The Mystery Disease: Fibromyalgia

Within the last ten years the condition of fibromyalgia has been an accepted disease within the medical community. According to the Arthritis Foundation fibromyalgia is a form of soft tissue or muscular rheumatism with muscular pain and fatigue that affects over 5 million people in the United States. See, Arthritis Foundation, What is Fibromyalgia, Unfortunately, the legal community is lacking in their awareness of the impairment. The few Social Security decisions that address fibromyalgia often reveal an Administrative Law Judge’s (hereinafter “ALJ”) unfamiliarity with the disease. This leads the ALJ to evaluate the claimant’s credibility rather than the disease. Of course, the ALJ’s unfamiliarity is also a direct reflection upon the advocate who’s duty is to inform the Court.

In 1996, the Seventh Circuit held that, the ALJ misunderstood the disease of fibromyalgia and improperly found the claimant’s credibility to be undermined. Sarchet v. Chater, 78 F.3d 305, 306 (7th Cir. 1996). The Court observed that the principal symptoms of fibromyalgia are “pain all over,” fatigue, disturbed sleep, stiffness, and the only symptom that discriminates between it and other diseases of a rheumatic character multiple aching spots. Id. at 307.

The Tenth Circuit stated that, “the mysterious nature of this disease and the ALJ’s lack of familiarity with it….impacted his decisions concerning the assessment of [the claimant’s] credibility.” Stephens v. Chater, No. 954110RDR, 1996 WL 304527 (D. Kan. June 4, 1996). The Stephens case epitomizes the difficulty in the evaluation of the disability claim where fibromyaglia is at issue. Often, because of the “mystery” of the disease the claimant’s credibility may wrongfully come into question.

As a result of ALJ decisions evaluating claimants’ credibility rather than fibromyalgia, recent rulings are now requiring a comprehensive assessment of medically documented fibromyalgia symptomology. Owen v. Chater, 913 F. Supp. 1413, 1419 (D. Kan. 1995); Social Security Ruling 967p. To dispel the “mystery” of the disease two circuits have aligned fibromyalgia with the well recognized disease of chronic fatigue syndrome (hereinafter “CFS”). The Eleventh Circuit held that, fibromyalgia is “not inconsistent with a diagnosis of [CFS].” Sabo v. Chater, 955 F. Supp. 1456, 1462 (M.D. Fla. 1996), quoting Fragale v. Chater, 916 F. Supp. 249, 254 (W.D.N.Y. 1996). The Ninth Circuit held that, a diagnosis of CFS and fibromyalgia may exist simultaneously, especially since they both share a number of common features. Powell v. Chater, 959 F. Supp. 1238 (C.D. Cal. 1997).

The advocate should keep in mind that physical examinations will usually yield normal results a full range of motion, no joint swelling, as well as normal muscle strength and neurological reactions. There are no objective tests which can conclusively confirm the disease. The medical literature indicates that fibromyaglia patient’s may have psychological disorders, the disease commonly strikes between the ages of 35 and 60 and it affects women nine times more than men. See, Preston v. Secretary of Health and Human Services, 854 F.2d 815, 818 (6th Cir. 1988).