There are a number of disability options for fibromyalgia, but it pays to think ahead
If you have fibromyalgia and are unable to work, you may need to investigate what your options are, both short term and long term, for taking time off from your job or even for going on permanent disability. To make it successfully through a disability process, however, you will need to work closely with your doctor and your employer, and for long-term solutions, deal with insurance companies, the government, and maybe even a professional facilitator. You will also need to educate yourself thoroughly about the process, which can be lengthy and complicated, so you don’t inadvertently do something now that will limit your options in the future. Here are some ideas about where to start:
If your fibromyalgia is preventing you from doing your job or going to work, the best place to begin is with your employer’s Human Resources (HR) Department. You need to ask about the company’s policy for short-term disability and what the requirements are to be eligible for it. Often two to three months of rest and lack of stress can improve fibromyalgia symptoms to the point where it’s possible to return to work. The reassuring news is that if your company employs more than 50 people your employer is required to keep your job open for you under the Family Medical Leave Act, which protects those who need to take time off for a medical condition.
Working with Your Doctor, Record Keeping, and Testing
During this period it is important that you coordinate with your doctor to make sure that all your fibromyalgia symptoms are being meticulously documented — there should be detailed notes about all your office visits that chart how many tender points are sensitized and where they are located. You will need 11 of 18 tender points documented to be eligible for disability. All your symptoms should be noted as well, including the level of your pain and any activities you are unable to do. These records are critical if after a few months’ rest you are still unable to return to work.
It’s also good idea to keep detailed notes yourself. A pain diary, for instance, can help you track activities you can and can’t do, times of day that are better or worse for you, and how often pain or other symptoms interfere with your capability to do your job.
Before you apply for the next level of assistance, it’s often a good idea (and may be a requirement) to have an independent analysis of what you are able to do physically and mentally. Functional capacity testing is usually done by a physical therapist or other healthcare professional who evaluates your ability to do such things as sit, stand, walk, lift and carry, push and pull, drive and understand directions, and concentrate on tasks you’re given to do.
About Long-term Disability
Long-term disability insurance is offered through private employers and also through the federal government as Social Security Disability Insurance (SSDI). If a person qualifies, disability insurance will provide a reasonable replacement of monthly earnings for extended periods of time.
According to government statistics, only 15 to 20 percent of fibromyalgia sufferers are currently on long-term disability; however, because many people with fibromyalgia also suffer from overlapping conditions, these other illnesses may be cited as the reason for long-term disability rather than the fibromyalgia itself.
If your employer provides long-term disability insurance, your first step should be to talk to the HR department and find out how to apply for it.
Who Qualifies for Disability?
In order to qualify for long-term disability, you must have been employed in the past five years and stopped working because you became disabled. Other qualifications the Social Security Administration (SSA) will look at include whether your condition is on the list of “disabling impairments,” and if not, if it’s severe enough to keep you from holding down a job. Currently, fibromyalgia is not on the list of disabling impairments, which makes proving a case for long-term disability harder, though by no means impossible. It makes good record keeping and symptom tracking particularly important, however.
The SSA also examines the type of work you’ve been doing over the last 15 years, and if you are able to perform other types of work. To qualify for long-term disability benefits, you must be unable to return to full-time work of any kind because your activities of daily living have been so severely impaired by your illness. These “activities of daily living” might include your ability to shop for groceries, to drive, to make your own food, or even to take a shower on your own.
Applying for Long-term Disability
If you do decide to file for long-term disability, the first thing you should do is contact your local social security office and request a disability application. (You can also apply online at http://www.ssa.gov/.)
The Social Security Administration can then request your medical records directly, so make sure they include a clear diagnosis, preferably from a rheumatologist, before submitting this paperwork. Sometimes, a medical record will say something like “displaying symptoms of fibromyalgia,” without offering a clear diagnosis, and this can cause a denial of disability benefits. The more specific your doctor can be, the better — for example, rather than just stating that you have fibromyalgia, have your doctor note all the finer points of your symptoms and how those symptoms are interfering with your ability to perform your job.
After your forms are submitted, you may be asked to take what is called an independent physical examination (IME), which is often conducted by a physician hired by an insurance company. Your application will then either be accepted or denied. Unfortunately, only 35 percent of all disability applications are accepted at this point, so it’s common to have to appeal the SSA’s decision. Applicants have the option to appeal within 60 days by filing the Appeal Disability Report form (which can also be done online). Some people also hire an attorney who specializes in disability law and, though this is not a requirement, it can be very helpful to have an experienced advocate guiding you through the application process.
Staying in the Workforce
If you’re not sure that the idea of leaving work is right for you just yet, consider these options:
Job modifications: Are there any adjustments you could make, so that you could continue working instead of going on disability? (An ergonomic desk or keyboard, for example.) What about more frequent rest periods? Talk your situation over with your doctor. He or she will be able to tell you if your job complicates your condition and if it would be best to go on disability.
Job change: You may also want to explore other jobs within the company, or consider cutting down on your hours. There’s an emotional component to being on disability: besides providing an income, one’s job also often provides a social network and sense of purpose. That said, remember that if you cut down your hours now and then go on disability later, you’ll be paid at the lower rate; or, in the event that you can’t keep up with a new position and are fired, you’ll have no recourse.
For more information about your rights as an employee with fibromyalgia, read theU.S. Department of Labor Job Accommodation Network’s work guidelines.
It is well to remember that applying for long-term disability is a process that can take months to years to complete, especially with a complicated disorder like fibromyalgia. However, if you’re unable to work, it might be the best option for you.