The Social Chamber of the Supreme Court of Catalonia has considered in a recent ruling, dated February 24 (Rec. Suplicación), fibromyalgia and chronic fatigue syndrome (CFS) are grounds for declaring “permanent disability”.
The statement refers to a case of a woman, a chemical industry operator, who suffered from recurrent major depression without psychotic symptoms of a serious nature, neck pain and a degenerative process without root involvement, fibromyalgia and CFS.
In its ruling, the Supreme Court of Catalonia emphasizes the resolved jurisprudence on the establishment of LGSS on disability, which establishes that “the evaluation of permanent disability must be done mainly in response to functional limitations derived from the suffering of employees”.
For the Chamber, disability should be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify work capacity, and without that it would inhibit the qualification of the possibility of recovery of work capacity when it is present as uncertain or very uncertain. long-term.
That is, it should not only be recognized when you have no physical possibility for any professional job, but also when you maintain the skills to perform some activity, you do not have to do it with minimal efficiency, such as performing any job, even for simple Whatever it is, it requires a schedule of requirements, movement and interaction, as well as diligence and attention.
In the case, the patient’s ailments form an image that “prevents the proper performance of all types of work, including sedentary tasks and light nature that do not require the performance of particularly intense physical efforts.”
“At present, he is affected by an important disorder of a serious nature that occurs with sufficient intensity to cancel his work capacity, to which other degenerative diseases are added,” the ruling concludes.
The applicant has recurrent major depression without psychotic symptoms of a serious nature, neck pain and degenerative process without root involvement, fibromyalgia and CFS.
Therefore, the TSJC dismisses the appeal for annulment presented by the National Institute of Social Security (INSS) against the ruling already issued by the Labor Court 1 of Girona in 2013.
IPA situation of a social educator with fibromyalgia and CFS.
The Social Chamber of the Supreme Court of Catalonia, in ruling No. 1403/2015, of February 24 (Rec. 6239/2014), also pointed out the IPA situation for all the jobs of a social educator with fibromyalgia and fatigue syndrome Chronicle, confirming the sentence. of the Labor Court and dismissing the appeal filed by the National Institute of Social Security.
The worker paid for the services in which the educator suffered a very advanced fibromyalgia syndrome and chronic fatigue, grade III, along with a chronic depressive disorder, mild cognitive impairment and prevented carpal tunnel syndrome, among other diseases.
Considering the Chamber and only because of the severity of fibromyalgia and chronic fatigue, the degree suffered, it must be recognized that, even with skills to perform some activity, it lacks real authority to carry out the work with some efficiency.
The pathologies caused by the intense pain they cause seriously undermine the productive capacity, in terms of performance, capacity and efficiency, and without that they can perform light work, just no more to refute the incapacitating situation in consideration, for example, as permanent and absolute .
When establishing the LGSS in absolute permanent disability, there is great jurisprudence that has been responsible for pointing out that such a degree of disability should not only be recognized when it lacks physical possibilities for any professional work, but also when the skills to perform some are maintained. The activity does not have to be done with minimal effectiveness, since the performance of any job, even simple, requires scheduling, movement and interaction requirements, as well as diligence and attention.
Disability should be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify work capacity, and without that it would inhibit the qualification of the possibility of recovery of work capacity when present as uncertain or very long-term .
Does someone with fibromyalgia qualify for a disability?
Fibromyalgia (FM) is one of the most difficult conditions to be approved as a disability. Because symptoms are often self-reported, you will need medical documents and a doctor to support your case. But it is possible to have a successful claim for FM.
How is fibromyalgia diagnosed? »
Keep in mind that your best chance of being approved for a disability is to have:
- Relevant medical records
- Lab test
- Opinions of doctors
- Statements from friends, family and co-workers
Read on to learn what the Social Security Administration (SSA) requires and how you can build your case for fibromyalgia disability.
What are the disability criteria?
The SSA is responsible for evaluating all disability claims. When reviewing your case, the SSA will determine if you have a determinable medical impairment (MDI) from FM.
The criteria and requirements for claiming FM disability are extensive. They include:
- Symptoms that must be severe and present for at least three months.
- Documented evidence that rules out other conditions.
- Statements from you and others about any restriction or disability in your daily activities
- If FM prevents you from working
You must also have at least 11 of the 18 tender points above and below the waist, and on both sides of the body, or at least six continuous FM symptoms.
