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Fibromyalgia and Social Security Disability

Fibromyalgia is one of the listed medical conditions that the social security administration includes in their list of impairments, or “blue book.” As one of the medical conditions listed the social security administration believes Fibromyalgia to be either a permanent disability, expected to result in death, or meets a specific statement of duration outlined in the “blue book.” Evidence must show that the person has had the conditions for a period of at least 12 months.
The process used by the Social Security Administration to determine disability in relation to Fibromyalgia or other medical condition is five steps.

1. Determine if an individual is “working (engaging in substantial gainful activity)” and earning more than $1,040 a month as an employee. These basic thresholds disqualify a claimant.

2. Conclude that the Fibromyalgia is severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. This can include:

  • Walking
  • Standing
  • Sitting
  • Lifting
  • Pushing
  • Pulling
  • Reaching
  • Carrying
  • Handling
  • Seeing
  • Hearing
  • Speaking
  • Understanding instructions
  • Carrying out instructions
  • Remembering instructions
  • Responding appropriately to supervision, co-workers and other usual work situations
  • Dealing with changes in work settings

3. Determine if the disabled meets any of the criteria in 14.08 of the “blue book” or is of equivalent severity to any impairment in 14.08. 14.08 impairments are produced below for easy reference.

A. Bacterial infections:
1. Mycobacterial infection (for example, caused by M. avium intracellulare, M. kansasii, or M. tuberculosis) at site other than the lungs, skin, or cervical or hilar lymph nodes, or pulmonary tuberculosis resistant to treatment; or
2. Nocardiosis; or
3. Salmonella bacteremia, recurrent non typhoid; or
4. Multiple or recurrent bacterial infections, including pelvic inflammatory disease, requiring hospitalization or intravenous antibiotic treatment three or more times in a 12-month period.

B. Fungal infections:
1. Aspergillosis; or
2. Candidiasis involving the esophagus, trachea, bronchi, or lungs, or at a site other than the skin, urinary tract, intestinal tract, or oral or vulvovaginal mucous membranes; or
3. Coccidioidomycosis, at a site other than the lungs or lymph nodes; or
4. Cryptococcosis, at a site other than the lungs (for example, cryptococcal meningitis); or
5. Histoplasmosis, at a site other than the lungs or lymph nodes; or
6. Mucormycosis; or
7. Pneumocystis pneumonia or extrapulmonary Pneumocystis infection.

C. Protozoan or helminthic infections:
1. Cryptosporidiosis, isosporiasis, or microsporidiosis, with diarrhea lasting for 1 month or longer; or
2. Strongyloidiasis, extra intestinal; or
3. Toxoplasmosis of an organ other than the liver, spleen, or lymph nodes.

D. Viral infections:
1. Cytomegalovirus disease (documented as described in 14.00F3b(ii)) at a site other than the liver, spleen, or lymph nodes; or
2. Herpes simplex virus causing:
a. Mucocutaneous infection (for example, oral, genital, perianal) lasting for 1 month or longer; or
b. Infection at a site other than the skin or mucous membranes (for example, bronchitis, pneumonitis, esophagitis, or encephalitis); or
c. Disseminated infection; or
3. Herpes zoster:
a. Disseminated; or
b. With multidermatomal eruptions that are resistant to treatment; or
4. Progressive multifocal leukoencephalopathy.

E. Malignant neoplasms:
1. Carcinoma of the cervix, invasive, FIGO stage II and beyond; or
2. Kaposi’s sarcoma with:
a. Extensive oral lesions; or
b. Involvement of the gastrointestinal tract, lungs, or other visceral organs; or
3. Lymphoma (for example, primary lymphoma of the brain, Burkitt’s lymphoma, immunoblastic sarcoma, other non Hodgkin’s lymphoma, Hodgkin’s disease); or
4. Squamous cell carcinoma of the anal canal or anal margin.

F. Conditions of the skin or mucous membranes (other than described in B2, D2, or D3, above), with extensive fungating or ulcerating lesions not responding to treatment (for example, dermatological conditions such as eczema or psoriasis, vulvovaginal or other mucosal Candida, condyloma caused by humanPapillomavirus, genital ulcerative disease).

G. HIV encephalopathy, characterized by cognitive or motor dysfunction that limits function and progresses.

H. HIV wasting syndrome, characterized by involuntary weight loss of 10 percent or more of baseline (computed based on pounds, kilograms, or body mass index (BMI)) or other significant involuntary weight loss as described in 14.00F5, and in the absence of a concurrent illness that could explain the findings. With either:
1. Chronic diarrhea with two or more loose stools daily lasting for 1 month or longer; or
2. Chronic weakness and documented fever greater than 38°C (100.4°F) for the majority of 1 month or longer.

I. Diarrhea, lasting for 1 month or longer, resistant to treatment, and requiring intravenous hydration, intravenous alimentation, or tube feeding.

J. One or more of the following infections (other than described in A-I above). The infection(s) must either be resistant to treatment or require hospitalization or intravenous treatment three of more times in a 12-month period.
1. Sepsis; or
2. Meningitis; or
3. Pneumonia; or
4. Septic arthritis; or
5. Endocarditis; or
6. Sinusitis documented by appropriate medically acceptable imaging.

K. Repeated (as defined in 14.00I3) manifestations of HIV infection, including those listed in 14.08A J, but without the requisite findings for those listings (for example, carcinoma of the cervix not meeting the criteria in 14.08E, diarrhea not meeting the criteria in 14.08I), or other manifestations (for example, oral hairy leukoplakia, myositis, pancreatitis, hepatitis, peripheral neuropathy, glucose intolerance, muscle weakness, cognitive or other mental limitation) resulting in significant, documented symptoms or signs (for example, severe fatigue, fever, malaise, involuntary weight loss, pain, night sweats, nausea, vomiting, headaches, or insomnia) and one of the following at the marked level:
1. Limitation of activities of daily living.
2. Limitation in maintaining social functioning.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

4. Determine if an individual could perform work done in the past despite their AIDS disability. If the person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the final step.

5. Review age, education, work experience and physical and mental condition to determine what other work, if any, the person can perform. The elements reviewed in Step 2 are more closely analyzed with specific relation to the individual. A substantial loss of ability to meet any one of these basic work related activities would severely limit the potential occupational base and justify a finding of disabled.