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Utah • Chronic Illness
People with fibromyalgia in Utah may qualify for federal and state disability benefits, including SSDI, SSI, Medicaid waivers, and work incentives. Eligibility depends on medical evidence, income, and work history. This guide covers how to apply, what benefits are available, and how to avoid overpayments.
To qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) with fibromyalgia, you must prove your condition prevents you from working for at least 12 months. SSDI requires a work history and payment of Social Security taxes. SSI is for those with limited income and resources, regardless of work history.
The Social Security Administration (SSA) uses a strict definition of disability. You must show your fibromyalgia symptoms are severe enough to stop you from doing any substantial work. Medical records, doctor statements, and functional limitations are key. The SSA reviews your ability to do past work and any other jobs.
In 2025, the Substantial Gainful Activity (SGA) limit is $1,620 per month for non-blind individuals and $2,700 for those who are statutorily blind. Earning above this limit may affect your benefits. The SSA also considers your income, resources, and living situation for SSI eligibility.
Source: SSA.gov, 2025 SGA limits and eligibility rules (accessed 2025-11-06)
In Utah, people with fibromyalgia may qualify for additional state programs and Medicaid waivers. The Utah Division of Services for People with Disabilities (DSPD) offers Home and Community-Based Services (HCBS) waivers for those who need support to live independently. These waivers can cover personal care, respite, and other services.
Utah also participates in the Medicaid Buy-In program, which allows people with disabilities to work and keep Medicaid coverage even if their income is above normal limits. To qualify, you must have a qualifying disability and meet income and resource rules.
Utah’s SGA limit for 2025 is $1,620 per month for non-blind individuals and $2,700 for those who are statutorily blind. This is the same as the federal limit. Earning above SGA may affect your SSDI/SSI benefits, but Utah offers work incentives and support services to help you stay employed.
Source: Utah Division of Services for People with Disabilities (accessed 2025-11-06), Utah Medicaid Buy-In (accessed 2025-11-06)
Source: SSA.gov, How to Apply for Disability (accessed 2025-11-06), Utah DSPD Waiver Application (accessed 2025-11-06)
Source: SSA.gov, Medicaid.gov, Medicare.gov (accessed 2025-11-06)
[Source: Utah DSPD, Utah Medicaid, Utah ABLE](https://dsdp.utah.gov/, https://medicaid.utah.gov/, https://jobs.utah.gov/) (accessed 2025-11-06)
Utah ABLE accounts allow people with disabilities to save up to $19,000 per year (or $34,650 if your employer doesn’t contribute to your retirement account) in 2025. Funds can be used for disability-related expenses without affecting SSI or Medicaid eligibility. Accounts are tax-advantaged and can be opened online.
Source: Utah ABLE (accessed 2025-11-06)
In 2025, the SSI income limit is $943/month for an individual and $1,415/month for a couple. Resources must be under $2,000 for an individual and $3,000 for a couple. The Substantial Gainful Activity (SGA) limit is $1,620/month for non-blind individuals and $2,700/month for those who are statutorily blind. Earning above SGA may affect SSDI/SSI benefits.
[Source: SSA.gov, Utah Medicaid](https://www.ssa.gov/benefits/disability/qualify.html, https://medicaid.utah.gov/) (accessed 2025-11-06)
You must report any changes in income, work, or health to the SSA and Medicaid. This helps avoid overpayments and keeps your benefits active. If you receive an overpayment, you may have to repay it. You can request a waiver if the overpayment was not your fault. Report changes online, by phone, or in person.
[Source: SSA.gov, Utah Medicaid](https://www.ssa.gov/disability/eligibility/reporting-changes.html, https://medicaid.utah.gov/) (accessed 2025-11-06)
Contact Utah DSPD or a local disability advocate for help with your application. They can guide you through the process and answer your questions.
Yes, fibromyalgia can qualify for SSDI or SSI if it prevents you from working for at least 12 months. You must provide medical evidence and meet SSA’s disability definition.
The SGA limit in 2025 is $1,620 per month for non-blind individuals and $2,700 for those who are statutorily blind. Earning above this may affect your benefits.
Contact Utah DSPD or Medicaid to apply for Medicaid waivers. You may need to complete a separate application and provide medical and financial documentation.
Yes, Utah offers work incentives and Medicaid Buy-In programs. You can earn some income without losing benefits, but there are limits.
An ABLE account is a tax-advantaged savings account for disability-related expenses. In Utah, you can save up to $19,000 per year in 2025 without affecting SSI or Medicaid.
Yes, you must report any changes in income, work, or health to the SSA and Medicaid. This helps avoid overpayments and keeps your benefits active.
Disclaimer: This guide is for informational purposes only. Always check with official agencies for the most current rules and eligibility.
If you earn more than the SGA limit, your SSDI/SSI benefits may be suspended or terminated. You may be able to restart benefits if your earnings drop below SGA.
Children with fibromyalgia may qualify for SSI if they meet the disability and income rules. Benefits usually stop at age 18 unless the child has a qualifying disability.
SSDI is for those who worked and paid Social Security taxes. SSI is for those with limited income and resources, regardless of work history.
It can take 3–6 months to get a decision on your disability application. If denied, you can appeal within 60 days.
