Fibromyalgia & Chronic Pain LIFE Summer 2013, Issue 9 - Page 21

Filing SSDI and physical/mental condition to determine what other work, if any, the person can perform. To determine chronic pain disability, the SSA enlists medical-vocational rules, which vary according to age. For example, if a person is: • Under age 50 and, as a result of the symptoms of chronic pain, is unable to perform sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day. • Age 50 or older and, due to the chronic pain, is limited to sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled. • Age 55 or older and, due to the disability, limited to light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled. • Over age 60 and, due to the chronic pain disability, unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled. • Any age and, because of chronic pain, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of chronic pain disabled. Individuals with conditions that ca use chronic pain also experience common overlapping conditions, such as depression, chronic fatigue syndrome, irritable bowel syndrome and anxiety disorders. “It is important to document comorbid conditions and their effect on your ability to work,” said Ed Swierczek, Allsup senior claimant representative. “What are the limitations imposed by your condition? Are there other symptoms such as stiffness, fatigue and emotional concerns such as anxiety and depression?” Swierczek offered the example of arthritis pain so severe that it interferes with sleep, causing fatigue. Swierczek added that in his more than 39 years of working for and with the SSA, he has seen a significant increase in awareness and understanding chronic pain conditions, including fibromyalgia. “It is vital that patients let their doctors know about their symptoms at every visit,” said Swierczek. “Let them know if you are having muscle pain. Let them know if you are not getting restful sleep. If you have fibromyalgia, encourage your doctor to include the requisite tender point examination if you have not received one. This is important because adjudicators want to see clinical evidence to help establish a diagnosis.” In cases of fibromyalgia, SSA will review the physician’s treatment notes to see if they are consistent with an FM diagnosis, determine whether the person’s symptoms have improved, worsened, or remained stable over time, and establish the physician’s assessment over time of the person’s physical strength and functional abilities. Individuals vary in their ability to withstand pain and respond to treatment. One person facing a specific set of limitations may be able to work, while another may not. For these and other reasons, SSA will generally request evidence for the 12-month period before the date of application. SSA will also consider information from nonmedical sources such as: • Neighbors, friends, relatives and clergy; • Past employers, rehabilitation counselors, and teachers; and • Statements from SSA personnel who interviewed the person It is best to paint the most accurate picture possible with your initial application. A professional SSDI representative can help increase your odds of being approved at this first level. If you are denied, your odds of being approved at the first appeal level are very small, with about 88 percent of people being denied again at level two. Your odds at level three, the hearing level, improve with a little more than half of all applicants at this level getting an SSDI award. It is important to note that most applicants at this level have a representative. Written by Tai Venuti at Expert.Allsup.com . Summer 2013 Fibromyalgia & Chronic Pain Life  21