Many people suffer back pain but at what point is the back pain severe enough to qualify for Disability Benefits?

Pain in your spine can be the symptom of various conditions. My discussion however, will focus on a specific disorder of the spine, namely Herniated Nucleus Pulposus or commonly referred as herniated disc, slipped disc, or ruptured disc. Disorders of the spine generally produce neck and/or back pain which then affects your mobility, your activities of daily living, and your quality of life. Specifically, a herniated disc is a common disorder of the spine that can occur in any part of the spine. The pain it produces varies greatly based on the size of the herniated disc and in the position.

When someone suffers from a herniated disc or other type of spine disorder, Social Security is more concerned with the damage to the spinal cord itself—neurological impairment. What’s really important about herniated discs is that it can press on the nerve root causing pain that can limit your ability to function.

According to the American Association of Neurological Surgeons:

 Lumbar spine (lower back): Sciatica frequently results from a herniated disc in the lower back. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling, and numbness that radiates from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected. This pain often is described as sharp and electric shock-like. It may be more severe with standing, walking or sitting. Along with leg pain, you may experience low back pain.

 Cervical spine (neck): Symptoms may include dull or sharp pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. The pain may increase with certain positions or movements of the neck.

If you suffer from neck or back pain, chances are you also have muscle spasms, stiffness, and loss of mobility to your spine as a result of a herniated disc or other spine problems. It is imperative that you address with your doctor (preferably a specialist) the pain level that you experience, as well as the frequency, intensity and precipitating factors. Make sure to provide as much detail as you possible and whether the pain is exacerbated by sitting, standing, walking, bending, stooping, lifting–even coughing, sneezing, etc. Documenting these symptoms during every visit with your doctor is important because this will help the State Agency or the Judge ascertain the severity of your functional limitations. Particular attention is given to the physical examinations conducted while in the examining room. The exams reveal whether abnormal pressure exist on the nerve root, whether you have significant muscle weakness, whether there’s changes in sensation and reflexes, etc. Some people get better with surgery while others don’t. For others, surgery is not even an option. If you have a spine disorder that has affected your quality of life and your ability to return to work, we will be happy to review your claim.

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Basic VA compensation is designed to compensate the veteran for reduced earning capacity with the maximum compensation for a single veteran without dependents being $2769 per month for a veteran who is rated 100% disabled.  While this amount is certainly helpful to a disabled veteran, we are often approached by veterans for whom this amount falls short of providing the care they need.  In addition, some disabilities affect more than a veteran’s ability to earn.  Recognizing these shortcomings in the compensation system, the VA regulations do provide for compensation above and beyond 100% in specific circumstances.  This type of compensation is called special monthly compensation and is often referred to as SMC.

SMC’s are not based on a disability’s effects on earning but, rather, are designed to compensate a veteran for non-economic factors such as personal inconvenience, social inadaptability, or the profound nature of a disability.  For instance, SMC’s may be available to veterans with disabilities which involve the loss of a limb, loss of vision, loss of hearing, or erectile dysfunction.  It is important to note that while loss of a limb qualifies for SMC, a veteran may also qualify for SMC for loss of use of a limb.  For instance, if a veteran cannot balance or step off of his foot, he may have lost the use of that foot so as to qualify for an SMC.  Similarly, if a veteran cannot pick up objects with his hand or write with a pen, he may qualify for an SMC for loss of use of that hand.

SMC’s are identified by letters ranging from (k) to (s), and while the SMC(k) ratings provide only an additional $99 per month, some of these SMC’s provide substantial support above and beyond the amount awarded for a 100% disability.

 One SMC that we are commonly asked about is entitlement to aid and attendance.  This SMC is available for veterans who, due to their service connected disabilities, need assistance in tending to their daily needs.  Depending on the level of care the veteran needs, this SMC can provide anywhere from an additional $677 per month to an additional $5156 per month.   This is, then, a significant benefit to the veteran and his family.

What does it mean to need aid and attendance?  If the veteran regularly needs someone to help him with dressing and undressing, bathing, taking care of personal hygiene, or making sure that he does not injure himself, he may qualify for this SMC.  It is important to note that the person providing this care does not necessarily have to be a medical professional.  Even if this care is provided by a family member or neighbor, the veteran may still qualify for aid and attendance benefits.  Where the care of a medical professional is required, the veteran may qualify for special aid and attendance benefits which provide increased compensation.

