SSR 12-2p: Evaluation of Fibromyalgia

What actually decides a claim under SSR 12-2p

The ruling requires a licensed physician's diagnosis plus either widespread pain with tender points, or widespread pain with repeated manifestations of six or more fibromyalgia symptoms — and, critically, evidence that other disorders which could cause the symptoms have been excluded. That exclusion work is the part claimants most often have not had done, and it is the most common reason a well-documented fibromyalgia claim still fails.

Conditions evaluated under SSR 12-2p

• FibromyalgiaHow SSA evaluates it, the evidence that decides it, and why claims are denied

Frequently asked questions

Do you have to meet SSR 12-2p to be approved?

No. Meeting a ruling's criteria is one route to approval and not the most common one. Most awards are made on residual functional capacity — what SSA concludes you can still do across a full working week, given your age, education and past work. A claim that falls short of SSR 12-2p can still be approved that way, which is why a denial citing this ruling is not the end of the matter.

What if my records do not meet SSR 12-2p exactly?

Two things can still happen. SSA can find your condition medically equals the ruling — equal in severity and duration without matching every criterion — or it can move on to the functional assessment described above. What sinks these claims is usually a gap in the file rather than a gap in the criteria: a limitation you live with that no doctor wrote down.

Which conditions are evaluated under SSR 12-2p?

Fibromyalgia. The criteria are the same; what differs is the evidence each condition needs to satisfy them.