The basic standard is that the disability has to prevent all competitive employment in the US no matter what it is. The mushier the disability, the harder it is to actually succeed in meeting this standard even if you do meet it...
The SSA recognized the potentially unfair obstacles for people with fibromyalgia and issued new guidelines for fibromyalgia disability claims in 2012.
Getting access to Medicare benefits due to disability for fibromyalgia isn’t easy, but it can be done. Here’s what you should know so you have the best chance of getting approved.
Understanding fibromyalgia and “medically determinable impairment”
The first hurdle in getting a disability claim approved is proving a “medically determinable impairment,” or MDI, with Social Security. The SSA defines an MDI like this: “an impairment that results from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques.”
In plain language, it means that your impairment, or disability, must be backed up with objective medical tests and evidence. It’s not enough to just have subjective statements that you have a disease or condition—the SSA needs proof.
That’s where things get difficult for people with fibromyalgia. Unlike other conditions such as rheumatoid arthritis or disc disease which can be seen on x-rays and other imaging studies or lab work, there’s no definitive test that proves fibromyalgia. Diagnosis usually depends on self-reported symptoms of pain, dizziness, “fibro fog,” and other classic signs of fibromyalgia.