Is Fibromyalgia a Disability? SSDI and ADA Eligibility Requirements
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Yes, fibromyalgia can qualify as a disability that may entitle you to Social Security benefits and ADA accommodations, but proving that your condition is severe enough to affect your ability to earn substantial income can be difficult.
You’ll need to show that you have been evaluated by a doctor, do not have other conditions that could cause your symptoms, have symptoms that limit your job performance and are unable to perform tasks for any job that will provide you with enough income.
If you’re thinking of applying for Social Security Disability Insurance (SSDI) with a fibromyalgia diagnosis, here are the things you need to know before submitting your application.
Does fibromyalgia qualify as a disability for SSDI?
Yes, SSDI recognizes fibromyalgia as a disability. Although the condition is difficult to classify, the Social Security Administration (SSA) views it as related to immune system and musculoskeletal disorders. Because it doesn’t fit neatly into a category, you won't find it in the SSA’s list of recognized impairments that are usually approved for benefits. But you can qualify for SSDI if you are able to show that your condition meets the criteria for disability.
How to get SSDI benefits for fibromyalgia
Here are the key steps.
1. Show that you have a diagnosis.
The SSA requires documentation proving the qualifying disability. To diagnose fibromyalgia properly, doctors must show that you:
Have had pain for at least three months on both sides of the body, above and below the waist and along your axial skeleton (your core and back), such as with your cervical or thoracic spine or lower back.
Do not have other conditions that could cause the symptoms.
Additionally, one of the following must be true:
You have pain in at least 11 of 18 possible tender points when the doctor tests your body using a specific method.
» MORE: Is disability income taxable?
If you have a qualifying condition besides fibromyalgia, include that information on your SSDI application. Your odds of qualifying for benefits may increase if you can show you have a coexisting condition that also affects your ability to earn income.
2. Provide documentation.
Types of evidence you might need to submit include:
Medical records showing that you’ve been seeking medical evaluations and treatment for the condition. Some cases require 12 months or more of documentation.
Records from medical professionals other than your specialist, such as therapists or psychologists, that discuss the severity of your condition and its effects on your day-to-day activities.
Statements from nonmedical sources who are familiar with your condition and its effects on your life. Examples include family, friends, previous employers, teachers and Social Security Administration (SSA) personnel who have spoken with you about your condition.
If the SSA cannot determine if you have a qualifying disability by reviewing your submitted records, it can request that you visit a physician for a consultative exam. The SSA pays for this appointment to ensure that an unbiased doctor performs the exam.
3. Prove fibromyalgia keeps you from earning a living.
You must be able to show that your symptoms interfere with you keeping a job and earning substantial income. This is not always clearly stated in a document but can be proven through a history of being unable to work because of your condition or its treatments.
The SSA also considers whether your pain or symptoms are severe enough to affect your ability to do basic work tasks. This includes the SSA evaluating your “residual functional capacity” — how much you are able to do despite your symptoms.
SSDI is for people with disabilities who cannot perform any job that provides substantial income. You are unlikely to qualify for benefits if you can perform a job that will give you adequate income, even if that job is unrelated to your previous career or training.
SSDI benefits for fibromyalgia
SSDI gives disabled workers monthly payments to replace the income they can no longer earn. How much the SSA pays depends on how much of their lifetime earnings were covered by Social Security and whether they receive other government benefits or pension payments.
The average SSDI payment was $1,537.13 in December 2023, which is $18,446 annually. That amount is just $3,386 a year more than the 2024 federal poverty level.
Does fibromyalgia qualify as a disability under the ADA?
To qualify for accommodations at work under the Americans with Disabilities Act, your condition needs to limit a major life activity severely, and performing your job qualifies as one of those activities.
Your employer has the right to ask for medical documentation that states that you have a disability that requires accommodations — but an employer cannot require you to provide documentation that is unrelated to your accommodation request (i.e., all of your medical records).
In some cases, a letter from your specialist stating you have a disability and listing the accommodations that will help you at your job is all you’ll need to submit.
The accommodations depend on the type of job you perform. For example, someone who works at a computer while sitting at a desk will need different accommodations than a person who works in a warehouse or automotive shop. Here are examples of accommodations that might help at various types of jobs:
An ergonomic workspace, such as a more supportive chair to allow you to sit in different positions.
Frequent breaks to give your joints and muscles time to recover.
Headsets or telephone holders to reduce stress on neck, wrist, elbow and shoulder muscles.
Cold-resistant or heated gloves to avoid temperatures that aggravate symptoms.
Electric scissors, page turners, reachers and other equipment to minimize the use of certain joints.
Anti-fatigue matting to ease stress on your joints when you have to stand for long periods.
Pneumatic tools to decrease the strength required to use them.
Flexible schedule or task rotation to let you work on certain tasks when your body is most likely to respond more positively to them.
How to improve your chances of qualifying for SSDI
Know what’s required for a qualifying fibromyalgia diagnosis. The SSA has requirements for what a doctor must do and show in medical records before it will accept a fibromyalgia diagnosis. Ensure that your doctor is aware of these requirements.
Include any coexisting conditions. If you have coexisting conditions, especially ones that are related to or caused by fibromyalgia, include these in your SSDI claim. Sometimes a single condition isn’t enough for an approval, but the effects of multiple conditions can be enough to show that you are unable to earn substantial income.
Don’t stop treatment. The SSA wants to see consistent treatment on your part to determine if continued treatment is likely to improve your condition. If a certain treatment isn’t working, talk with your doctor about trying a different treatment so you can show the SSA that you’ve given everything a chance before applying for SSDI.
Read more about whether these conditions may qualify for disability benefits.
