Social Security published today new Ruling 12-02p, which is called “Title II and XVI: Evaluation of Fibromyalgia.”
Upon first read, the ruling seems to raise the bar for fibromyalgia as a medically determinable impairment. The ruling states:
We cannot rely upon the physician’s diagnosis alone. The evidence must document that the physician reviewed the person’s medical history and conducted a physical exam. We will review the physician’s treatment notes to see if they are consistent with the diagnosis.
It seems that the SSA wants the fibromyalgia diagnostic criteria to be spelled out in the claimant’s treatment notes before a fibromyalgia diagnosis can become a medically determinable impairment. Unfortunately, doctors don’t tend to keep records that way.
This new ruling will play a central role in fibromyalgia disability cases, starting today. You need to measure the medical evidence you have against the requirements of the ruling. You may need to send a claimant back to the rheumatologist for an exam, to document physical findings. And of course, you should address the ruling in your prehearing statement.