The VA is supposed to consider whether a veteran is entitled to SMC benefits whenever the evidence in his claims file indicates that he is entitled, even if he has never formally requested such benefits.  Sometimes, however, this can be overlooked.   You know your disabilities and your limitations better than anyone else, so it is important that you be aware of what may be available to you so that you can make the VA aware of the benefits to which you are entitled.

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Service connected disabilities are defined as injuries or illnesses that are incurred in or aggravated by active military service. A disability can also be service connected through “secondary” service connection.  Secondary service connection was discussed in our October 4, 2011 post.

Many veterans are aware that when filing for VA disability benefits, they are entitled to file for service connected compensation. However, many are unaware that there are disability benefits available for other disabling conditions, even if they are not related to military service.  These benefits are known as non-service connected pension or simply known as veteran’s pension.  Assuming that a veteran meets all of the requirements for a pension, he/she could qualify even if none of the disabling conditions are related to service.

A veteran may qualify for pension if he/she:  (1) served during wartime, (2) has limited or no income, and (3) is age 65 and over, or if under 65, is permanently and totally disabled. In addition to these requirements, there is a length of service requirement (depending on the date the veteran entered active duty), the service must have been under conditions other than dishonorable, and the disabling conditions must not be the result of willful misconduct.

I will discuss three of the basic requirements for pension in this post.

Wartime Service– One might assume that this means a veteran has to have actually served in a war in order to be eligible. However, this assumption would be incorrect.  The wartime service requirement is fairly simple to meet as long the veteran’s service was within a qualifying period.  Meaning, the veteran does not have to have actually gone to war, the veteran simply has to prove that his/her service was during a period of war. In 38 C.F.R. §3.2, the VA gives the specific beginning and ending dates of each qualifying war period.  For example, the “Vietnam Era” encompasses the period beginning on February 28, 1961, and ending on May 7, 1975 for veterans who served in the Republic of Vietnam and from August 5, 1964 through May 7, 1975 in all other cases. 

Limited or No Income- a veteran must meet the income requirement in order to be eligible for pension. The VA will consider the veteran’s income, as well as the income of his dependents, including spouses and children. Countable income includes earnings or wages, retirement payments, interest and dividends, and some disability payments.  It is worth noting that even if a veteran has income that may appear to be over the limit, it is possible that the VA may be able to exclude some income from the calculation in certain circumstances, such as if the veteran has qualifying unreimbursed medical expenses, certain educational expenses, if the veteran receives Supplemental Security Income (SSI benefits), etc. It is best for a veteran to list all sources of income when filing for pension, and the VA will determine whether or not the veteran is over the income and net worth limits. 

Age 65 and Over- veterans who are age 65 and over do not have to prove they are permanently and totally disabled as long as they meet the other requirements such as qualifying length of service, wartime service, limited income, etc.  

If Under Age 65, Must be Permanently and Totally Disabled- The VA determines permanent and total disability by considering several factors, such as whether the disabilities are likely to improve with appropriate treatment, pertinent medical opinions regarding the permanency of the conditions, the length of any required hospital care, etc.  For veterans under age 40, the VA looks at the issue of permanent and total disability with more scrutiny.  For a veteran under 40, 38 C.F.R. § 3.342 states that “permanence of total disability requires a finding that the end result of treatment and adjustment to residual handicaps (rehabilitation) will be permanent disability of the required degree precluding more than marginal employment.”

Veterans entitled to pension are paid based upon the Maximum Annual Pension Rate (MAPR). The pension rates can be found on the VA’s website at http://www.vba.va.gov/bln/21/rates/pen01.htm.  As an example, as of December 1, 2011, a veteran without a spouse or child is entitled to a maximum pension rate of $12,256 per year, and a veteran with one dependent would be entitled to $16,051 per year. For each additional child, or if the veteran is housebound or requires aid and attendance, the amounts increase.

The lesson to take away is that a veteran may be able to receive pension benefits based on the combination of his/her disabilities, including service and non-service connected conditions.  It is important for the veteran to always file for non-service connected pension if there is a possibility that he/she may qualify. Even if a veteran is initially awarded based on disabilities that are not service connected, he/she can always attempt to establish service connection at a later date. If a veteran is entitled to both service connected compensation and non-service connected pension, the VA will pay whichever of the two benefits results in the higher amount, not both.

