The Social Chamber of the TSJ of Catalonia has considered in a recent judgment, S 1403/2015, of 24 February (Rec. Suplicación 6239/2014), fibromyalgia and chronic fatigue syndrome (CFS) is grounds for declaring the “permanent disability”.
The statement refers to a case of a woman, operaria chemical industry, which suffered a picture of recurrent major depression without psychotic symptoms serious nature, neck pain and degenerative process without root involvement, fibromyalgia, and CFS.
In its ruling, the Supreme Court of Catalonia emphasizes the settled jurisprudence on setting the LGSS ago on disability, which states that “the assessment of permanent disability must be done in response primarily derived functional limitations of the sufferings of employee”.
For the Chamber, the disability must be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify the labor capacity, and without that would inhibit the rating the possibility of recovery of working capacity when it is present as uncertain or very long term.
That is, not only must not only be recognized when it lacks any physical possibility for any professional work, but also when even keeping skills to perform some activity, do not have to do it with minimal effectiveness, as the realization of any job, even however simple, requires a schedule requirements, movement and interaction, as well as diligence and attention.
In case, the patient’s ailments make up a picture that “prevents the proper performance of all kinds of work, including sedentary tasks and lightweight nature that do not require the performance of especially intense physical efforts.”
“At the present time is affected by a major disorder of a serious nature that occurs with sufficient intensity to cancel its labor capacity, to which the other degenerative ailments are added,” the ruling.
The applicant has recurrent major depression without psychotic symptoms serious nature, neck pain and degenerative process without root involvement, fibromyalgia and CFS.
Therefore, the TSJC dismisses the appeal for reversal filed by the National Institute of Social Security (INSS) against the judgment already rendered the Labour Court 1 Girona in 2013.
IPA situation of a social educator with fibromyalgia and CFS
The Social Chamber of the Supreme Court of Catalonia, in judgment No 1403/2015, of 24 February (Rec. 6239/2014), also said the situation IPA for all work of a social educator with fibromyalgia and chronic fatigue syndrome , confirming the judgment of the Labour Court and dismissing the action brought by the National Institute of Social Security.
The worker paid services which educadora- suffered a syndrome very advanced fibromyalgia and chronic fatigue, grade III, coupled with chronic depressive disorder, mild cognitive impairment and antevenido carpal tunnel syndrome, among other diseases.
Consider the Chamber and only by the severity of fibromyalgia and chronic fatigue, the degree suffered, it must be recognized that even with skills to do some activity, lacks real authority to consummate work with some effectiveness.
It is pathologies by intense pain they cause, seriously undermine the productive capacity, in terms of performance, capacity and efficiency, and without that they can perform light work simply no more to rebut the disabling situation into consideration appreciated instance permanent and absolute.
On setting the LGSS ago on the absolute permanent disability is large jurisprudence that has been responsible for pointing out that such a degree of disability should not only be recognized when it lacks any physical possibility for any professional work, but also when while maintaining skills to perform some activity, do not have to do so with minimal effectiveness, since the performance of any work, even however simple, requires a schedule requirements, movement and interaction, as well as diligence and attention.
The disability must be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify the work capacity , and without that would inhibit the rating the possibility of recovery of working capacity when it is present as uncertain or very long term .
Does someone with fibromyalgia qualify for disability?
Fibromyalgia (FM) is one of the harder conditions to get approved for as a disability. Because the symptoms are often self-reported, you’ll need medical documents and a doctor to support your case. But it’s possible to have a successful claim for FM.
How is fibromyalgia diagnosed?
Keep in mind that your best chance of getting approved for disability is to have:
- Relevant medical records
- Laboratory testing
- Doctors’ opinions
- Statements from friends, family, and coworkers
Read on to learn what the Social Security Administration (SSA) requires and how you can build your case for fibromyalgia disability.
What’s the criteria for disability?
The SSA is responsible for evaluating all disability applications. When reviewing your case, the SSA will determine if you have a medically determinable impairment (MDI) of FM.
The criteria and requirements for claiming disability due to FM 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 restrictions or inabilities on your daily activities
- Whether 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 ongoing symptoms of FM.
