How is Chronic Fatigue Syndrome a Disability?

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How is Chronic Fatigue Syndrome a Disability? Chronic fatigue syndrome (CFS) may cause mental and physical exhaustion frequently over long periods of time.  Your fatigue may likely interfere with your daily activities.  Often, it can result in impaired cognitive functions.   If your chronic fatigue syndrome keeps you from working, you may qualify for Social Security disability benefits (SSDI). 

Chronic fatigue syndrome and Social Security disability

Social Security disability considers chronic fatigue syndrome a significant impairment.  However, you must meet certain requirements to receive SSDI benefits.  Generally, Social Security requires any disabling condition interfere with your normal daily activities.  Additionally, your symptoms must keep you from working for at least 12 months.  For SSDI, you must have worked a certain amount of years recently. 

Social Security defines chronic fatigue syndrome

Social Security relies, in part, on the Center for Disease Control’s (CDC) definition to evaluate CFS.  The CDC defines chronic fatigue syndrome as persistent fatigue that has a definite date of onset.  There is no other mental or physical cause. Rest or sleep doesn’t improve the fatigue.  Lastly, the fatigue significantly interferes with work, school, social, or personal activities.  The diagnosis also requires at least four of the following symptoms for at least six months:

  • A general feeling of being unwell that lasts at least 24 hours following a period of exertion
  • Memory or concentration problems that cause a significant reduction in your activities
  • Frequent sore throats
  • Tender lymph nodes in the neck or under the arm
  • Muscle pain
  • Joint pain in different areas without swelling or redness
  • Headaches of a new type, pattern or severity
  • Waking up unrefreshed

How does Social Security evaluate chronic fatigue syndrome?

Social Security Ruling 14-1p provides certain requirements to evaluate chronic fatigue syndrome.  First, Social Security must establish your chronic fatigue syndrome as a “medically determinable impairment” (MDI).  Social Security makes a finding that a condition is an MDI when there is objective medical evidence including medical signs and/or laboratory findings. 

Establishing chronic fatigue as a medical determinable impairment

First, you must provide evidence from an acceptable medical source.  This includes a licensed physician such as a medical or osteopathic doctor.  Second, you must show that your doctor reviewed your medical history.  They must also perform a physical exam.  Sometimes, your doctor may make a diagnosis on reported symptoms.  However, Social Security requires medical signs and laboratory findings to support the diagnosis.  Additionally, there can’t be another medical condition causing the fatigue. 

What medical signs does Social Security require?

Social Security will look for specific medical signs that document your chronic fatigue syndrome.  These signs must be documented over at least 6 consecutive months.  The medical signs include:

  • Palpably swollen or tender lymph nodes
  • Nonexudative pharyngitis
  • Persistent muscle tenderness and/or positive tender points
  • Positive Epstein-Barr virus
  • Abnormal tests such as an MRI, exercise stress test and/or sleep studies
  • Other medical signs such as frequent viral infections, sinusitis, ataxia, extreme pallor and significant weight changes

How does Social Security determine if I am disabled due to my chronic fatigue syndrome?

Social Security evaluates any physical or mental limitations caused by your chronic fatigue syndrome.  This helps determine your residual functional capacity (RFC).  Your RFC is what you can do despite your medical conditions.  Your doctor can also fill out an RFC form.  They can explain specifically how your symptoms impact your functioning. 

Documenting your chronic fatigue symptoms

Your medical records should include all laboratory testing your doctors ordered.  Your doctor should note any other medical conditions considered and ruled out for a cause of your symptoms during each visit.  This should also include all positive objective findings.  Thus you doctor should note any tender points.  They should also document symptoms such as problems with memory, attention or concentration. 

Example 1:  documenting your chronic fatigue symptoms

Janet’s doctor diagnosed her with chronic fatigue syndrome.  Her doctor ordered blood work that showed positive Epstein-Barr virus.  He tested for other conditions but nothing explained her chronic fatigue.  Janet’s medical records consistently documented her tender points and muscle pain.  Her doctor also noted that she became very tired after doing even small tasks at home.  Social Security evaluated Janet’s records.  They determined that her chronic fatigue syndrome kept her from working.

Chronic fatigue syndrome and RFC forms

Your doctor can fill out an RFC form to help explain how your symptoms impact your daily activities.  Your doctor may note physical limitations.  As an illustration, your doctor may state that you can’t lift more than 10 pounds,have trouble standing and walking. You were limited to 2 hours in an 8 hour day.  Your doctor should also note any mental limitations, may state that you would have difficulty concentrating during a work day.  They may also note that you would frequently miss work.  Although these forms are well-supported by your medical records, they can help get your claim approved. 

Example 2:  how an RFC form can be helpful

Susan has been diagnosed with chronic fatigue syndrome.  Her medical records support her diagnosis.  Susan’s doctor completed an RFC form.  Specifically, She noted that Susan had difficulty sitting or standing for long periods.  She also could not lift or carry more than 10 pounds.  Additionally, Susan’s doctor reported that her symptoms would cause Susan to miss work frequently.  Social Security found that Susan was unable to work.  Consequently, they approved her claim. 

Disability Help Group winning case study

Justin’s doctor diagnosed him with chronic fatigue syndrome.  He could no longer work.  Justin needed to file for Social Security disability.  Justin contacted Disability Help Group.  Justin’s advocate helped explain what he needed to win his case.  Justin was able to speak with his doctors about properly documenting his signs and symptoms.  His doctors made sure to include all of his positive findings in each office visit note.  Social Security was able to fully evaluate Justin’s chronic fatigue syndrome.  As a result, Disability Help Group helped Justin win his disability benefits. 

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How Can I Get TDIU?

How Can I Get TDIU?

Many veterans are unable to earn a living because of service-connected disabilities. Congress created a special benefit called TDIU to help these veterans live comfortably. Also known as Unemployability. TDIU pays the same monthly amount as a 100% disability rating.