The Social Chamber of the Catalan TSJ considered in a recent trial, S 1403/2015, of February 24 (Rec. Suplicación 6239/2014), fibromyalgia and chronic fatigue syndrome (CFS) is a reason to declare “permanent disability”.
The statement refers to a case of a woman, who would operate a chemical industry, who suffered from recurrent major depression without severe psychotic symptoms, neck pain and degenerative process without compromising the root, fibromyalgia and CFS.
In its decision, the Supreme Court of Catalonia emphasizes the jurisprudence established on the definition of the LGSS above on disability, which states that “the assessment of permanent disability must be made in response mainly to the functional limitations derived from the employee’s suffering”.
For the Chamber, the deficiency should be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify the work capacity, and without this would inhibit the rating the possibility of recovery of the work capacity when present as uncertain or very long deadline.
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In other words, not only must it not be recognized when it has no physical possibility for any professional work, but also, even maintaining the skills to perform some activity, it does not have to do it with minimal efficiency, such as doing any work, even simple as it is, it requires programming, movement and interaction requirements, as well as diligence and attention.
In this case, the patient’s illnesses make up a picture that “prevents the good performance of all types of work, including sedentary and light tasks, which do not require the performance of particularly intense physical efforts”.
“At the moment it is affected by a major disorder of a serious nature that occurs with enough intensity to cancel its ability to work, to which the other degenerative diseases are added,” the decision.
The applicant has severe recurrent depression without psychotic symptoms, severe nature, neck pain and degenerative process without root involvement, fibromyalgia and CFS.
Therefore, TSJC dismisses the reversal appeal filed by the National Social Security Institute (INSS) against the decision already handed down by Labor Court 1 in 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 February 24 (Rec. 6239/2014), also referred to the IPA situation for all the work of a social educator with fibromyalgia and fatigue syndrome chronic, confirming the judgment of the Labor Court and dismissing the appeal filed by the National Institute of Social Security.
The worker paid for services that the educator suffered from a very advanced fibromyalgia syndrome and chronic fatigue, grade III, along with chronic depressive disorder, mild cognitive impairment and prevented carpal tunnel syndrome, among other diseases.
Consider the Chamber and just by the severity of fibromyalgia and chronic fatigue, the degree suffered, it must be recognized that, even with the skills to do some activity, it does not have real authority to carry out the work with any effectiveness.
They are pathologies of intense pain that cause, seriously undermine the productive capacity, in terms of performance, capacity and efficiency, and without this they can do a light job simply to refute the incapacitating situation in consideration of a permanent and absolute appreciated instance.
When defining the LGSS above on absolute permanent disability, there is a great deal of jurisprudence that has been responsible for pointing out that such a degree of disability should not be recognized only when you have no physical possibility for any professional work, but also when you maintain skills to perform some activity, does not have to do it with minimal effectiveness, since the performance of any job, even simple, requires scheduling, movement and interaction requirements, as well as diligence and attention.
Disability should be understood as the loss of capacity for serious anatomical or functional reductions that reduce or nullify the ability to work, and without this would inhibit the rating the possibility of recovery of the work capacity when present as uncertain or very long term.
Does anyone with fibromyalgia qualify for disability?
Fibromyalgia (FM) is one of the most difficult conditions to obtain approval as a disability. Since symptoms are usually self-reported, you will need medical documents and a doctor to support your case. But it is possible to have a successful claim to FM.
How is fibromyalgia diagnosed? »
Keep in mind that your best chance of obtaining disability approval is to have:
- Relevant medical records
- Laboratory testing “or” Experimental testing
- Doctors’ opinions
- Statements from friends, family and co-workers
Read on to find out what the Social Security Administration (SSA) requires and how you can build your cause for fibromyalgia deficiency.
