Social Security Benefits for Fibromyalgia and Chronic Fatigue Syndrome

June 28,2016
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Nothing is more frustrating than having a disease that is difficult to diagnose. Fibromyalgia and chronic fatigue syndrome (CFS) both mimic an array of other conditions and are often difficult to prove. Most doctors diagnose these conditions by eliminating the possibility of other impairments before finally settling on a diagnosis of fibromyalgia or CFS. While you are waiting to obtain a diagnosis, your disease may become so severe that you cannot work. If you suffer from fibromyalgia or CFS, and have been unable or expect to be unable to perform substantial gainful activity for at least 12 months, you should contact a Bergen County disability lawyer to discuss making a claim for Social Security disability benefits.


What Is Fibromyalgia?


Fibromyalgia is a condition that results in musculoskeletal pain, fatigue, impaired memory, mood disorder, and sleep difficulties. Although the exact cause is unknown and all of the symptoms are not fully documented, it is believed that fibromyalgia makes pain worse by affecting the way your brain’s receptors perceive it.


Fibromyalgia sometimes occurs after trauma, surgery, severe infections, or chronic stress. Symptoms may occur gradually over time with no indication of cause or suddenly after a triggering event. Although fibromyalgia often masquerades as arthritis, it does not cause widespread inflammation of joints, muscles, and other tissue like arthritis does. It also does not appear to damage tissues permanently.


Fibromyalgia was first diagnosed in the 1800s; however, it was long-treated as an arthritis-related disease. It was not until 1987 that the American Medical Association recognized it as an autonomous disease. Only recently have specific task forces been created to focus on finding treatments and a cure for fibromyalgia. It can affect anyone of any age, but it is most common in women.


Treatments for fibromyalgia often focus on alleviating the symptoms rather than addressing the underlying cause. Pain medications, antidepressants, anti-anxiety medications, physical therapy, moist heat, relaxation, and stress reduction techniques are often used to treat the symptoms of fibromyalgia. The goal is to reduce symptoms so that you can sustain a productive lifestyle. However, often the disease results in symptoms that are so severe you cannot work for extended periods of time.


What Is CFS?


Chronic fatigue syndrome is a disorder that results in continuous extreme fatigue that cannot be explained. The fatigue may be manifested physically and mentally. It may become worse with activity and stress; however, it does not improve with rest and relaxation. CFS is difficult to diagnose, and often doctors eliminate other diseases first before settling on a diagnosis of CFS.


The cause of CFS is unknown; however, it may be triggered by viral infections, psychological stress, hormonal imbalances, or immune system problems. Symptoms include extreme fatigue, loss of memory, difficulty concentrating, sore throat, enlarged lymph nodes, muscle and joint pain, headache, constant need for sleep, and extreme exhaustion lasting longer than 24 hours after physical exercise or mental strain.


Tests are often used to eliminate diagnoses of diabetes, adrenal gland issues, HIV/AIDS, thyroid conditions, or other diseases that can cause symptoms similar to CFS; however, there is no test that diagnoses CFS. Thus, it is important to document all other medical evidence possible to prove your CFS is severe enough to qualify for disability benefits.


How to Prove Fibromyalgia or CFS Is “Severe”


Unfortunately there are no specific tests used to diagnose fibromyalgia or CFS. However, the Social Security Administration (SSA) requires objective medical evidence to prove that a condition is severe enough to qualify for disability benefits.


In order to receive disability benefits, you must be unable to perform substantial gainful activity on a sustained basis (i.e., a full time job) for at least 12 months. You may document your symptoms in the following ways:


Daily Journal – Keep an ongoing record of your symptoms, their severity, and any treatment that you receive. Document how your disease affects your life, and how it limits your daily life.


Doctor’s Notes – Although there are no specific tests that can be completed to prove Fibromyalgia or CFS, a doctor can assess your situation from a professional perspective and note how those conditions affect your life. Your doctor can also indicate whether he or she believes you are a malingerer, or whether you’re inclined to exaggerate symptoms. The SSA puts significant weight on the medical opinions of a licensed professional.


Medication and Treatment Record – You should carefully document the medications and treatments you receive for your conditions. A recorded account of how those medications affect your condition will show the SSA how you’ve reacted to treatment. Seeking and following treatment is persuasive evidence that you actually suffer from the symptoms you claim to have.


Description of Functionality – Your doctor can complete a functionality assessment to describe your abilities. An Adult Function Report details your conditions, onset, prognosis, daily activities, personal care routines, social activities, physical and mental limitations, and endurance. If you do not have this information fully documented, the SSA may send you to a doctor to determine your functionality. You may also submit a statement from someone who knows you well to show how well you can complete activities of daily living.


Get Help from a Bergen County Disability Lawyer


It can be extremely difficult to prove your fibromyalgia or CFS is severe enough to qualify for disability benefits. A Bergen County disability lawyer will help you collect all the information necessary to prove you have a severe condition. You may be referred to a doctor who specializes in your condition or in Social Security disability documentation. If you are seeking Social Security disability benefits for fibromyalgia or CFS in Bergen County or elsewhere in the New York Metropolitan Area, call the Hermann Group at 877-773-3030 for a free evaluation of your case.