Fibromyalgia Benefits in Texas: 2025 Guide

• To qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), your fibromyalgia must be medically documented and expected to last at least 12 months or result in death.
• Your condition must prevent you from doing substantial gainful activity (SGA). In 2025, SGA is $1,620/month for non-blind individuals and $2,700/month for blind individuals.
• The Social Security Administration (SSA) uses a 5-step process to decide eligibility, including whether your condition is listed in the Blue Book, your residual functional capacity, and your ability to adjust to other work.
• SSDI requires a work history and payment of Social Security taxes. SSI is for those with limited income and resources, regardless of work history.
• For fibromyalgia, SSA looks for evidence of widespread pain, fatigue, and other symptoms that significantly limit daily activities and work ability.

Source: SSA Disability Qualification [Accessed: 2025-11-06]

• Texas does not have a state-run disability benefits program. Residents rely on federal SSDI and SSI programs for financial support.
• The Texas Disability Determination Services (DDS) reviews medical evidence and makes eligibility decisions for the SSA.
• For fibromyalgia, DDS will assess your medical records, doctor’s notes, and how your symptoms affect your ability to work.
• You must provide detailed documentation of your diagnosis, symptoms, treatments, and how fibromyalgia limits your daily life and work.
• If your fibromyalgia is severe enough to prevent you from working, you may qualify for SSDI or SSI, but approval is not automatic and requires strong medical evidence.

Source: Texas Disability Benefits Guide [Accessed: 2025-11-06]

• Gather medical records and work history.
• Complete the online application at SSA.gov or call 1-800-772-1213.
• Provide detailed information about your fibromyalgia symptoms and how they affect your ability to work.
• Submit all required documents and follow up on your application status.
• If denied, you can appeal within 60 days.

• Step 1: Collect Documentation

  • Get medical records from your doctors, including diagnosis, treatment history, and how fibromyalgia affects your daily life.
  • Gather work history and pay stubs to show your employment and earnings.

• Step 2: Start Your Application

  • Apply online at SSA.gov, by phone at 1-800-772-1213, or in person at a local Social Security office.
  • Choose SSDI if you have a work history, or SSI if you have limited income and resources.

• Step 3: Complete the Application

  • Fill out all sections, including personal information, medical details, and work history.
  • Describe how fibromyalgia limits your ability to work and perform daily activities.

• Step 4: Submit and Follow Up

  • Submit your application and all supporting documents.
  • Check your application status online or by phone.
  • Respond promptly to any requests for more information.

• Step 5: Appeal if Denied

  • If your application is denied, you have 60 days to appeal.
  • You can request a reconsideration, a hearing, or further review.
  • Consider getting help from a disability advocate or attorney.

Source: SSA How to Apply [Accessed: 2025-11-06]

• Social Security Disability Insurance (SSDI): Monthly payments for disabled workers who have paid Social Security taxes. In 2025, the average SSDI payment is about $1,500/month, but the amount varies based on your work history.
• Supplemental Security Income (SSI): Monthly payments for people with limited income and resources. In 2025, the federal SSI payment is $967/month for individuals and $1,450/month for couples.
• Medicare: After 24 months of SSDI, you qualify for Medicare. SSI recipients may qualify for Medicaid.
• Medicaid Waivers: Texas offers Medicaid waivers for people with disabilities who need home and community-based services. These can help with healthcare, personal care, and support services.

Source: SSA Benefits Overview [Accessed: 2025-11-06]

• Texas does not have a state disability benefits program. All disability benefits are provided through federal programs like SSDI and SSI.
• Texas Medicaid offers waivers for people with disabilities, including those with fibromyalgia, to help with healthcare and support services. These waivers can provide home health care, personal care, and other services.
• The Texas Health and Human Services Commission (HHSC) manages Medicaid and waiver programs. You can apply for Medicaid and waivers through the YourTexasBenefits website.
• Texas also offers ABLE accounts, which allow people with disabilities to save money without losing eligibility for SSI and Medicaid.
• Work incentives and support programs are available to help Texans with disabilities find and keep employment.

Source: Texas Health and Human Services [Accessed: 2025-11-06]

• ABLE accounts allow Texans with disabilities to save up to $18,000 per year without losing eligibility for SSI or Medicaid.
• Funds can be used for disability-related expenses like medical care, education, housing, and transportation.
• To open an ABLE account, visit the Texas ABLE website or call 1-800-531-2227.

Source: Texas ABLE Program [Accessed: 2025-11-06]

• For SSI in 2025, the federal benefit rate is $967/month for individuals and $1,450/month for couples.
• The resource limit is $2,000 for individuals and $3,000 for couples.
• The SGA limit is $1,620/month for non-blind individuals and $2,700/month for blind individuals.
• Students can exclude up to $2,350/month in earned income, capped at $9,460 annually.
• Free or reduced-cost housing may reduce SSI payments unless rent is at least $342.33/month.

Source: SSA SSI Program [Accessed: 2025-11-06]

• You must report any changes in income, resources, or living situation to the SSA to avoid overpayments.
• Overpayments can result in repayment demands or benefit reductions.
• Report changes promptly to avoid penalties and ensure accurate payments.
• For more information, see the SSA guide on reporting changes.

Source: SSA Reporting Changes [Accessed: 2025-11-06]

• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Hours: 8:00 AM - 7:00 PM

  Website

  For questions about SSDI, SSI, and applying for benefits.
• Texas Health and Human Services Commission
  Phone: 2-1-1

  Hours: 24/7

  Website

  For questions about Medicaid, waivers, and other state programs.

• Can fibromyalgia qualify for disability benefits in Texas?

  Yes, fibromyalgia can qualify for SSDI or SSI if it is medically documented, expected to last at least 12 months, and prevents you from doing substantial work. You must provide strong medical evidence to support your claim.

• What is the SGA limit for fibromyalgia in Texas in 2025?

  The SGA limit in 2025 is $1,620 per month for non-blind individuals and $2,700 per month for blind individuals. Earning above this limit may affect your eligibility for disability benefits.

• How do I apply for disability benefits for fibromyalgia in Texas?

  You can apply online at SSA.gov, by phone at 1-800-772-1213, or in person at a local Social Security office. Be sure to provide detailed medical records and information about how fibromyalgia affects your ability to work.

• What medical evidence do I need for a fibromyalgia disability claim?

  You need medical records from your doctors, including diagnosis, treatment history, and how fibromyalgia limits your daily activities and work. Doctor’s notes and test results are also important.

• What is the difference between SSDI and SSI for fibromyalgia in Texas?

  SSDI is for disabled workers with a work history and payment of Social Security taxes. SSI is for people with limited income and resources, regardless of work history. Both programs can provide monthly payments for fibromyalgia.

• Can I work while receiving disability benefits for fibromyalgia in Texas?

  You can work during a trial work period without losing benefits. After that, your earnings must stay below the SGA limit. Work incentives allow you to earn more without immediately losing eligibility.