What is the criterion 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 disability (MDI) for 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 excludes other conditions
- Statements by you and others about any restrictions or disabilities in your daily activities
- If FM prevents you from working
You should also have at least 11 of the 18 tender points above and below the waist, on both sides of the body, or at least six continuous 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 SSA requires a medical 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, SSA will examine whether you are able to work.
How to document your disability case
Documentation is the key to a successful disability case. This means more than providing the SSA with your medical records. If your symptoms result in lost days, your employer may need to provide a statement saying so.
In general, your application should contain:
- Confirmed diagnosis of a rheumatologist
- Dates and contact information for your doctors, social workers and hospitals
- Your current and relevant medical records, such as medications, laboratory tests, or visits by psychologists
- Residual functional capacity (RFC) about your deficiencies filled by your doctor
- Summary of your previous work
It is also useful to keep a fibromyalgia diary. This can help you keep track of every day that you feel pain and how it interferes with your normal daily routine. You can consider migraines, painful periods and chronic exhaustion.
Your rheumatologist can also give you a professional opinion about your limitations. This includes an assessment of your ability to:
- Sit, stand and walk an eight-hour workday
- Lift and transport heavy loads
- Conduct fluid movements like bending, rocking or crawling
- Maintain punctuality and frequency at work
SSA takes all documentation into account before making a decision on your disability application. After submitting your application, a team of doctors working with 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 deficiencies are based on:
- information processing speed
The team interprets your medical information and predicts how long your condition is likely to last.
How to archive your information
When you are ready to claim disability benefits, you can apply:
- Call 1-800-722-1213, or TTY 1-800-325-0778, if you have hearing difficulties
- At your local social security office
You will want to call ahead and make an appointment if you plan to sign up in person.
The SSA says you can claim benefits as soon as you are diagnosed with fibromyalgia deficiency.
How long do you have to wait?
The SSA estimates an average waiting time of three to five months for claims for disability benefits. It is best to apply for this after becoming disabled.
In some cases, SSA will request additional documents to process your disability claim. Providing everything you need in advance can help reduce your waiting period.
What is the benefit of signing up for disability support?
Disability benefits can help if FM prevents you from working for at least a year. The average cost for annual fibromyalgia treatment can add up to $ 5,945 per person. This amount may be even higher if your health insurance does not cover all of your treatments. Disability can help with costs, especially if you are unable to work.
Fibromyalgia FAQ’s “I have fibromyalgia and I’m too sick to work, do I qualify for disability benefits?”
Unfortunately, in most countries, fibromyalgia is not a classified disability. I hope that the more research that is done, the fibro will be classified as a deficiency. It is not listed in the blue book of government illnesses that are considered disabling.
Proving your fibromyalgia deficiency can be extremely difficult, but it can be done. It is a sad fact that when we are sick and at our lowest point, we need to find the strength to fight the system. However, when a claim is made for a condition that is not in your blue-book. Then the claim is processed on the basis of the RFC – residual functional capacity.
Disability examiners will assess your SSI and SSD application based on the medical evidence provided. They will also require proof of your physical limitations. They then work with your doctor or clinic to come up with a rating for your physical or mental ability. Once they are armed with these facts, they turn their attention to the history of their past. If they agree that you are unable to return to your current / past job, do not jump up and down with joy. This is just the first step. There is another obstacle to rise.
What is the next
Okay, so they agreed that you can’t go back to your previous job. They will now assess the type of work you could reasonably expect to do. They will take into account your education, age, skills and limitations.
This opens up a huge area of employment and some of them you may be able to perform. Individuals with a good education and work skills are likely to be considered by the contractor as employable. So while it is possible to obtain disability based on the severity of your condition, it is simply not easy.
What the judges do not realize is that the symptoms of fibromyalgia vary daily. We have no idea what we will feel in a few hours. Let yourself go every morning when it’s time to go to work. It is common to be refused for the first time for disability benefits of fibromyalgia. You should keep trying and read everything you can about the process. If you can afford it, hire a fibro specialist to ensure that you get your benefits application approved first.