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Social Security uses a five-step sequential evaluation process to determine a claimant’s eligibility for benefits.  First, the agency considers whether the claimant is presently working, and doing so at the level of what is known as “substantial gainful activity.”  If so, the claimant will be found not disabled; if not, the agency moves onto step two.  At step two, the agency asks whether the claimant has a severe medically determinable physical or mental impairment (or combination of impairments) which will last for twelve months or end in death.  If so, it will move onto step three; otherwise the claimant will be found not disabled.

The third step is the focus of this post.  At this step, the agency considers whether a claimant has an impairment that meets or equals one of the descriptions of conditions posted at appendix 1 of CFR §404.1520.  (Adult listings (Part A) can be found at http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm.  Childhood listings (Part B) can be found at http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm.)  This appendix addresses with specificity a number of medical conditions, and details various aspects of each condition that must be present and documented for a claimant to meet or equal the listing.  If a listing is met or equaled, the claimant is found to be disabled.  If not, the agency moves onto the next step.

Although not the focus here, the last two steps of the process are worth noting.  At the fourth step, the agency considers a claimant’s functional capacity despite their documented limitations and asks whether that claimant could perform the work they have performed in the last fifteen years.  If a claimant would be able to perform past work, he or she will be found not disabled.  If a claimant is unable to perform his or her past work, the agency moves onto the last step, which asks whether the claimant could perform other work, given their age, education and work experience.  If a claimant can perform other work, they are not disabled; if step five yields no jobs that a claimant could do despite their impairments, then benefits are generally awarded.

Returning to step three and the listing of impairments, there are fourteen categories of impairments in the appendix, including musculoskeletal system, special senses and speech, respiratory system, cardiovascular system, digestive system, genitourinary impairments, hematological disorders, skin disorders, endocrine disorders, impairments that affect multiple body systems, neurological, and mental disorders.  Within each category are various impairments.

As a claimant enters the Social Security disability process, it is wise to consult the listings and consider whether his or her condition (and its severity) is described in the listings.  This is somewhat rare, as the standards are difficult to meet.  Furthermore, even if a claimant’s condition does meet one of the listings, he or she must be able to prove it with documentation. 

A great example is epilepsy, which is addressed in sections 11.02 and 11.03 under the category “Neurological.”  To meet the listing for convulsive epilepsy (grand mal or psychomotor), the condition must be documented by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once a month, in spite of at least 3 months of prescribed treatment; with daytime episodes (loss of consciousness and convulsive seizures) or nocturnal episodes manifesting residuals which interfere significantly with activity during the day.  Though the severity of a claimant’s epilepsy may meet this description, it may not be documented.  However, a claimant who is aware of these requirements would know to carefully document and report to their treating neurologist specific information about each seizure occurrence.  This type of documentation could allow for much quicker resolution of a claim.

Remember, documentation is the key.  A claimant must report disabling symptoms to their doctors so that the information appears in their medical records, especially when trying to prove listing-level severity.

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There are several types of mental impairments that qualify for Social Security Disability. Social Security has carved out categories of mental impairments that are considered severe enough to prevent a person from doing any gainful activity. Even though there are many different types of mental illness that may satisfy the requirements for benefits, this article will focus on Bipolar disorders and its effect.

According to The Merck Manual, “Bipolar disorders are characterized by episodes of mania and depression, which may alternate, although many patients have a predominance of one or the other.” Moreover, Bipolar disorders are classified as:

 Bipolar I disorder: Defined by the presence of at least one full-fledged (i.e., disrupting normal social and occupational function)

 Bipolar II disorder: Defined by the presence of major depressive episodes

 Bipolar disorder not otherwise specified (NOS): Disorders with clear bipolar feature that do not meet the specific criteria for other bipolar disorders

This type of condition involving depression and/or elation has to be well documented. It must also show that your condition has lasted or is expected to last for 12 consecutive months. Social Security will review all hospitalizations related to your mental illness we well as mental status exams, and Psychological testing. This is how Social Security determines how limited you are and if the condition satisfies the requirements of the law.

Bipolar disorder is a mental illness that is commonly misunderstood because those diagnosed with the disorder often have good and bad days. Even if someone responds to treatment, that person may still be seriously limited in their ability to work.

Some people experience loss of interest in things they used to enjoy, changes in appetite, difficulty sleeping—whether it is sleeping too much or not able to sleep at all. I have interviewed people that during a manic episode, they are full of energy and euphoric. At times, they can go days without sleeping then suddenly crash into dark depression experiencing feelings of guilt or worthlessness– even suicidal thoughts.

