Social Security will publish in the Federal Register tomorrow a Ruling 12-2p on the evaluation of fibromyalgia in disability claims. The ruling states that "FM [Fibromyalgia] is an MDI [Medically Determinable Impairment] when it is established by appropriate medical evidence. FM can be the basis for a finding of disability." The ruling specifies that either the 1990 American College of Rheumatology (ACR) Criteria for the Classification of Fibromyalgia or the 2010 ACR Preliminary Diagnostic Criteria may be used to determine if the claimant has FM as a MDI.As to determining Residual Functional Capacity, the Ruling states that (footnotes omitted):
Widespread pain and other symptoms associated with FM, such as fatigue, may result in exertional limitations that prevent a person from doing the full range of unskilled work in one or more of the exertional categories ... People with FM may also have nonexertional physical or mental limitations because of their pain or other symptoms. Some may have environmental restrictions, which are also nonexertional.The problem with the Ruling is that it demands that a physician write down a long list of the factors used in the ACR criteria which led to the diagnosis of FM. Even rheumatologists don't do that generally any more than psychiatrists record each factor leading to a diagnosis of major depression. If you're a specialist, you may "know it when you see it" without bothering to record each step leading to the diagnosis.