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What medical evidence is needed for SSD for Fibromyalgia?

There are many chronic illnesses that can affect the ability of New Jersey residents to work and function in their everyday lives. While some may be more life-threatening, perhaps none is more frustrating than fibromyalgia. Because its causes are uncertain at best, treatment often targets just the symptoms of the disease, which is generally consistent pain and tenderness in joints, ligaments and surrounding soft tissue. Further, because there is no accepted laboratory test for the disease -- diagnosis is basically by default. That is, if no other cause can be found for the symptoms, and they are consistent with those of previous fibromyalgia sufferers, then the diagnosis may be made.

This can create difficulties for those applying for Social Security Disability Insurance or Supplemental Security Income benefits due to the disease. Because the Social Security Administration often relies on objective medical evidence such as blood tests and the like to determine the existence of disabling illnesses, it might seem impossible to prove that one has this disease. However, an SSA ruling from 2012 shows that the administration recognizes the existence of fibromyalgia and what to look for when adjudicating benefits applications.

Basically, the SSA will look at whether the applicant has a history of pain in all four quadrants of his or her body. The pain doesn't need to be always there, and can change in intensity, but it needs to have persisted for at least three months. Further, in a medical exam by a licensed doctor, the patient needs to have shown tenderness in at least 11 of 18 designated "tender points" on the body. Finally, any other cause for the symptoms, mental or physical, must have been ruled out.

Of course, as with other Social Security disability for illness applications, the applicant will still need to also show that the presence of the fibromyalgia prevents him or her from engaging in substantial gainful activity and has lasted or is expected to last for the requisite one-year time period. Because of the potential difficulties involved in providing evidence for fibromyalgia, people in this situation may wish to consider consulting a New Jersey disability attorney.

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