[social_warfare]I have to be honest with you: Fibromyalgia disability claims are a tricky thing to win. I know it sounds discouraging but it shouldn’t be.
Do you know why?
Because most claimants and even attorneys forget about the most important person in the process: The judge.
I can hear you saying: “this is my claim and you say the most important person is the judge and not me?“
That’s right! Let me explain.
As you probably know, Fibromyalgia is a condition that will not show in films (Xrays, MRIs, CTs) or bloodwork. It is also a condition that even doctors don’t understand. Some doctors will go as far as calling it a “psychosomatic disorder” (“that the condition is in your head”). Finally, Fibromyalgia is still seen as a “default” diagnosis when doctors can’t figure out your source of pain.
Having said all that, now let’s use that information to get into the mind of the judge.
There are two types of judges when it comes to evaluating and deciding a Fibromyalgia case. And they are somewhat obvious: either you get a judge who believes you or you get a judge who doesn’t.
Aside from stating the obvious here, we need to analyze how to approach each one.
The judge who believes Fibromyalgia is real
This is a judge who actually has a personal connection to the condition. Either a family member or a friend has it and he has been exposed to the daily difficulties that a person with Fibromyalgia goes through.
This judge will certainly be a little easier to convince you are disabled because he sees your condition in a ‘favorable’ way. But that doesn’t mean that winning will be easy.
The fact that he believes that Fibromyalgia exists doesn’t mean he is convinced that YOU are disabled because of it. In other words, the judge will still need ‘good excuse’ to award you.
What does that mean, ‘an excuse’ to award?
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That means, even if the judge believes you and wants to award you benefits he still needs to justify to his ‘superiors’ WHY he awarded you (yes, judges have bosses too). And the way the judge justifies the award is by noting in his decision that there was enough medical evidence to approve the case.
In this situation, what you need to do is ‘help the judge’ to approve your case. How do you do that?
By presenting medical notes and records showing that you not only have the proper diagnosis for Fibromyalgia BUT ALSO evidence that shows your inability to function.
In my post about medical records, I talk about the importance of proper treatment to prove you are disabled. Please read that article because it really explains why medical treatment is so important in Social Security cases.
Remember that there are people who work while diagnosed with Fibromyalgia. So what you have to show in your medical records is that you are in such bad shape that you cannot do any activities. Especially because most doctors and even specialists recommend that you do as many activities as possible if you were diagnosed with Fibromyalgia.
Of course, the tendency is not to do any activities because your body is fighting with fatigue, brain fog, etc. So your job is to show that you have tried to do these activities and that you failed miserably.
As a final thought on this particular judge, the more “on board” your doctor is to show that you are disabled the easier it is to get approved.
The judge who believes that Fibromyalgia is in your head
This particular judge either doesn’t have any connections with people with Fibromyalgia or he’s simply just “jaded“. That is, this judge thinks he’s seen it all and just “stopped caring” at some point in his career. He also may think that you’re either lazy or that you just want to “play victim“.
It sounds harsh but these judges do exist.
To explain how to convince this type of judge that you are disabled and that the condition is very real I have to back up a little bit.
As I mentioned before, Fibromyalgia is hard to prove because it doesn’t show in films or bloodwork.
So how is it diagnosed? You probably know by now that Fibromyalgia is diagnosed by examination and confirmation of trigger points around certain areas of your body.
That’s where things can get tricky and that’s why some judges simply don’t believe that Fibromyalgia exists
First, the doctor is relying on you to tell him that a certain trigger point hurts. Second, you need to have a minimum of 11 confirmed trigger points to be considered disabled for Fibromyalgia.
Some doctors will diagnose patients with the condition with a lesser amount of trigger points without exploring the idea that it could be some other condition with similar symptoms. This creates confusion because, if your doctor is “defaulting” your diagnosis to Fibromyalgia that can mean there really isn’t a proper diagnosis. That can also mean you may not be getting proper treatment either.
A judge will then be suspicious, not of you necessarily but suspicious of your doctor and your treatment. If your doctor is misdiagnosing you and you’re are not getting proper treatment, how do you or your doctor know you are “permanently” disabled?
Because of this uncertainty, that judge will always wonder about the diagnosis and will more likely deny your case.
While medical treatment and evidence of functional limitation are very important here, you will also have to demonstrate that there’s more than just “make believe” symptoms that prevent you from working.
Tell me if this is not true? Were you one of those “high achieving, hard working, “can-do-it-all” person”?
If you answered yes, know that this is the most common Fibromyalgia patient out there. And I honestly can’t remember one single client of mine who did not fit this profile. And when I say high achiever, it doesn’t mean money or awards, but a really hardworking person (family, work, house, “the works“).
What’s the secret to convincing this “non-believer” judge that your Fibromyalgia is real?
With this particular judge, in addition to good medical records, evidence of inability to function and treatment, you need to show an excellent work history! You need to show ‘the before and after’. That is, how you were at work and how you are now.
Your work history will serve to give you credibility. The judge will find you more credible if he sees that you would not be asking for disability if you weren’t very sick. In other words, no one in their right mind would leave that great job/life if it weren’t for something really serious preventing them from working.
How do you show your excellent work history?
First, the judge will have access to your work history report you completed during the early stages of the case. But there is an additional step you should take to improve that report: Letters!!
You should try to contact your former bosses, co-workers, and anyone who is not your family and who have seen how hard you worked. They can write about your work ethic and how accomplished you were at work, and how they saw your health declining right before their eyes before you had to quit.
These letters are very compelling testimonials because they are considered ‘less biased’. This judge will know that these people (co-workers, etc) have nothing to gain by writing a letter on your behalf. After all, you are not going back to work and yet they thought your decline was so evident that they didn’t have any problem writing a letter to the judge.
Notice that I’m not talking about family members’ letters here. Those usually don’t help. But a letter from a coworker? Golden!
Of course, nothing is 100% sure in Fibromyalgia cases. But I have noticed that when my clients have a good set of medical records, evidence of minimal functional capacity and excellent work history, their chances to win are much higher.
So, if any of these “ingredients” are missing in your case, please start now! Start with medical treatment and making sure that your doctor fully supports your disability based on your symptoms and limitations.
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Until next time,