Fibromyalgia: Work and Disability

Many people with fibromyalgia continue to work full or part time. But the chronic pain and fatigue associated with fibromyalgia often make working very difficult. If you are employed, it's important to learn about managing fibromyalgia symptoms and coping with pain and fatigue. In addition, if you have tried different jobs and are unable to work, you might consider applying for disability. Disability may be difficult to get, however, because of rules about work capacity.

Can People With Fibromyalgia Work?

By self-managing fibromyalgia pain and controlling daily stress, most people with fibromyalgia can do almost anything they choose. Unless you have physical pain that's directly work-related, you should be able to make simple modifications to your workplace that allow you to continue working.

What Type of Workplace Changes Can Help Someone With Fibromyalgia?

First, openly discuss your fibromyalgia with your boss and coworkers. Talk about the symptoms of pain, fatigue, and stiffness. Explain how you may have good days and bad days.

Explaining fibromyalgia will give people at work a better idea of what you are feeling each day. Ask your boss if you can take rest periods on bad days. Or ask if you can take work home if you are feeling fatigued. Ask if you can come in on Saturday if you miss a day of work to make up the lost time and income. In addition, ask if you can put a cot in your office for a brief nap at lunchtime. Taking a midday nap helps many people with fibromyalgia and other chronic health conditions function on the job.

Are There Workplace Modification Guidelines for People With Fibromyalgia?

People with fibromyalgia can use the following lists when talking with their employer about making modifications. The lists come from the U.S. Department of Labor's Job Accommodation Network. They contain recommendations for accommodations employers should be willing to consider for employees with fibromyalgia.

To address concentration issues, employers should consider:

• Providing written job instructions when possible
• Prioritizing job assignments and providing more structure
• Allowing flexible work hours and allowing a self-paced workload
• Allowing periodic rest periods to reorient
• Providing memory aids, such as schedulers or organizers
• Minimizing distractions
• Reducing job stress

To address depression and anxiety, employers should consider:

• Reducing distractions in the work environment
• Providing to-do lists and written instructions
• Reminding the employee of important deadlines and meetings
• Allowing time off for counseling
• Providing clear expectations of responsibilities and consequences
• Providing sensitivity training to coworkers
• Allowing breaks to use stress management techniques
• Developing strategies to deal with work problems before they arise
• Allowing telephone calls during work hours to doctors and others for support
• Providing information on counseling and employee assistance programs

To address fatigue and weakness, employers should consider:

• Reducing or eliminating physical exertion and workplace stress
• Scheduling periodic rest breaks away from the workstation
• Allowing a flexible work schedule and flexible use of leave time
• Allowing the employee to work from home
• Implementing ergonomic workstation design

To address migraine headaches, employers should consider:

• Providing task lighting
• Eliminating fluorescent lighting
• Providing air purification devices
• Allowing flexible work hours and work from home
• Allowing periodic rest breaks

To address issues associated with sleep problems, employers should consider:

• Allowing flexible work hours and frequent breaks
• Allowing the employee to work from home

Can I Get Disability Because of Fibromyalgia?

The Americans with Disabilities Act (ADA) does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. Therefore, some people with fibromyalgia will have a disability under the ADA and others will not.

Because fibromyalgia is difficult to diagnose -- typically, health care providers rule out other conditions through a physical exam and various blood tests -- it's important that you do your homework before you apply for disability.

According to federal regulations, to qualify for disability you must prove that you have a severe impairment. You also need to prove that the impairment limits your physical or mental ability to do work.

The Social Security disability regulations define disability as "the inability to do any substantial gainful activity due to your medical or mental problem." In addition, according to the Social Security Administration, your condition must interfere with basic work-related activities. If it doesn't, your claim won't be considered. Instead, Social Security will find that you are not disabled.

The combined effect of having multiple impairments is taken into account. That can be important for many people with fibromyalgia. You must be unable to do your previous work or any other substantial gainful activity. Your age and education are considered, as well as your remaining abilities and your work experience.

How Do I Apply for Disability?

To apply for disability benefits, call your Social Security office. Much of the information may be provided over the phone, by mail, or the Internet. You will be asked specific questions about how you have trouble with daily activities. And you will need to be as specific as you can, describing your limitations and why you cannot work. You will be asked to give the names and addresses of your doctors. The Social Security office will contact each one for records.

What Other Proof Must I Provide for Disability?

Describing your fibromyalgia symptoms alone will not qualify you for Social Security disability. You have to be specific about signs and physical findings related to fibromyalgia and pain and how that impacts your ability to work. The Social Security staff will consider all your symptoms, including pain.

All of this information considered together must lead to a conclusion that you are disabled before you will be granted disability with benefits. If more detailed information is needed, you may have to be examined by a doctor approved by the Social Security Administration.

What if I'm not Approved for Disability?

It is common that fibromyalgia patients are not approved for disability, especially with the first application. If you are not approved, you'll have the right to appeal before a judge who specializes in these cases. Some patients with fibromyalgia find it necessary to have the help of an attorney during the appeal process. Although it may increase your costs, the chance your case will be approved is usually better if you have legal counsel.

What Type of Documentation Is Needed to Get Disability?

It's important to get detailed documentation -- reports -- from your doctors, including psychologists, at the onset of your illness. Have your doctors submit documentation of all prescribed medications, therapies, and lifestyle remedies necessary to resolve your fibromyalgia symptoms. You should also be evaluated by a fibromyalgia specialist, usually a rheumatologist. This doctor will give a detailed assessment of your impairment along with a list of the many tests and treatments used in your condition.

For further details on disability and the steps you must take, visit the Social Security website or call the local Social Security office.

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