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Hawaii • Chronic Illness
Hawaiʻi residents with fibromyalgia—a chronic illness that can cause severe pain, fatigue, and disability—may qualify for state temporary disability benefits or federal SSI/SSDI. This guide clarifies eligibility, application steps, workplace protections, and benefit programs specific to people with fibromyalgia in Hawaiʻi.
To qualify for SSI or SSDI due to fibromyalgia, you must show that your symptoms make it impossible for you to work at a level that supports yourself. This requires detailed medical records, documentation of failed treatments, and sometimes expert testimony. For SSDI, you also need enough work credits; SSI is based on financial need. No two cases are alike—the process is detailed and can take months.
Hawaii’s Temporary Disability Insurance (TDI) covers employees who cannot work due to illness, including fibromyalgia, but only for up to 26 weeks. You must have worked at least 14 weeks, with at least 20 hours paid each week, in the last year. Unlike federal programs, TDI is not administered by the state—your employer chooses a private plan. You do not have to quit your job to get TDI, but you do have to file a claim within 90 days of becoming disabled[1][2][4].
Hawaii also offers job protection under state and federal leave laws if you qualify. The state does not pay benefits directly—private insurers or employers handle claims, but you can appeal denials.
If you have fibromyalgia and can’t work, get your medical records together. For TDI, ask your Human Resources department how the claims process works at your employer. If you need SSI/SSDI, call the Social Security Administration or go online to start. If denied, you have 20 days to appeal a TDI denial—send your appeal to the nearest Labor office[4].
For Medicaid waivers, contact the Hawaii Department of Human Services. Always gather pay stubs, doctor letters, and treatment records to support your claim.
Step-by-Step: Start by letting your employer know you need time off for fibromyalgia. If your employer provides TDI, fill out the required forms—your provider must certify your illness. Claims must be filed within 90 days of disability or you risk losing benefits[4]. If denied, appeal within 20 days, including medical evidence and pay proof.
For SSI/SSDI: Apply online, by phone, or in person at a Social Security office. Have your address, Social Security number, birth certificate, and detailed medical records ready. Treatment history, medication lists, and failed therapies should be documented. If denied, file for reconsideration—use a lawyer if needed.
For Medicaid: Apply at the Hawaii Department of Human Services. If you’re between jobs, ask about Medicaid waivers for those with disabilities who want to live in the community, not in a facility. All applications benefit from clear, written evidence and timely follow-ups.
Fibromyalgia can qualify you for federal SSI or SSDI if you prove a minimum 12-month expected duration and inability to work due to pain, fatigue, and cognitive symptoms. SSDI is for those with enough work credits; SSI is for those with limited income and resources, regardless of work history. Both programs require extensive medical proof of your inability to work, not just a diagnosis.
Medicaid covers most people with SSI, but if you earn too much, you can still qualify using a waiver. Waivers help people with disabilities like fibromyalgia live at home and avoid nursing facilities. You must show that your symptoms are severe enough to impact daily life and self-care.
Hawaii’s Temporary Disability Insurance (TDI) pays about 58% of your wages, up to $837 a week in 2025, for up to 26 weeks for non-work-related illness, including fibromyalgia, if you meet minimum work requirements[1][2][6]. The state does not pay benefits directly—employers select private insurers to manage the program. If your employer does not have a TDI plan, contact the State Disability Compensation Division[4][8].
Hawaii does not have a separate state disability program, so most longer-term support comes from SSI/SSDI and Medicaid. However, Hawaiʻi’s Disability Compensation Division can help if you are denied TDI and need to appeal[4]. For chronic illnesses like fibromyalgia, you may also qualify for Medicaid waivers for home and community supports, but these programs are limited—apply early.
Hawaii residents can access ABLE accounts, a tax-advantaged savings program for people with disabilities. These accounts let you save for disability-related expenses without losing your SSI or Medicaid benefits (if you keep the balance below $100,000). Check the ABLE National Resource Center or your local financial advisor to set one up for your fibromyalgia needs.
SSI has strict limits on income and resources ($2,000 for individuals, $3,000 for couples). Any earnings or unearned income (like TDI benefits) can affect what you get. SSDI does not have strict income limits after approval, but you must show you cannot do any substantial work. If you’re over 18 and under 65, you must fall under Federal Poverty Level (FPL) guidelines for most Medicaid programs.
Always report changes in income, health status, living situation, and work status quickly to SSI, SSDI, and Medicaid. If you get an overpayment notice from Social Security, appeal in writing. For TDI, appeal denials within 20 days. See our guide to avoiding overpayments and reporting changes for savings, work, and personal updates.
You have just 90 days to file a TDI claim in Hawaii—after that, you may lose all or part of your benefits. Appeals must be filed within 20 days of a denial. Miss these windows, and your case may be closed for good.
SSDI pays monthly benefits based on your earnings history, so if you worked full-time and paid Social Security taxes, it usually pays more than SSI. SSI is a flat rate, but includes Medicaid, which can be valuable for ongoing healthcare.
No, TDI is only paid when you cannot work due to illness. If you can work any job, you are not eligible. However, SSDI and SSI allow limited work under special rules—keep detailed records and consult your benefits counselor.
You have 20 days to appeal in writing. Send two copies of your appeal, with medical proof and pay stubs, to the nearest Labor office (address on the denial notice). If you are disabled, you can request a hearing.
Most Medicaid waivers are for those at risk of institutionalization, but some home- and community-based services are available. Contact the Hawaii Department of Human Services for full options.
No. You must prove your symptoms are severe enough to prevent full-time work for at least 12 months, despite treatment. Diagnosis alone is not enough—detailed medical records are key.
No, TDI only covers the period you cannot work due to illness. If your condition improves and you return to work, benefits stop—but you never owe back benefits for weeks you were disabled.
Disclaimer: This guide is for informational purposes only and does not constitute legal or medical advice. Always consult with a qualified professional regarding your specific situation.
Ask your rheumatologist, neurologist, or primary care provider to document your pain, fatigue, and other symptoms, as well as your response (or lack of response) to treatments. The more detailed the record, the better.
Sometimes—if your SSDI payment is low enough, you may also qualify for SSI (this is called a “concurrent claim”). But if you get too much from SSDI, you may get nothing from SSI.
A Medicaid waiver lets you get more services at home or in the community. If you have fibromyalgia and can’t care for yourself, a waiver might help with home health, personal care, or respite—but they are limited.
Call (808) 586-9155 or visit the nearest District Office during business hours for help with TDI appeals, complaints, or questions.