As mentioned earlier, the symptoms from the diagnosis have to be severe enough. This means, that your ability to function is limited resulting in serious restrictions in your daily activities, social functioning or even difficulties in maintaining concentration. This is how Social Security evaluates whether you have the ability to carry out simple tasks required in the most basic type of work.

It is helpful if your psychiatrist or psychologist can put in writing just how the symptoms of Bipolar affect you. If anyone knows you well enough and how your life is affected, it would be your psychologist or psychiatrist. They are in the best position to tell social security just how the condition affects you daily life and whether you have responded to medication, and if there is likelihood of improvement.

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There are many different conditions that are recognized as mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition, also known as the DSM-IV. Examples of common mental health conditions include post-traumatic stress disorder (PTSD), depression, generalized anxiety disorder, bipolar disorder, and schizophrenia.  The VA utilizes the DSM-IV when rating mental disabilities.

We receive many calls from veterans who have multiple mental health conditions, and they are unhappy because they feel the VA has not taken all of their conditions into account when assigning a disability rating.  For example, a veteran may suffer from PTSD and depression based on the DSM IV criteria; however, the VA has only assigned a total rating of 30% for both conditions. 

Although assigning only one rating may seem odd because the veteran is suffering from two distinctly separate conditions, the VA regulations pertaining to mental health generally mandate that the veteran be assigned only one disability rating for all mental conditions, even if there is more than one. So in the above example, even though the veteran has PTSD and depression, only one rating will be assigned. Of course, it may logically follow that a veteran with more conditions may be more seriously impaired than a veteran with only one condition; however, that is not necessarily always the case.

The VA uses the General Rating Formula for Mental Disorders to rate mental disabilities. This is found in 38 C.F.R. § 4.130. The Rating Formula assigns ratings ranging from 0% all the way to 100%. A 0% rating means that “a mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.” A 100% rating is warranted when there is “total occupational and social impairment” due to certain symptoms. Most veterans fall somewhere in the middle. Their mental conditions warrant more than a 0% rating; however, they are not ratable at the 100% level. 

The real issue when rating claims involving mental disabilities is determining the appropriate rating to be assigned, which really has nothing to do with the total number of conditions because the VA is using only one rating scale.  When determining the appropriate rating, the VA considers the effect of the mental conditions on occupational and social impairment. Symptoms that are considered include but are not limited to: impairment in thought processes or communication; grossly inappropriate behavior; persistent danger of hurting self or others; suicidal ideation; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); memory loss; panic or depression affecting the ability to function; impaired impulse control; chronic sleep impairment; and decreased work efficiency.

Since the VA is rating these claims based on subjective symptoms there is often room for error in the ratings. Oftentimes, veterans will attend compensation and pension examinations at the VA, and the result is a rating decision that underrates the severity of the mental condition(s). This happens despite the VA regulations which state that the VA is to assign a rating based on all evidence of record,  and not just “solely on the examiner’s assessment of the level of disability at the moment of the examination.” 38 C.F.R. § 4.126(a).

The VA has stated that its goal on rating veterans is to determine how much the service connected disability affects the veteran’s ability to work.  The first question I ask a veteran when discussing a claim is whether or not they are working. If the veteran is not working I then ask whether the mental illness is contributing to the unemployment.  If the answer is yes it is then the veteran should be receiving a rating of 100% or Total Disability due to Individual Unemployability (commonly called TDIU or IU).  If the veteran is working then we discuss how much the disability affects the veteran’s employment.

If the degree of disability has been underrated, it is important that the veteran file a timely appeal of the rating decision contesting the rating assigned. An experienced veterans’ law attorney can assist you with filing any necessary appeals and developing the record to properly document the severity of the mental conditions.

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The basis of any Social Security disability claim is a claimant’s residual functional capacity.  In other words, the extent of their functional ability despite their medically documented impairments.  To make a determination about a claimant’s residual functional capacity, Social Security obtains his or her medical records.  Then a doctor (one who will never actually meet the claimant) reviews these records and decides what the claimant would be able to do in various work related areas, such as how long they can sit, stand, walk or lift.  In the area of mental impairment, limitations are considered such as social functioning, concentration, persistence, pace, and ability to perform activities of daily life.  

            Although medical records are the most significant element in a disability claim, they often do not contain the type of information needed to prove disability.  This may happen for a number of reasons.  For example, a patient who has been treated for the same condition for years may not report a full list of the same symptoms on every visit to their doctor.  In other cases, a doctor may have handwritten notes that are difficult or impossible to read.  Similarly, a doctor may use an electronic records system which automatically fills areas of an exam report, even though they may not accurately reflect the patient’s current condition.

