FIBROMYALGIA AND WORK DISABILITY: Is Fibromyalgia a Disabling Disorder?

https://doi.org/10.1016/S0889-857X(05)70277-5Get rights and content

It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories instead of theories to suit facts., SHERLOCK HOLMES

It is often necessary to make a decision on the basis of knowledge sufficient for action but insufficient to satisfy the intellect., IMMANUEL KANT

Section snippets

The Process of Work Disability

The word disability can have two separate meanings: (1) functional disability and (2) work disability. Functional disability refers to the inability of a person to perform certain activities, such as activities of daily living, instrumental activities of daily living, or more complex tasks. Work disability refers to the inability to perform all or some of an individual's job. In the current discussion we use work disability to mean the inability to perform all or substantially all of one's work

Aspects of the Process of Disability Determination in the Social Security System

A worker* who believes he or she is disabled files an application with the Social Security Administration (SSA). The SSA interviews the claimant and requests the claimant's medical records. SSA has no published criteria or rules to govern fibromyalgia decisions. Because there are no published criteria or rules to govern the evaluation of

Is the Diagnosis of Fibromyalgia Valid and Reliable?

In general, fibromyalgia has enough general acceptance that it is no longer an issue as to whether it is a "medical condition" or "a medical impairment that results from anatomical, physiological, or psychological abnormalities." Although the diagnosis of fibromyalgia in the past generally was made on the basis of a physician's assertion, current legal opinion suggests that formal criteria (or a representation of such criteria) be used for diagnosis. This usually means that the American College

A Practical Definition of Work Disability.

The authors find this definition by one of us (JP) as it applies to fibromyalgia to be useful. Three pillars of each and every employer-employee relationship (work) are: (1) regular and consistent work hours and attendance; (2) accurate and complete work; and (3) the ability to respond appropriately to supervision, criticism, and the general public. Where the sequelae of fibromyalgia significantly erode all of the three pillars of employment, disability should be judicially determined. Thus,

THE RATE OF DISABILITY PAYMENTS FOR PATIENTS WITH FIBROMYALGIA

There are scant data available concerning work disability from official sources because most official databases do not count fibromyalgia as a separate category. Table 3describes disability payment data derived from one insurance survey and several clinical surveys.

McCain et al22 reported data from a Canadian life insurance company, London Life, using a representative sample. A file review indicated that fibromyalgia was responsible for 9% of long-term disability cases. Bengtsson et al1

DOES TRAUMA CAUSE FIBROMYALGIA?

A number of reports have dealt with fibromyalgia developing in the work disability or compensation setting.* Although almost no data are available on the issue of causal relationships between work or trauma and fibromyalgia, the association between work disability or compensation and fibromyalgia is well established. A recent fibromyalgia consensus report42 on disability stated:

The clinical dilemma, whether an injury or work place stress

References (44)

  • M.A. Cathey et al.

    Functional ability and work status in patients with fibromyalgia

    Arthritis Care and Research

    (1988)
  • M.A. Cathey et al.

    Demographic, work disability, service utilization and treatment characteristics of 620 fibromyalgia patients in rheumatologic practice [abstract]

    Arthritis Rheum

    (1990)
  • P. Croft et al.

    Silman Population study of tender point counts and pain as evidence of fibromyalgia

    BMJ

    (1994)
  • S. Greenfield et al.

    Reactive fibromyalgia syndrome

    Arthritis Rheum

    (1992)
  • N.M. Hadler
  • N.M. Hadler
  • N.M. Hadler

    To be a patient or a claimant with a musculoskeletal illness.

  • N.M. Hadler

    Work-related disorders of the upper extremity, part I: Cumulative trauma disorders—a critical review

    Occupational Problems in Medical Practice

    (1989)
  • D.J. Hawley et al.

    Pain, disability, and relationships in seven rheumatic disorders: A study of 1522 patients

    J Rheumatol

    (1991)
  • D.J. Hawley et al.

    Marital status in rheumatoid arthritis and other rheumatic disorders: A study of 7,293 patients

    J Rheumatol

    (1991)
  • A. Hidding et al.

    Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia

    J Rheumatol

    (1994)
  • M.H. Liang et al.

    Evaluation of Social Security disability in claimants with rheumatic disease

    Ann Intern Med

    (1991)
  • Cited by (38)

    • Fibromyalgia: Clinical and occupational aspects

      2012, Revista da Associacao Medica Brasileira
    • The impact of judges' perceptions of credibility in fibromyalgia claims

      2008, International Journal of Law and Psychiatry
      Citation Excerpt :

      The courts have not reached a consensus regarding the validity of FM, and will likely continue to struggle over the disability issue in FM even if objective evidence were available, because an objective finding is only one factor to be considered in resolving the question of disability. As such, plaintiff credibility is an increasingly important issue in the context of disability claims (Ericson & Doyle, 2004; Wolfe & Potter, 1996), especially because there is no simple method of assessing disability in FM claimants (Littlejohn, 1995). Cases involving more subjective medical conditions often rely, to varying degrees, on expert evidence to assist the court in disability determinations.

    • Disability evaluation of fibromyalgia

      2001, Physical Medicine and Rehabilitation Clinics of North America
    View all citing articles on Scopus

    Address reprint requests to Frederick Wolfe, MD, Arthritis Research and Clinical Centers, 1035 North Emporia, Suite 230, Wichita, KS 67214, [email protected]

    *

    From the Departments of Internal Medicine and Family and Community Medicine, University of Kansas School of Medicine-Wichita; and the Wichita Arthritis Research and Clinical Centers, Wichita, Kansas (FW); and Potter, Cohen & Samulon, Pasadena, California (JP)

    View full text