If you have fibromyalgia in Virginia, you may qualify for federal disability benefits like SSI and SSDI, as well as state Medicaid waivers and support programs. This guide explains eligibility, how to apply, and what benefits are available in 2025.
To qualify for federal disability benefits with fibromyalgia, your condition must be severe enough to stop you from doing substantial work for at least 12 months. The Social Security Administration (SSA) uses a five-step process to decide eligibility:
You also need enough work credits for SSDI (usually 40, with 20 in the last 10 years)[^1].
Virginia does not add extra money to SSI, so recipients get only the federal amount: $943/month for individuals and $1,415/month for couples in 2025[^2]. Fibromyalgia is not considered a developmental disability, so you won’t qualify for Virginia’s DD Waivers, but you may qualify for other Medicaid programs if you meet income and disability rules[^6].
Virginia Medicaid for Persons who are Aged, Blind, or Disabled (ABD) may help if you have fibromyalgia and meet income and asset limits. You can apply through your local Community Services Board or online at CoverVA[^6].
Some people with fibromyalgia may also qualify for state-funded support services, but these are limited and often have waiting lists. Always check with your local CSB for the latest options.
Get your medical records: Collect all doctor notes, test results, and treatment plans for fibromyalgia. The SSA needs proof that your condition is severe and long-term.
Check your work credits: For SSDI, you need 40 credits (about 10 years of work), with 20 earned in the last 10 years[^5].
Apply for SSI/SSDI: You can apply online at SSA.gov, by phone, or in person at a Social Security office. The application asks for personal info, work history, and medical details[^5].
Apply for Medicaid: If you have low income, apply for Medicaid through CoverVA or your local Community Services Board. You may qualify for ABD Medicaid if you are disabled[^6].
Check for other programs: Ask your CSB about state-funded support services or waivers. While fibromyalgia does not qualify for DD Waivers, you may get help with home care or other needs.
Report changes: If your income, health, or living situation changes, report it to SSA and Medicaid to avoid overpayments[^7].
Virginia offers ABLE accounts for people with disabilities that started before age 26. These accounts let you save money without losing SSI or Medicaid benefits. You can use the funds for housing, education, health care, and other needs. Apply online at the Virginia ABLE website[^8].
If your income, health, or living situation changes, you must report it to SSA and Medicaid. Failing to report changes can lead to overpayments and penalties. Always report changes as soon as possible to avoid problems[^7].
Contact your local Community Services Board or call the Virginia Department of Behavioral Health and Developmental Services at (804) 786-3921 for help with Medicaid and waiver applications.
Yes, fibromyalgia can qualify for SSI and SSDI if it severely limits your ability to work for at least 12 months. You must provide medical proof and meet SSA’s eligibility rules.
Virginia SSI recipients get only the federal benefit: $943/month for individuals and $1,415/month for couples in 2025. Virginia does not add extra money to SSI.
SSDI payments depend on your work history. In 2025, the maximum SSDI payment is about $3,917/month. Most people get less, based on their earnings record.
You can work, but your earnings must be below the SGA limit: $1,550/month in 2025. Some work incentives let you test your ability to work without losing benefits.
No, Virginia’s Medicaid waivers are for people with developmental disabilities. Fibromyalgia does not qualify, but you may get help through other Medicaid programs if you meet income and disability rules.
Apply for SSI/SSDI online at SSA.gov or at your local Social Security office. For Medicaid, apply online at CoverVA or through your local Community Services Board.
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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You need doctor notes, test results, and treatment plans that show your fibromyalgia is severe and long-term. The SSA will review your medical records to decide if you qualify.
Yes, you can get both if you meet the rules for each. SSI is for low income, SSDI is for people who have worked and paid Social Security taxes.
The Virginia ABLE program lets people with disabilities save money without losing SSI or Medicaid benefits. You can use the funds for housing, education, health care, and other needs.
Report changes to your income, health, or living situation as soon as possible to SSA and Medicaid. Failing to report changes can lead to overpayments and penalties.
