Can You Qualify for Disability Benefits with Fibromyalgia?

To qualify for SSDI or SSI benefits due to fibromyalgia, your condition must meet certain criteria outlined by the Social Security Administration (SSA). Fibromyalgia can be a qualifying disability, but proving your case can be challenging because it’s often a condition that doesn’t have clear-cut diagnostic tests.

The SSA doesn’t have a specific listing for fibromyalgia in its Listing of Impairments (a list of medical conditions that automatically qualify for benefits). However, you can still qualify by showing that your fibromyalgia causes significant limitations that prevent you from working.

How Does the SSA Evaluate Fibromyalgia Claims?

When evaluating disability claims for fibromyalgia, the SSA looks for the following:

• Medical Documentation: The most crucial part of your claim is medical evidence. You will need to provide detailed records that document your diagnosis and treatment, including:
• Doctor's notes: A diagnosis of fibromyalgia, as well as records of regular treatment, including prescribed medications, physical therapy, or other interventions.
• Objective medical tests: While there are no specific tests to diagnose fibromyalgia, records of tests (like blood tests or X-rays) may be used to rule out other conditions and support the diagnosis.
• Symptom Documentation: Detailed accounts of how your symptoms (pain, fatigue, cognitive issues, etc.) affect your ability to work and perform daily activities.
• Functional Limitations: The SSA will assess the severity of your fibromyalgia by examining how your symptoms impact your ability to work. This includes:
• Physical limitations: How the pain and fatigue from fibromyalgia affect your ability to stand, sit, walk, or lift.
• Cognitive limitations: Many individuals with fibromyalgia experience fibro fog, which affects memory, concentration, and cognitive function. You will need to provide evidence of how this impacts your ability to complete tasks or work.
• Failure to Perform Substantial Gainful Activity (SGA): You must prove that fibromyalgia prevents you from working full-time and performing substantial work tasks. If you can still perform any type of gainful employment, you may not qualify for SSDI or SSI benefits.

How the SSA’s Five-Step Evaluation Process Works

The SSA uses a five-step evaluation process to determine if you qualify for disability benefits. Here’s how fibromyalgia fits into each step:

• Step 1: Are You Working?
• If you’re working and earning above the Substantial Gainful Activity (SGA) threshold, which is $1,470 per month in 2025 for non-blind individuals, the SSA will determine that you are not disabled.
• Step 2: Is Your Condition Severe?
• Fibromyalgia can be considered a severe condition if it significantly limits your ability to perform basic work-related tasks, such as standing, walking, lifting, and concentrating.
• Step 3: Does Your Condition Meet or Equal a Listing?
• Fibromyalgia is not listed specifically in the SSA’s Listing of Impairments, so you’ll need to show that your condition is severe enough to limit your ability to work. You can meet the SSA’s definition of disability by proving that your fibromyalgia is equivalent to a listing, which typically requires substantial medical evidence.
• Step 4: Can You Do Your Previous Work?
• The SSA will evaluate whether you are able to perform the work you did in the past. If fibromyalgia prevents you from doing your previous job, they will move to the next step.
• Step 5: Can You Do Any Other Work?
• At this step, the SSA will determine whether there is any other type of work you can do given your age, education, and work experience. If you cannot perform any other work, you may be eligible for SSDI or SSI benefits.

Tips for Increasing Your Chances of Approval for Fibromyalgia Claims

To maximize your chances of getting approved for disability benefits due to fibromyalgia, consider the following:

• Work with Your Doctor: Regular visits to your doctor and keeping detailed records of your treatment are essential. Ask your doctor to provide written opinions on how your fibromyalgia affects your ability to work.
• Document All Symptoms: Keep a symptom journal that tracks the severity and frequency of your pain, fatigue, sleep issues, and cognitive problems. This can be helpful when proving the impact of fibromyalgia on your daily activities.
• Consider a Functional Capacity Evaluation: A functional capacity evaluation (FCE) performed by a medical professional can help assess your ability to perform work-related tasks. This evaluation may support your claim that fibromyalgia severely limits your ability to work.
• Consider Working with a Disability Lawyer: An experienced disability attorney can help you navigate the complexities of the SSDI or SSI application process, especially when applying with fibromyalgia, a condition that can be harder to prove.