These symptoms include:
- Memory or problems with thoughts, also known as fibro fog
- Irritable bowel syndrome
- Waking up exhausted
What are the complications of fibromyalgia? »
While the SSA requires a doctor’s diagnosis, cases are often won or lost based on symptoms and limitations, according to The National Fibromyalgia Association. Even if you have a diagnosis for FM, the SSA will look at whether you’re capable of work.
How to document your disability case
Documentation is the key to a successful disability case. This means more than supplying the SSA with your medical records. If your symptoms result in missed workdays, your employer may need to provide a statement saying so.
Overall, your application should contain:
- Confirmed diagnosis from a rheumatologist
- Dates and contact information of your doctors, caseworkers, and hospitals
- Your current and relevant medical records such as medications, lab tests, or psychologist visits
- Residual Functional Capacity (RFC) about your impairments filled out by your physician
- Summary of your previous jobs
It’s also helpful to keep a fibromyalgia diary. This can help you track all the days you experience pain, and how it interferes with your normal daily routine. You 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 workday
- Lift and carry heavy loads
- Conduct fluid movements like bend, balance, or crawl
- Maintain punctuality and attendance at work
The SSA takes all documentation into consideration before making a decision on your disability application. Once you submit your application, a team of doctors that work with the SSA will evaluate all of its components. The team of doctors will also include a psychologist to see if FM has resulted in any mental impairment.
These impairments are based on:
- speed of information processing
The team interprets your medical information and predicts how long your condition is likely to last.
How to file your information
When you are ready to apply for disability benefits, you can apply:
- By phone at 1-800-722-1213, or TTY 1-800-325-0778, if you’re hard of hearing
- At your local social security office
You’ll want to call ahead and make an appointment, if you plan to apply in person.
The SSA says 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 wait time of three to five months for disability benefit claims. It’s 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 may help shorten the waiting period.
What’s the benefit of applying for disability support?
Disability benefits can help if FM prevents you from working at least one year. The average cost for annual fibromyalgia treatment can add up to $5,945 per person. This amount may be even more if your health insurance doesn’t cover all your treatments. Disability can help with the costs, especially if you are unable to work.
Fibromyalgia FAQ’s “I have fibromyalgia and I am too sick to work, do I qualify for disability benefits?”
Unfortunately, in most countries fibromyalgia is not a classified disability. Hopefully as more research is studies are done fibro will be classed as a disability. It is not listed in the government’s blue-book of illnesses that are considered disabling.
Proving your fibromyalgia disability can be extremely difficult but it can be done. It is a sad fact that when we are ill and at our lowest ebb we have to find strength to fight the system. However, when a claim is made for a condition that isn’t in their blue-book. Then the claim is processed under the RFC basis- residual functional capacity.
Disability examiners will evaluate your claim for SSI and SSD based the medical evidence provided. Also they will require proof of your physical limitations. They then work with your doctor or clinic to arrive at a rating for your physical or mental capacity. Once they are armed with these facts they turn their attention to your past work history. If they agree you are incapable of returning to your current/past employment, don’t jump up and down in glee. This is only the first step. There is another hurdle to clamber over.
Okay so they have agreed you can no longer return to your past job. Now they will assess what type of work you could reasonably be expected to perform. They will take into consideration your education, age, abilities and limitations.
This opens up a huge area of employment and some of them you may well be able to perform. Individuals with a good education and work skills will most likely be considered by the adjudicator to be employable. So whilst it is possible to get disability based on the severity of your condition it simply isn’t plain sailing.
What the adjudicators fail to realize is that fibromyalgia symptoms vary on a daily basis. We have no idea what we are going to feel like in a few hours. Let along every morning when it is time to go to work. It is common to be turned down for fibromyalgia disability benefits the first time. You must keep trying and read all you can about the process. If you can afford it, hire a professional that specializes in fibro to ensure you get your benefit application approved the first time.
Source: Written by Kristeen Cherney, medically evaluated by Brenda b. Spriggs, MD, FACP Healthline