FAME CONFERENCE - MAY, 2000

Disability, like Fibromyalgia, is a label which portends much but signifies little. In each instance the words are the mere descriptor for consequences and conditions that have great depth. Fibromyalgia may be seen as a shorthand for a constellation of problems which are not limited to pain, fatigue, irritable bowel, mush brain, and profound headaches. Disability may be absolute to minimal. The word disability is analogous to use of the word "snow" to describe frozen precipitation to an Inuit. It lacks precision. Disability may be fractional or absolute, it may describe profound limitations or rather mild dysfunction. Disability is both a descriptor and a concept of law, medicine, and fact. It is impossible to harmonize the many facets of disability without focusing exclusively on what it is that the label is meant to signify. To use the word disability with clinically diagnosed conditions such as Fibromyalgia, Chronic Fatigue, or migraine headaches, one must consider the context of what it is that is limited. This is particularly important in resolving questions relative to an individual's capacity to perform ongoing competitive employment. It is axiomatic that a person with Fibromyalgia may be disabled and yet may be capable of performing all aspects of work and attending to all facets of family. The label of disability is appropriate if there is some change from baseline capacities. At the farther end of an imaginary continuum, the presence of cycles of pain, fatigue, irritable bowel, migraine headaches and mush brain may be so profound and pronounced that the impact on activities of daily living foreclose performance of occupation or activities of family. There are points throughout the continuum which adequately, accurately and completely describe the disability attendant to Fibromyalgia. At one end of such an imaginary spectrum, disability is, of course, a bother. At the other end, it is catastrophic. One must employ a high degree of precision to describe incapacity when the symptoms begin to eclipse more of a normal routine of work or family.

The precision of describing one's disability due to the aspect of Fibromyalgia is patent as one approaches a decision whether or not ongoing work activity can be sustained. The decision to leave the workplace because of Fibromyalgia symptomatology, should not be lightly taken. It is a perilous path which may be as frustrating as the cure for the symptoms themselves. It is important to consider prior to abandoning occupation, what specific programs or benefits might be applied for. Those benefits are public, private, and governmental. They comprise Social Security Disability, State Disability programs, Industrial Injury/Occupational Disease programs, Private Insurance, and Hybrid programs. It is absolutely essential to appreciate before embarking on a quest for benefits what the specific requirements are for each program. It is further fundamental to such a process of application to understand in detail what information lies within the medical record. It is well considered to consult with an expert in these specific areas prior to commencing any application for disability. It is small investment considering the stakes. Ultimately, the passage through the gates of disability whether public, private, require a clear and knowing description of why it is that the benefits are sought and should be paid.

For these reasons, seek help before embarking on the voyage.

Joshua W. Potter

Joshua W. Potter is a partner in the firm of Potter, Cohen & Samulon, Pasadena, CA. His practice is limited to questions of disability.