When Is Disability Appropriate?

By Lynne Matallana

In a survey conducted by the National Fibromyalgia Association in 2003, 99 percent of the respondents who were currently disabled because of fibromyalgia said that they would return to work immediately if they could find some relief for their pain. In my experience, people with fibromyalgia only apply for social security disability as a last resort—when it has become impossible for them to maintain work on a consistent basis. The reality, however, is that the disability process is a taxing one and for someone with fibromyalgia, it can be arduous at best. Many find the process too exasperating and give up, only to find themselves living a financial nightmare. In the majority of fibromyalgia cases, the individual can continue to work, but in some situations disability is not a choice but rather a necessity.

 

Social Security Disability Insurance

The onset of disease is usually not the onset of disability. To qualify, you have to meet Social Security’s qualifications, which are determined by five questions:

• Are you working?

If you are working and your earnings average more than $800 a month, you cannot be considered for disability. However, this is not a hard-and-fast rule, and there are exceptions.

• Is your condition “severe?”

Your condition must interfere with basic work-related activities for your claim to be considered disabling.

• Is your condition found in the list of disabling impairments, and if not, is it sufficiently severe?

The listing is contained in the booklet “Disability Evaluation Under Social Security.” The Office of Medical Evaluation is the source of all Social Security information pertaining to medical issues. Here is the address to obtain a copy of the booklet:

 

Office of Medical Evaluation

Office of Disability, SSA

6401 Security Blvd.

Baltimore, MD  21235

 

The list of disabling impairments is maintained by Social Security. Certain impairments are considered so severe that they automatically qualify you as disabled. Fibromyalgia is not on the list, and must be decided based upon medical and vocational (or work-related) considerations. Those rules are not easy to find because they take concepts from a wide body of regulations, case law, and vocational evidence.

• Can you do the work you did in the last 15 years?

If your condition is severe, but not at the same severity as impairment on the list, it must be determined whether it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim may be denied. There are rules that incorporate age, education, and past work experience, which may affect the entire situation.

• Can you do other work?

If you cannot do the work you did in the past, you will be evaluated to see whether you are able to adjust to other work. To be disabled, you must be unable to perform an unskilled, sit-down job on a full-time, regular basis. If you cannot adjust to other work, your claim will be approved.

 

How Do I Get Back to Work?

Most individuals prefer to go back to work rather than try to live on disability benefits. To do this, you need to be aware of the rules of the “work incentives” and “employment support” programs that provide cash benefits and Medicare while you attempt to work. Working on a trial basis is only available if you are receiving SSDA. The SSA’s intention in creating the trial work period is to give you an opportunity to see whether you can go back to work without compromising your approved disability benefits. Everyone on SSDI is eligible to participate in the trial work period. The trial work period cannot begin before the month in which you file your application for disability benefits. You can participate in this program until you have accumulated nine months of work within a 60-month period of time. This allows you to return to work and not be penalized by SSA. The SSA, however, may find that your disability has ended at any time during the trial work period if medical or other evidence shows that you are not disabled.

 

For more information, you can call toll-free 1-800-772-1213 and ask for the fact sheet, “Ticket to Work and Work Incentives Improvement Act of 1999” (Publication No. 05-10060). The fact sheet also is available at www.socialsecurity.gov/work. For more information about social security work incentives, ask for a copy of the booklet “Working While Disabled … How We Can Help” (Publication No. 05-10095).

 

--Excerpted from the book, The Complete Idiot’s Guide to Fibromyalgia by Lynne Matallana. ORDER HERE

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National Fibromyalgia Association
2200 N. Glassel Street, Suite A
Orange, CA 92865
Phone: 714. 921.0150
Fax: 714. 921.6920
www.FMaware.org