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Victories for Fibromyalgia Disability Claims in Federal Appeals

February 20, 2015

Updated 3/27/2023

Obtaining disability benefits for clients suffering from fibromyalgia can be challenging.  Proving such a case can be difficult for some disability attorneys to tackle. 

The challenge of fighting for clients with fibromyalgia has never deterred Balin Law attorneys. This was made clear by Paulette Balin’s and Matt Shupe’s numerous victories in federal court for clients with fibromyalgia.  In three recent cases, Balin Law won reversals for clients wrongly denied disability benefits for fibromyalgia.  These 3 cases were published by the United States District Court:

  • Earls v. Colvin, 2014 WL 1333261 (N.D. Ohio Mar. 28, 2014)
  • Dorsey v. Commissioner of Social Security, 2014 WL 657849 (N.D. Ohio Feb 19, 2014)
  • Cohen v. Commissioner of Social Security, 2013 WL 3421832 (N.D. Ohio July 8, 2013)

How Disability Appeals End Up in Federal Court

These cases are referred to as a Federal Review, where we file civil action against the Social Security Administration (SSA).  The Federal Review is the last possible chance to get a denial for disability benefits overturned. In each of these cases, our client’s application was reviewed and denied repeatedly. After first requesting a Reconsideration, the next level of appeal is a hearing with an Administrative Law Judge (ALJ).

Why They Were Denied Disability Benefits for Fibromyalgia

In each case, the ALJ rejected the opinions of a person’s treating physician. They disregarded the impact of his or her fibromyalgia, as stated by the physician, because they didn’t have objective medical evidence. Unlike medical conditions that can be confirmed by objective testing, fibromyalgia patients present no objectively alarming signs. It is not unusual for an individual with fibromyalgia to experience severe fatigue and musculoskeletal pain, but show normal muscle strength and range of motion when examined by a doctor. Our mission in the cases of Earls, Dorsey, and Cohen was to convince a federal judge who does not specialize in Social Security law that the ALJs were wrong to rely on medical testing when such evidence is of little relevance when a person suffers from the elusive disease of fibromyalgia.

Medical Requirements for Disability Benefits for Fibromyalgia

Fibromyalgia is a complicated condition. Even Social Security’s own assessment calls it “complex” in its evaluation introduction for SSR 12-2p, the law governing Social Security’s criteria for considering the disease as a disability.

According to the criteria, even if a court finds a person with a medically determinable impairment (MDI) of fibromyalgia is disabled, that court “must ensure there is sufficient objective evidence to support a finding that the person’s impairment(s) so limits the person’s functional abilities that it precludes him or her from performing any substantial gainful activity.”

These criteria include:

  • A history of widespread pain “in all quadrants of the body… and axial skeletal pain,” persisting at least 3 months.
  • At least 11 positive tender points on physical examination. Must be found on the left and right sides of the body and above and below the waist.
  • Evidence that other disorders that could cause the symptoms or signs were excluded.

Many attorneys choose to avoid taking on clients with fibromyalgia. Rather than take the shy approach, Balin Law shines in such cases.

If you have fibromyalgia and have been struggling to get approved for disability benefits, contact Balin Law today.