Addressing the “Severity” of a Person's Fibromyalgia in a Disability Case

 Posted on January 24, 2020 in Social Security Disability Medical Conditions

Fibromyalgia is one of the more difficult medical conditions to address in the context of applying for Social Security disability insurance. The medical definition of fibromyalgia, according to the U.S. Centers for Disease Control and Prevention, is a “condition that causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress.” While fibromyalgia can manifest itself through these symptoms, there is no simple medical “test” that can diagnose a patient with the condition.

As a result, Social Security administrative law judges (ALJs) tend to discount subjective complaints of pain by disability applicants as insufficient to prove their fibromyalgia prevents them from working. Illinois courts have repeatedly told Social Security, however, that ALJs cannot require such “objective” tests to confirm a fibromyalgia diagnosis.

Appeals Court Rejects Widower's Appeal of Social Security Decision

At the same time, an ALJ may consider additional objective evidence when evaluating the “severity” of fibromyalgia under the Social Security Administration's disability listings. A recent decision from the U.S. Seventh Circuit Court of Appeals here in Chicago, Gebauer v. Saul, illustrates this principle in greater detail. This sad case actually involved the widower of a woman (the decedent) who died suddenly while her application for disability benefits was still pending.

The decedent suffered from fibromyalgia and chronic fatigue. She made several complaints regarding her chronic pain to her primary care physician, who said in a report the decedent's condition rendered her unable to work “at even a sedentary position.” But the ALJ who conducted a hearing on the decedent's application chose not to give “controlling” or “significant probative” weight to the doctor's opinion, determining it was “unsupported by medically acceptable clinical or laboratory findings and inconsistent with [the decedent's] reported daily activities.”

On appeal, the decedent's husband argued the ALJ made a legal error in failing to properly credit the physician's expert opinions. The Seventh Circuit disagreed. It noted the issue here was not the improper use of objective evidence to discredit the diagnosis of fibromyalgia. Rather, it was that the treating physician's conclusions “conflicted with his own treatment notes.” The ALJ was also permitted to use other medical tests in the decedent's records to assess the severity of her pain and its effect on her ability to work prior to her death.

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The appeals court also pointed out that the decedent's physician's opinions consisted of nothing more than “simple forms where the doctor checked 'yes' to prepared questions, as opposed to "open-ended assessments of [the decedent's] capacities and limitations.” In disability cases, it is essential for an applicant's medical providers to provide as complete a medical picture as possible in order to guide Social Security towards a finding of disability. If an ALJ feels the medical records are insufficient, they will try to “fill in the gaps” themselves, which often leads to a finding the applicant is not disabled.

If you need assistance in preparing and presenting your disability case from an experienced Chicago Social Security benefits lawyer, contact Pearson Disability Law, LLC, at 312-999-0999 today to schedule a free consultation.

Source:

https://scholar.google.com/scholar_case?case=11144918751380692411