Is Fibromyalgia A Medically Determinable Impairment?
In order to be found disabled, an individual must suffer from a "medically determinable" impairment. It is often said that symptoms alone cannot be the basis of disability.
Fibromyalgia, as we know, cannot be "seen under a microscope." That is to say, it is a disease which cannot be "objectively" manifested in lab results. This characteristic of the disease has created difficulties in the way that Social Security Administration processes a disability claim for an individual who suffers from fibromyalgia. Years ago, the way in which disability was established (or not established) for persons suffering from fibromyalgia was arbitrary, and seemed to depend on whether the decision maker (usually an Administrative Law Judge) believed in the reality of the disease.
In a memo addressed to an Administrative Law Judge, dated May 11, 1998, Ms. Susan Daniels, then Deputy Commissioner for Disability and Income Security Programs, wrote words of historic significance. Ms. Daniels' memo was addressed to an Administrative Law Judge who had written to say that the Administration "needs to take a definitive position with respect to whether fibromyalgia and chronic fatigue syndrome (CFS) constitute medically determinable impairments." It was the judge's position that neither fibromyalgia nor CFS could be considered a medically determinable impairment within the meaning of the Social Security Act.
In words of pristine clarity, Ms. Daniels wrote that "SSA has taken a definitive position that fibromyalgia and CFS can constitute medically determinable impairments..." From that day forward, it has been the Administration's clearly stated position that no claim based upon fibromyalgia or CFS may be denied on grounds that fibromyalgia and CFS are not "medically determinable" impairments.
Claims relating to fibromyalgia must still document the diagnosis by a competent physician (most typically a rheumatologist) using the diagnostic criteria established by the American College of Rheumatology.. Additionally, the restrictions imposed on an individual by the disease must be established through a body of clinical records reflecting ongoing medical care and assessment.
Over time, the Administration has extended and expanded its awareness of fibromyalgia and/or CFS as potentially disabling conditions. The various Social Security Rulings dealing with the subject have become more precise. See, for example, Social Security Ruling 99-2p, dealing with both fibromyalgia and CFS (see SSR 99-2p footnote #4), and establishing the various criteria for adjudicating claims.