            Claimants can address these pitfalls in a number of ways.  First, claimants should continually report symptoms to their doctors at each visit.  This may include functional issues such as the following: how long a claimant can sit, stand, and walk at one time; whether and why they need to elevate their feet during the day and if so, how often and for how long; whether they experience significant side effects from their medications; whether they must sleep or rest during a typical day; and how frequently they must take bathroom breaks.  Regarding mental impairments, several examples of functional issues includes how often they experience panic attacks and how long they last; whether they have trouble being in public; whether they are able to concentrate on simple tasks; whether they have memory impairment; and whether they can handle normal levels of stress.

            Secondly, a claimant should be aware of the substance and content of their medical records.  They should know, for example, whether their doctors’ records are legible, or whether their electronic records contain accurate information.  With electronic medical records, information is often entered at the time of the initial visit and the information may or not be updated after that point.  Some examples of when this is an issue are references to smoking when a claimant previously quit, or references to working when the claimant has been unable to work.  Such references are misleading and can be relied upon by a decision maker.

            A third way to document limitations in a disability claim is through functional capacity forms.  This is a form with questions intended to document a treating physician’s opinion of his or her patient’s impairments such as those mentioned above.  These forms can be the most critical piece of evidence in a claim, but a claimant must be proactive in obtaining such a form.  Whether or not Social Security gives credit to these forms depends on whether they are consistent with the same doctor’s medical records.

            When a claimant’s medical records thoroughly document their limitations, odds of a favorable outcome are greatly increased.

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When someone considers filing for social security, I am often asked whether a divorced person is eligible to receive benefits from their former spouse’s social security record as well as from their own social security record. This is a common question and I wanted share the different types of benefits available as well as their requirements to obtain them.

In the case of a Divorced Spouse, the benefit comes from the ex-spouse’s social security record provided certain conditions are met. The former spouse must have been eligible to receive their own benefit for retirement or disability. To receive these benefits, your marriage must have lasted at least ten (10) years, you must have been divorced for at least two years, you must remain unmarried, and the age requirement is that you must be at least 62 years old. Additionally, the amount you would otherwise receive from your ex-spouse’s social security benefits would be higher than the amount of benefits you would receive from your own social security benefit.  The caveat here is that if you remarry, then you are no longer entitled to divorced spouse benefits. There’s an exception however, where the subsequent marriage ends in divorce, death or annulment then you can become eligible for benefits again.

What happens if the divorced spouse who has worked and paid Social Security dies? Where the divorced spouse dies, the Surviving Divorced Spouse, could get benefits provided the marriage lasted at least ten (10) years and the deceased ex-spouse was fully insured upon death (having contributed to Social Security). Social Security has carved out an exception to the ten year marriage rule. According to Social Security, if you are Surviving Divorced Spouse taking care of a child under the age of 16 or disabled who is getting benefits on the former spouse’s social security record, then you do not have to satisfy the ten (10) year marriage rule.

Notice the age requirement for the Surviving Divorced Spouse. You must be at least 60 years of age to qualify or between the ages of 50 to 59 and disabled. If you are between the ages of 50 to 59, you have the additional component of proving that a disability exists that limits your ability to work. Lastly, you have to make sure or social security can verify for you that your own social security benefit would not be higher than the amount of benefit you would receive from your deceased divorced spouse’s benefit.

Unlike in Divorced Spouse benefits where remarrying (someone other than the former spouse) terminates the benefit,  someone eligible for Surviving Divorced Spouse benefits can remarry and not run the risk of terminating the benefits.  

How much will be paid out? The amount depends on the earnings of the deceased. At age 60, the surviving divorced spouse can receive 71.5% to 99% of the deceased spouse’s amount; at ages 50-59 the disabled surviving divorced spouse can receive 71 ½ %. And, a Divorced Spouse can receive up to 50%. For additional details see SSA.gov/pubs/10084.html

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Once a veteran is granted service connection for a disability, the next logical question is, “How much money will I receive?”  The amount of compensation benefits a veteran receives depends on the disability rating that the VA assigns to the veteran’s disability.  Disability ratings range from 10% to 100%.  The idea behind these ratings is that the veteran should be compensated according to the impairment that the disability would cause to the average person’s ability to earn a living. Somehow, though, the numbers don’t seem to add up. 

