The extreme fatigue that chronic fatigue syndrome (CFS) causes can impair a person’s ability to do normal everyday activities. People with the condition do not feel better with rest. Rather, the pain, weakness, and range of additional physical symptoms from respiratory to bladder problems tend to persist and recur.
According to the Centers for Disease Control and Prevention (CDC), over one million Americans have CFS, a condition of unknown causes that is hard to diagnosis and harder to treat. If you have been diagnosed with CFS that is impairing your ability to work, you might be able to collect Social Security Disability (SSD) benefits. Below is an overview of how the Social Security Administration (SSA) evaluates CFS for disability. For help filing an application for benefits or for general questions about the Social Security Disability for chronic fatigue syndrome in Pittsburgh, call Berger and Green at 412-661-1400 and request a free consultation.
Does the SSA consider CFS to be disabling?
The SSA maintains a Listing of Impairments that contains all of the physical and mental conditions that the Administration considers as automatically disabling. CFS is not on the list. However, the SSA recognizes that CFS is a legitimate condition that can cause disability. In 2014, the agency released a new policy, SSR 14-1p, which helps claims examiners evaluate claimants for disability based on CFS.
In order for CFS to qualify as a medically determinable and disabling impairment, the claimant must meet the CDC’s case definition of CFS, have ample evidence from an acceptable medical source, and have such severe symptoms that he or she is unable to work.
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What kinds of symptoms does the SSA look for in applicants with CFS?
The SSA uses the CDC’s published guidelines for CFS diagnoses. “Under the CDC case definition, the hallmark of CFS is the presence of clinically evaluated, persistent or relapsing chronic fatigue that:
- Is of new or definite onset (that is, has not been lifelong);
- Cannot be explained by another physical or mental disorder;
- Is not the result of ongoing exertion;
- Is not substantially alleviated by rest; and
- Results in substantial reduction in previous levels of occupational, educational, social, or personal activities,” explains the SSA.
For your diagnosis to be valid for the purposes of disability benefits, you must have four or more of the following specific symptoms that persisted or recurred for at least the last six months and that developed after you experienced chronic fatigue:
- Malaise that lasts longer than 24 hours following any exertion
- Short-term memory or concentration impairments that affect your occupational, educational, social, or personal activities
- Sore throat
- Tender cervical or axillary lymph nodes
- Muscle pain
- Pain in multiple joints without joint swelling or redness
- A new type, pattern, or severity of headache
- Feeling unrefreshed upon waking
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What else must I prove for the SSA to consider my CFS as a disability?
The SSA only provides disability benefits for people with total disabilities that leave them unable to work. To assess whether your CFS is truly preventing you from working, the claims examiner will review your residual functional capacity, or RFC.
Using your medical records and any RFC forms that might be filled out by your doctor, the examiner will analyze how your condition affects your ability to do certain job-related activities. For instance, if your CFS causes you to need frequent breaks, prevents you from lifting objects over 20 pounds, impairs your memory, or causes other symptoms that inhibit your ability to work, your RFC will affect your ability to perform certain jobs.
If, given your limitations, age, education, and skills, the examiner decides that you are unable to do your old job and are unable to adjust to new types of work, the SSA may still grant you benefits based on what is called a medical vocational allowance.
Are there other criteria I must meet to win my disability claim?
In a nutshell, the criteria you must meet to qualify for disability benefits are:
- You must have medically determinable impairing (like CFS) that will last a year or more or result in death.
- Your condition must be so severe that you cannot work. More specifically, you cannot be capable of substantial gainful activity (SGA), which means your monthly income does not exceed a certain amount. In 2017, this threshold is set at $1,170.
- You must either A) have enough work credits on your Social Security record if you are applying for Social Security Disability Insurance benefits, or B) have limited assets and resources and very limited income if you are applying for Supplemental Security Income.
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How do I prove my disability claim based on CFS to the SSA?
Proving you are disabled due to CFS will be challenging, given the subjective nature of most of the evidence. Still, medical evidence will be your primary tool for proving your CFS disability to the SSA. You should collect all your medical and mental health records from the doctors, clinics, hospitals, treatment centers, therapists, and other providers that you have seen for your CFS and related conditions.
Lack of evidence is one of the top reasons why the SSA denies disability claims. Our team at Berger and Green can help you file your claim and get you the benefits you need.
Contact our office at 412-661-1400 for a free consultation with a CFS disability attorney in Pittsburgh today.