A Must-Know Fibromyalgia SSD Case in the Fourth Circuit

If you litigate Social Security Disability (SSD) cases in the Fourth Circuit, Hultz v. Bisignano is a decision you’ll want to keep close. This case builds on Arakas v. Commissioner and provides a strong reminder, and a warning, about how fibromyalgia claims must be properly evaluated.

Hultz Reinforces Arakas: No Objective Evidence Requirement for Fibromyalgia

The core error in Hultz involved the ALJ denying benefits by discounting subjective symptoms simply because they weren’t “consistent with the medical evidence.” But as the Court reaffirms:

Fibromyalgia does not produce objective medical evidence.ALJs may not rely on the absence of such evidence, even as one factor, to discredit a claimant’s testimony. Full stop.

A Rare Remedy: Reversal, Not Remand

What makes Hultz stand out is the remedy. The Court didn’t just remand the case for a new hearing. It reversed outright and ordered benefits to be calculated.

Why Did the Court Reverse Instead of Remand?

Once the improper demand for objective proof was removed, the remaining record consistently supported disability:

• Years of documented chronic pain and fatigue

• Rheumatology records showing fibromyalgia as the primary symptom driver

• Credible third-party testimony (from the claimant’s grandmother)

• Recognition that fibromyalgia waxes and wanes, making isolated “good days” irrelevant

  
  

ALJ Reasoning Rejected by the Court

The Court firmly rejected several common rationales used by ALJs:

• Temporary improvement ≠ sustained ability to work full-time

• Gaps in treatment ≠ symptom resolution, especially for an untreatable condition

• Daily activities ≠ functional capacity to maintain full-time, competitive employment

✅ These clarifications are vital when rebutting ALJ decisions based on superficial or outdated assumptions.

Treating Source Rule: Substance Over Paperwork

The Court also found error in how the ALJ discounted the treating rheumatologist’s opinion. The reasons?

• The physician didn’t quantify limitations on a form

• There were gaps in treatment

  
  

However, the Court emphasized:

• Consistency with the full record matters more than administrative neatness

• Credibility of treating opinions shouldn’t hinge solely on checkbox forms

  
  

Q&A: What Can We Learn from Hultz?

Q: Can an ALJ deny fibromyalgia claims due to lack of objective evidence?

A: No. Following Arakas and reaffirmed in Hultz, fibromyalgia claims must not be denied based on lack of objective evidence—even in part.

Q: What happens if an ALJ makes credibility errors in fibromyalgia cases?

A: As Hultz shows, such errors may justify outright reversal—not just a remand.

Q: Does daily functioning disprove disability?

A: Not necessarily. The Court reiterated that intermittent daily activities don’t equate to the ability to sustain full-time work.

A Note on the Dissent: Ongoing Legal Tension

Judge Agee’s partial dissent acknowledges the ALJ violated Arakas, but warns against awarding benefits outright. He argues this could risk turning fibromyalgia into a per se disability—a concern that highlights ongoing tension between ALJ deference and claimant protection.

Final Thoughts

For attorneys working on fibromyalgia-based SSD cases, Hultz v. Bisignano is a powerful precedent. It affirms that:

• Subjective symptoms must be taken seriously

• ALJs cannot use outdated or improper rationales

• Reversal—not just remand—may be the right remedy

Got any questions? Schedule a consultation with us. I’m here to help. It’s a lot to take in, but we’ll get through it together. After all, navigating these waters is always easier when you’ve got someone to chat with.