These symptoms include:
- Memory or thinking problems, also known as fibro fog.
- Irritable bowel syndrome
- Waking up exhausted
What are the complications of fibromyalgia? »
While the SSA requires a medical diagnosis, cases are often won or lost based on symptoms and limitations, according to the National Fibromyalgia Association. Even if you have an FM diagnosis, the SSA will assess whether you are able to work.
How to Document Your Disability Case
Documentation is the key to a successful disability case. This means more than just giving the SSA your medical records. If your symptoms result in missed work days, your employer may need to provide a statement indicating this.
In general, your application should contain:
- Diagnosis confirmed by a rheumatologist
- Dates and contact information for your doctors, social workers, and hospitals
- Your current and relevant medical records, such as medications, lab tests, or psychologist visits
- Residual Functional Capacity (RFC) on your disabilities completed by your doctor
- Summary of your previous work
Keeping a fibromyalgia diary is also helpful. This can help you track every day that you experience pain and how it interferes with your normal daily routine. It can take into account migraines, painful periods, and chronic exhaustion.
Your rheumatologist can also give a professional opinion on your limitations. This includes an assessment of your ability to:
- Sit, stand and walk in an eight hour work day
- Lifting and carrying heavy loads.
- Perform fluid movements such as bending, balancing, or crawling
- Maintain punctuality and attendance at work.
SSA takes all documentation into consideration before making a decision on your disability claim. Once you submit your application, a team of doctors working with SSA will evaluate all of its components. The team of doctors will also include a psychologist to see if FM has caused any mental impairment.
These deficiencies are based on:
- information processing speed
- Word search
The team interprets your medical information and predicts how long your condition is likely to last.
How to archive your information
When you are ready to apply for disability benefits, you can apply for:
- By phone at 1-800-722-1213, or TTY 1-800-325-0778, if you are hearing impaired
- At your local social security office
You will want to call ahead and make an appointment, if you plan to apply in person.
The SSA says that you can apply for benefits as soon as you receive a fibromyalgia disability diagnosis.
How long do you have to wait
The SSA estimates an average waiting time of three to five months for claims for disability benefits. It is best to apply for this once you become disabled.
In some cases, the SSA will request additional documents to process your disability claim. Providing everything you need in advance can help shorten the waiting period.
What is the benefit of applying for disability support?
Disability benefits can help if FM keeps you from working for at least one year. The average cost of annual fibromyalgia treatment can add up to $ 5,945 per person. This amount can be even higher if your health insurance doesn’t cover all of your treatments. Disability can help with costs, especially if you can’t work.
Fibromyalgia FAQ “I have fibromyalgia and am too sick to work, am I eligible for disability benefits?”
Unfortunately, in most countries, fibromyalgia is not a classified disability. Hopefully as more research studies are done, fibro will be classified as a disability. It does not appear in the government’s blue book of diseases that are considered disabling.
Proving that your fibromyalgia disability can be extremely difficult, but it can be done. It is a sad fact that when we are sick and at our lowest ebb we have to find the strength to fight the system. However, when a claim is made for a condition that is not in your blue book. The claim is then processed on the basis of RFC’s residual functional capacity.
Disability examiners will evaluate your SSI and SSD claim based on the medical evidence provided. They will also require proof of your physical limitations. They then work with your doctor or clinic to come up with a rating for your physical or mental ability. Once they are armed with these facts, they turn their attention to your previous work history. If they agree that you are unable to return to your current / past job, don’t jump for joy. This is just the first step. There is another obstacle to climbing.
Well, they have accepted that you can no longer go back to your previous job. Now they will evaluate what kind of work you could reasonably expect to do. They will take into consideration your education, age, abilities, and limitations.
This opens up a large area of employment and some of them may be able to perform. Individuals with good education and job skills will likely be considered by the adjudicator as employees. So while it is possible to get disabled based on the severity of your condition, it just isn’t easy.
What the adjudicators don’t realize is that fibromyalgia symptoms vary daily. We have no idea how we will feel in a few hours. We go every morning when it comes to going to work. It is common to be turned down for disability fibromyalgia benefits the first time. You should keep trying and reading everything you can about the process. If you can afford it, hire a professional who specializes in fibro to make sure your benefit request is approved the first time.
Source: written by Kristeen Cherney, medically evaluated by Brenda b. Spriggs, MD, FACP Healthline