Case Law Update: Hart v. Commissioner - Court Reverses SSDI Denial Over Missing Fibromyalgia Tender Points

What happened

On September 21, 2026, a United States magistrate judge in the Middle District of Florida reversed the Commissioner of Social Security and sent a disability insurance benefits claim back to the agency in Kari Hart v. Frank Bisignano, Commissioner of Social Security, No. 6:25-cv-997-JRK (Orlando Division). The Opinion and Order holds that the administrative law judge faulted the claimant for not having 11 documented tender points “as required” by Social Security Ruling 12-2p — even though the same ALJ had already found fibromyalgia to be a severe impairment at step two. A sentence-four remand under 42 U.S.C. § 405(g) is not an award of benefits; the claim returns to the agency for a second look.

How the claim reached federal court

The claimant protectively filed for disability insurance benefits on April 25, 2023, alleging she could not work because of depression, migraines, back, neck and hip injuries, anxiety, fibromyalgia, severe constipation, and weight loss. The alleged onset date was later amended to July 15, 2022. The agency denied the application initially and on reconsideration.

An ALJ held a telephone hearing on November 12, 2024, with the claimant represented by counsel and a vocational expert testifying, and on March 10, 2025 found her not disabled. The Appeals Council denied review on April 7, 2025, making that decision the Commissioner’s final decision, and she filed her federal complaint on June 6, 2025.

At step two the ALJ listed fibromyalgia among the severe impairments, alongside spine disorders, bilateral hip pain, headache, rectal prolapse, and anxiety and depressive disorders. The residual functional capacity was a wide range of light work with postural, environmental, and mental restrictions. At step four the ALJ found she could not return to her past work as a nursing case manager or medical nursing auditor, and at step five relied on the vocational expert to identify other jobs.

Why the court sent it back

The order sets out the two routes SSR 12-2p gives for establishing fibromyalgia as a medically determinable impairment. The first requires a history of widespread pain, at least 11 positive tender points on examination, and evidence excluding other disorders. The second requires a history of widespread pain; repeated manifestations of six or more fibromyalgia symptoms, signs, or co-occurring conditions — “especially manifestations of fatigue, cognitive or memory problems (‘fibro fog’), waking unrefreshed, depression, anxiety disorder, or irritable bowel syndrome” — and evidence excluding other disorders. The ruling also directs that for a person with fibromyalgia the agency “will consider a longitudinal record whenever possible because the symptoms of [fibromyalgia] can wax and wane so that a person may have ‘good days and bad days.’”

The ALJ’s decision went the other way. It emphasized that “the record certainly does not show physical examinations revealing any ongoing point tenderness, let alone at 11 or more tender points as required per The 1990 American College of Rheumatology Criteria for the Classification of Fibromyalgia (SSR 12-2p),” and catalogued normal findings — no acute distress, normal range of motion, intact motor function, unremarkable gait.

The court found three problems. First, the ALJ “conflates Plaintiff’s fibromyalgia with other impairments” while leaning on a lack of objective evidence. Second, the ALJ “does not at all discuss the treatment modalities for fibromyalgia,” discussing acupuncture, physical therapy, Flexeril, and ibuprofen for other impairments while the record showed duloxetine prescribed for fibromyalgia and trazodone added after complaints of fatigue.

Third, the reliance on missing tender points “is in error for multiple reasons: it is factually incorrect” — the record did document tender points — and “the presence of tender points or lack thereof is not part of the inquiry once fibromyalgia has been established as a medically determinable impairment (which the ALJ did by making the severe finding at step two).” Tender points are also not the only way to establish the impairment, given the second pathway in the ruling.

The conclusion: “judicial review is frustrated because the Court cannot be sure the ALJ considered the relevant evidence pertaining to Plaintiff’s fibromyalgia and actually applied the directives of SSR 12-2p.” Because that reconsideration may affect the rest of the analysis, the court did not reach the claimant’s remaining arguments about an assistive device and her digestive disorders. The remand instructions direct the ALJ to reconsider the effects of fibromyalgia consistent with SSR 12-2p and to address the other arguments if necessary.

What this means if you have an SSDI claim involving fibromyalgia

This is one district court order on one record and does not decide anyone else’s claim. A few points are worth knowing.

The 11-tender-point criterion is one of two routes into a fibromyalgia finding, not a standing requirement the condition keeps having to meet. Once an ALJ has found fibromyalgia to be a medically determinable impairment, the analysis moves to symptoms and function, and a decision that keeps returning to tender points after that step may be applying the wrong test.

Normal examination findings are also a weak answer to fibromyalgia. Normal gait, full range of motion, and intact strength are findings fibromyalgia patients often have, which is why SSR 12-2p tells the agency to look at daily activities, medications and other treatments, the frequency of attempts to get treatment, and statements from other people when objective evidence does not substantiate the reported symptoms.

It also matters that the file shows which treatments were aimed at which condition. Records connecting a drug or therapy to the fibromyalgia diagnosis, and treatment notes spread across time rather than a single snapshot, are what the longitudinal-record instruction is asking for.

Finally, a sentence-four remand is a second look by the agency, not a ruling that benefits are owed.

If your Social Security disability claim has been denied, our Social Security disability guide explains how the appeals process works, and you can request a free case evaluation. More rulings are on our case law updates page.

Case cited: Hart v. Commissioner of Social Security, No. 6:25-cv-997-JRK (M.D. Fla.), Doc. 14, dated Sept. 21, 2026. Current as of September 23, 2026.