Where a single veteran with no dependents has only one service-connected disability, it is fairly easy to figure out the appropriate amount of benefits according to the VA’s Compensation Benefits Rate Tables.  Even though it is easy to come up with the correct dollar amount, however, the numbers may not always make sense.  For instance, a veteran with no dependents who is 100% disabled currently receives $2673.00 according to the Rate Tables.  A veteran with a 50% disability rating, however, receives only $770.00.  So, even though the veteran with a 50% disability rating is presumed to suffer from about half of the impairment to his ability to work, he does not receive half of the amount of money that the 100% disabled veteran receives—in fact, he receives only about a third.

Another issue with the current Compensation Benefits Rate Tables is that despite the tough economic times in which we find ourselves, the amount of compensation benefits are not keeping pace with the times.  While prices keep rising and the cost of living is going up, the rates for VA benefits have not changed since 2009.  There has been no cost of living adjustment for veterans’ benefits since that time.

Where things become really confusing is when a veteran suffers from two or more service connected disabilities which must be combined according to the VA Combined Ratings Table.  Using what many veterans refer to as “VA Math,” under the Combined Ratings Table, two 50% disability ratings do not add up to a 100% rating as most people would expect.  Rather, two 50% disabilities are combined to give a veteran a 75% disability rating ( which would then be rounded up to an 80% disability rating).

The justification for this combination is that once a veteran’s ability to work is 50% impaired by a disability, any other disability ratings are applied only to the remaining, unimpaired 50%.  In other words, the second 50% disability rating applies only to the 50% of the veteran’s ability to work that is not already impaired.  50% of 50% is only 25%, so the additional impairment only adds 25% to the veteran’s overall disability rating.  So this veteran who has two, service –connected disabilities with a 50% disability rating for each is entitled only to an 80% disability rating which will pay him only $1427.00.  Again, here, $1427 is not 80% of the $2673.00 that the veteran with a 100% disability rating receives.  The veteran with the 80% disability rating receives just over half the amount that the veteran with the 100% disability receives. 

These amounts are affected by numerous other factors.  Veterans can receive additional benefits where they have dependent children, spouses or parents.  In addition, increases may be made to a veteran’s rating if he has a disability which affects both arms or both legs.  Finally, a veteran may be eligible for additional compensation benefits called Special Monthly Compensation where he has certain types of disabilities which include the loss or loss of use of a part of the body.

The amount of benefits to which a veteran is entitled is a complicated issue affected by many factors such as those discussed above.  It is important to make sure that the VA has considered every angle in determining how much compensation you should receive.

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Fibromyalgia is a disorder characterized by chronic pain, tenderness in the muscle, joints, and soft tissue.  This condition has been linked to fatigue, sleep problems, chronic headaches, and depression, memory and concentration problems.

If you are considering filing for Social Security Disability due to Fibromyalgia, the condition must be diagnosed by the appropriate specialist and the impact on your inability to work must be properly documented.

It is important that you undergo a physical examination to confirm the diagnosis and establish treatment with a rheumatologist. Once you establish treatment with a rheumatologist, it is imperative that your rheumatologist complete a Residual Functional Capacity form (“RFC”). This form gives your rheumatologist the opportunity to describe how your disability affects your ability to work. 

Since a diagnosis alone will not be enough to prove disability, it is absolutely necessary that your records show all of your symptoms and your limitations. For this reason, during each visit with your rheumatologist, you should address the intensity, location, and frequency of your pain.  For example, if you experience diffuse muscle and joint pain make sure that you describe the level of pain that you feel on a scale from 1-10, whether the pain was aching, throbbing, burning, etc., and if it interferes with your daily activities. You may want to keep a pain diary to help remember the symptoms you experienced on a daily basis. Other symptoms may include: numbness and tingling, chronic fatigue, morning stiffness, muscle weakness, irritable bowel syndrome, and panic attacks.

Some people with fibromyalgia may become irritable, easily upset and commonly suffer from depression, memory problems, insomnia, anxiety, and difficulty concentrating. These psychological symptoms should also be documented and addressed with your doctor.  Depending on the severity of the psychological condition, your doctor will decide to refer you to a psychologist or psychiatrist.  It is not uncommon to suffer from psychological symptoms especially after learning that you suffer from a medical impairment that now renders you disabled and unable to work. 

If you plan on applying for social security disability benefits, it is imperative that you work with your doctors and hire a qualified Social Security Attorney. A qualified Social Security Attorney will help develop the record and present the best case before the United States Administrative Law Judge.

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