On January 11, 2016, Administrative Law Judge Richard J. Ortiz-Valero entered a decision awarding disability insurance benefits and finding that due to her fibromyalgia the claimant was disabled under sections 216(i) and 223(d) of the Social Security Act. The decision is significant in that fibromyalgia is not a "listed" impairment under the Social Security Administration's regulations.
These regulations, 20 C.F.R. Part 404, Subpart P, Appendix 1, list many of the most readily diagnosed medical conditions and their symptoms which can reach a severity which is considered disabling. In the usual case, in order to award benefits the Social Security Administration must determine that the claimant's impairment is of a severity to meet or medically equal the criteria of a "listed" impairment.
This claimant's condition had been diagnosed by several physicians as fibromyalgia ("FM"). FM affects the muscles and soft tissues. Symptoms include chronic muscle pain, fatigue, sleep problems and painful "tender points." Fibromyalgia Center: Symptoms, Treatments, Causes, Tests, and ...
CDC estimates that as many as 15 million people may suffer from this condition.
Even though it is not a "listed" disease, the Social Security Administration has issued guidelines on how it will determine whether a claimant's FM is a disabling impairment qualifying the claimant for benefits. SSR 12-2p Essentially the claimant's "residual functional capacity" must be evaluated i.e. her ability to do physical and mental work activities on a sustained basis, despite limitations from her impairment.
In order to show that the claimant was disabled in this care we used the SSR 12-p guidelines to formulate a questionnaire which we sent to each of the physicians who had treated the claimant.
Among other things the questionnaire included a diagram of the eighteen (18) trigger points shown in the SSR 12-2p guidelines. We asked the physician to describe at how many trigger points the claimant usually experienced pain. The questionnaire also provided for an evaluation of the various activities - walking, lifting, bending, etc. - the claimant could perform so that her functional capacity could be determined.
The Administrative Law Judge determined that the claimant's residual functional capacity was less than that needed to perform her past relevant work activities and precluded other work as well. As a result the ALJ found her to be disabled and qualified for benefits.
These regulations, 20 C.F.R. Part 404, Subpart P, Appendix 1, list many of the most readily diagnosed medical conditions and their symptoms which can reach a severity which is considered disabling. In the usual case, in order to award benefits the Social Security Administration must determine that the claimant's impairment is of a severity to meet or medically equal the criteria of a "listed" impairment.
This claimant's condition had been diagnosed by several physicians as fibromyalgia ("FM"). FM affects the muscles and soft tissues. Symptoms include chronic muscle pain, fatigue, sleep problems and painful "tender points." Fibromyalgia Center: Symptoms, Treatments, Causes, Tests, and ...
CDC estimates that as many as 15 million people may suffer from this condition.
Even though it is not a "listed" disease, the Social Security Administration has issued guidelines on how it will determine whether a claimant's FM is a disabling impairment qualifying the claimant for benefits. SSR 12-2p Essentially the claimant's "residual functional capacity" must be evaluated i.e. her ability to do physical and mental work activities on a sustained basis, despite limitations from her impairment.
In order to show that the claimant was disabled in this care we used the SSR 12-p guidelines to formulate a questionnaire which we sent to each of the physicians who had treated the claimant.
Among other things the questionnaire included a diagram of the eighteen (18) trigger points shown in the SSR 12-2p guidelines. We asked the physician to describe at how many trigger points the claimant usually experienced pain. The questionnaire also provided for an evaluation of the various activities - walking, lifting, bending, etc. - the claimant could perform so that her functional capacity could be determined.
The Administrative Law Judge determined that the claimant's residual functional capacity was less than that needed to perform her past relevant work activities and precluded other work as well. As a result the ALJ found her to be disabled and qualified for benefits.
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