For many with chronic fatigue syndrome, their symptoms prevent them from working. Fortunately, it is possible to get disability benefits for CFS.
Our firm’s disability lawyers in Arizona explain getting disability benefits for chronic fatigue syndrome.
Getting Disability Benefits for Chronic Fatigue Syndrome
You can get disability benefits for chronic fatigue syndrome if your symptoms prevent you from working for 12 months or more. While there is no specific listing for chronic fatigue syndrome, it is a medically determinable impairment that may qualify a person for SSDI benefits.
Does chronic fatigue syndrome qualify for disability?
Chronic fatigue syndrome may qualify someone for disability if their symptoms prevent them from working. Having CFS alone doesn’t make a person qualified. Rather, if the impact of the medical condition prevents the person from engaging in substantial, gainful employment, and the condition is expected to last for one year or more, a person with chronic fatigue may receive disability benefits.
Understanding chronic fatigue
The CDC estimates that as many as 2.5 million Americans have chronic fatigue syndrome. Myalgic encephalomyelitis (ME) and systemic exertional intolerance disease (SEID) are other names for chronic fatigue syndrome. It is a complex disorder causing exhaustion, cognitive difficulties, pain, sensitivity, and unrefreshing sleep.
CFS is not:
- Lifelong – it onsets at some point
- Symptomatic of a different medical condition
- The result of exertion
- Improved with rest
CFS reduces a person’s activity levels, including occupationally, educationally, socially, or personally. The cause is unknown.
SSDI for Chronic Fatigue Syndrome
Because the symptoms vary so much, simply having CFS is not enough to qualify for Social Security Disability benefits. Some people with CFS can work, but many can’t. Social Security first looks at whether the applicant has CFS. Then, it evaluates the impact of the condition on the person’s functional capacity in the workplace.
Qualifying for disability for chronic fatigue syndrome depends on how the medical condition impairs the person’s ability to work. SSDI for chronic fatigue is based on a medically determinable impairment that prevents someone from working.
20 C.F.R. § 404.1505 defines a disability for SSDI purposes. It’s different from the dictionary definition of a disability, as it focuses on the person’s ability to work. To be disabled for SSDI, a person must have:
- A physical or mental impairment
- That is medically determinable
- That can be expected to result in death or last for at least 12 months
- No ability to do their past work
- No ability for substantial gainful work that exists in the national economy
Is chronic fatigue a medically determinable impairment for SSDI purposes?
Yes. A medically determinable impairment results from anatomical, physiological, or psychological abnormalities. It must be established with medical evidence and able to be verified by clinical and laboratory diagnostic techniques.
A statement of symptoms is not enough. A medically determinable impairment can be verified with medical evidence. (DI 25205.005).
Does chronic fatigue have a Blue Book listing for SSDI?
No specific SSDI Blue Book is listed for chronic fatigue. A person can’t qualify for disability by showing that their medical condition equals a listing. However, it’s possible to qualify for SSDI by showing that residual functional capacity prevents employment. The residual functional capacity is the remaining ability to work despite limitations. (20 § 404.1520).
What medical evidence can be used to prove CFS for SSDI?
Evidence to prove CFS for an SSDI application must come from a licensed physician. However, their diagnosis alone is insufficient. The physician must rule out other causes and identify signs or make laboratory findings.
Medical signs may include:
- Lymph node abnormalities
- Nonexudative pharyngitis (throat inflammation without mucus)
- Muscle tenderness
- Inflammatory events, like viral infections with prolonged recovery, sinusitis, ataxia, pallor, and weight change
- Elevated antibody titer to Epstein-Barr virus (EBV) capsid antigen
- Abnormal M.R.I. scan, exercise stress test, or sleep study
- Neurally mediated hypotension (fainting from standing)
- Other laboratory findings
- Mental limitations like memory, information processing, speech, calculation, and other deficits
Examiners may evaluate treatment records, psychological evaluations, and non-medical sources like personal testimony. Family members, neighbors, friends, employers, and coworkers may speak to the applicant’s day-to-day function.
How do you make an application for SSDI based on chronic fatigue successful?
To make an SSDI application based on chronic fatigue successful, it’s essential to present detailed medical evidence of the type that examiners are looking to see. Healthcare professionals may state conclusively that the applicant is “disabled” or “unable to work.” However, it is the Social Security examiner who decides. They don’t give deference to a conclusive opinion, even when it comes from the person’s healthcare provider.
The applicant needs to present medical tests and observations verifying their condition and explaining its impact on their ability to work. If an examiner believes there is conflicting or insufficient evidence, they may ask for more information.
SSDI Guidance for Chronic Fatigue Syndrome
SSR 14-1p: Titles II and XVI: Evaluating Cases Involving Chronic Fatigue Syndrome (CFS) guides how Social Security examiners evaluate applications for CFS.
Can you get help from a lawyer?
When a person has chronic fatigue syndrome, getting the benefits they deserve is critical to their financial and personal well-being. At Pekas Smith Disability Attorneys, our lawyers understand the process for applying for SSDI benefits. We know what medical evidence application examiners need to see and how to prepare your submission.
We offer full-service representation to people applying for SSDI benefits based on chronic fatigue syndrome. Our lawyers lead a talented team of experienced and dedicated professionals. Let our team help you get the benefits you deserve.
Talk to a Lawyer About Chronic Fatigue Syndrome SSDI Benefits
If you are wondering if you qualify for SSDI for chronic fatigue syndrome or if you are looking for legal representation, we invite you to talk to a lawyer. See what you can do to claim your benefits and how our lawyers can help. We can assist you at any stage in the application process, even if you have previously been denied.