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SSA Issues Ruling on Evaluation of Fibromyalgia

NOSSCR

July 30, 2012

TO: NOSSCR Sustaining Members

FROM: Barbara Silverstone, Staff Attorney

RE: SSA Issues Ruling on Evaluation of Fibromyalgia

SSA has issued a Social Security Ruling (SSR) on the evaluation of fibromyalgia in disability claims. SSR 12-2p is effective July 25, 2012. 77 Fed. Reg. 43640 (July 25, 2012). This ruling states that fibromyalgia is a medically determinable impairment when it is established by appropriate medical evidence and that it can be the basis for a finding of disability. A claimant who alleges disability based on fibromyalgia must have a diagnosis by a licensed physician (medical or osteopathic doctor) and evidence of the criteria from either "the 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia" or "the 2010 American College of Rheumatology Preliminary Diagnostic Criteria."

SSA may consider additional medical evidence pursuant to SSR 06-3p. Recognizing that the symptoms and signs of fibromyalgia may vary in severity over time and may even be absent on some days, SSA will also make a longitudinal review of the doctor's treatment notes and the claimant's symptoms. Once it is established that a claimant has a medically determinable impairment of fibromyalgia, SSA will consider it in the regular sequential evaluation process to determine whether the person is disabled. Additional details about SSR 12-2p will be provided in the July 2012 NOSSCR Forum.

Final Rule Allows SSA to Skip Step 4 If "Insufficient Evidence" of Past Work

SSA has issued a final rule that gives adjudicators the discretion to skip step 4 in cases where they have "insufficient evidence" to make past relevant work (PRW) findings. 77 Fed. Reg. 43492 (July 25, 2012). The changes are effective August 24, 2012.

The "Expedited Vocational Assessment" will work as follows: If the adjudicator does "not have sufficient evidence about your past relevant work to make a finding at the fourth step, we may proceed to the fifth step of the sequential evaluation process." The adjudicator has the discretion to make the decision whether to use the proposed expedited process, i.e., deciding whether "sufficient evidence" regarding PRW exists. SSA will "not require an adjudicator to make a reasonable effort to collect additional evidence [re PRW] if he or she could use this expedited process." More details about the final rule will be provided in the July 2012 NOSSCR Forum.

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