Editor's comment: This study looked not only at the incidence of fibromyalgia patients receiving Social Security disability but also evaluated which factors were the strongest predictors of who would need/receive SSD. They found that approximately one-third of fibromyalgia patients received SSD. Not surprisingly, the strongest predictor was functional status.
Social security work disability and its predictors in patients with fibromyalgia
By Frederick Wolfe MD, et al.
To determine prevalence and incidence of US Social Security disability and Supplemental Security Income (SSD) in patients with fibromyalgia, and to investigate prediction of SSD.
Methods: Over a mean of 4 years (range 1-13), we studied 2,321 patients with physician diagnosed fibromyalgia (prevalent cases), and applied modified ACR 2010 research criteria to identify criteria positive patients.
During the study, 34.8% (95% CI 32.9, 36.8) of fibromyalgia patients received SSD.
The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (3.0, 3.9%),
and 25% were estimated to be work disabled at 9.0 years of follow-up.
By comparison, the prevalence of SSD in rheumatoid arthritis patients with concomitant fibromyalgia was 55.6% (54.3, 57.0) and was 42.4% in osteoarthritis.
By study conclusion, 31.4% of SSD awardees were no longer receiving SSD.
In univariate models, incident SSD in patients with fibromyalgia was predicted by socio-demographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability [HAQ]).
In multivariable models, HAQ and SF-36 Physical and Mental Component Summary scores, but no other variables predicted SSD.
Fibromyalgia criteria (+) patients had more SSD, but the continuous scale polysymptomatic distress (PSD) index derived from the ACR criteria was a substantially better predictor of SSD than a criteria positive diagnosis.
Conclusions: The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables. © 2014 American College of Rheumatology.
Source: Arthritis Care & Research
, February 10, 2014. By Frederick Wolfe MD, Brian T. Walitt MD MPH, Robert S. Katz MD and Winfried Häuser.