TN 12 (03-17)

DI 24515.076 Evaluation of Fibromyalgia (FM) SSR 12-2p

Citations:

SSR 12-2p

[NOTE: On January 18, 2017, SSA published final rules in the Federal Register titled “Revisions to Rules Regarding the Evaluation of Medical Evidence” (82 FR 5844) that revised how we consider medical evidence in disability claims and continuing disability reviews under titles II and XVI of the Social Security Act. These rules expanded the list of medical sources we recognize as acceptable medical sources (AMS). For claims filed on or after March 27, 2017, the AMS list also includes licensed advanced practice registered nurses (APRN) (for impairments within the licensed scope of practice), licensed physician assistants (PA) (for impairments within the licensed scope of practice), and licensed audiologists (for impairments of hearing loss, auditory processing disorders, and balance disorders within the their licensed scope of practice only). Therefore, these medical sources can provide objective medical evidence (medical signs, laboratory findings, or both) to help establish a person has a medically determinable impairment. Accordingly, we plan to revise relevant Social Security Rulings and the POMS to conform to these final rules.]

A. Background of the publication of SSR 12-2p

SSA published SSR 12-2p, “Evaluation of Fibromyalgia” on July 25, 2012. This Social Security Ruling (SSR), which took effect upon publication, explains our policies for developing evidence to establish that a person has a medically determinable impairment (MDI) of fibromyalgia (FM). SSR 12-2p also explains how we evaluate FM in disability claims and continuing disability reviews under titles II and XVI of the Social Security Act.

B. Sections of SSR 12-2p

A short section explains the purpose of the SSR.

An introduction defines the disorder.

Policy interpretation is in question-and-answer format and explains the evidence we need to establish an MDI of FM. The questions and answers also explain how we evaluate FM when we determine whether a person is disabled. The questions answered in the SSR are:

  1. What general criteria can establish that a person has an MDI of FM?

  2. What specific criteria can establish that a person has an MDI of FM?

  3. What documentation do we need?

  4. How do we evaluate a person's statements about his or her symptoms and functional limitations?

  5. How do we find a person disabled based on an MDI of FM?

  6. How do we consider FM in the sequential evaluation process?

SSR 12-2p also includes cross-references to additional rulings and Program Operating Manual System instructions.

C. References related to evaluating FM claims