your case to give you the best opportunity for success. Statistically, applicants who retain an attorney to represent them are much more likely to win benefits than those who do not.