Common Symptoms Of Chronic Fatigue Syndrome
Symptoms of CFS include thinking and memory issues, orthostatic intolerance such as dizziness, weakness, fainting when upright, and much more.
- Fatigue not relieved by sleep or bed rest which was not always present throughout life
- Worsening of symptoms after activities. These are sometimes referred to as a crash, relapse, or collapse, and some patients can tell when they will happen.
- Problems with sleep which include not being rested after sleep or difficulty staying and/or falling asleep.
For a true diagnosis of CFS the patient must also have one of the two following symptoms:
There are other symptoms that some but not all experience:
- Muscle aches and muscle pains.
- Joint pain without swelling or redness.
- Digestion issues like IBS .
- Chills and night sweats as well as low-grade fevers.
- Tender lymph nodes usually in the neck and underarms.
- Headaches which are new or have become worse.
- Allergies or sensitivities to foods, odors, chemicals, or noise.
Ii How Does A Person Establish An Mdi Of Cfs
A person can establish that he or she has an MDI of CFSby providing appropriate evidence from an acceptablemedical source. A licensed physician is the only acceptable medical sourcewho can provide such evidence. We cannot rely upon thephysician’s diagnosis alone. The evidence must documentthat the physician reviewed the person’s medical historyand conducted a physical exam. We will review thephysician’s treatment notes to see if they are consistentwith the diagnosis of CFS determine whether the person’ssymptoms have improved, worsened, or remained stable andestablish the physician’s assessment of the person’sphysical strength and functional abilities.
We will find that a person has an MDI of CFS if alicensed physician diagnosed CFS, and this diagnosis is notinconsistent with the other evidence in the person’s caserecord. Under the CDC case definition, a physician can makethe diagnosis of CFS based on a person’s reported symptomsalone after ruling out other possible causes for theperson’s symptoms. However, as mentioned, statutory andregulatory provisions require that, for evaluation ofclaims of disability under the Act, there must also bemedical signs or laboratory findings before we may findthat a person has an MDI of CFS. If we cannot find that theperson has an MDI of CFS but there is evidence of anotherMDI, we will not evaluate the impairment under this SSR.Instead, we will evaluate it under the rules that apply forthat impairment.
Nonexudative pharyngitis
Residual Functional Capacity Assessment For Chronic Fatigue Syndrome
What Is RFC?
If your chronic fatigue is not severe enough for you to be considered disabled at Step 3 of the Sequential Evaluation Process, the Social Security Administration will need to determine your residual functional capacity to decide whether you are disabled at Step 4 and Step 5 of the Sequential Evaluation Process.
RFC is a claimants ability to perform work-related activities. In other words, it is what you can still do despite your limitations. An RFC for physical impairments is expressed in terms of whether the Social Security Administration believes you can do heavy, medium, light, or sedentary workin spite of your impairments. An RFC for mental impairments is expressed in terms of whether Social Security Administration believes the claimant can do skilled, semi-skilled, or unskilled work in spite of impairments, or whether the claimant cannot even do unskilled work.The lower your RFC, the less the Social Security Administration believes you can do.
RFC and Chronic Fatigue Syndrome
If you have chronic fatigue syndrome, you may have significant residual limitations that could potentially result in allowance of your claim.
In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function. Symptoms of chronic fatigue that the adjudicator should consider include those mentioned in the Center for Disease Controls definition of CFS:
- Mental problems .
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How To Develop The Medical Evidence In A Cfs Case
Gathering the proper medical evidence is essential to prove a disability claim based on CFS. First, you should submit to Social Security all medical records relevant to your condition, including doctor’s clinic notes, the results of x-rays, MRIs, and other testing, and the records from any hospitalizations. If you suffer from other mental or physical conditions in addition to CFS, provide records of those impairments as well.
Next, it’s critical that you ask your treating primary care physician or specialist for an opinion about your work-related limitations. Your doctor can write a letter or fill out an RFC form that addresses your physical and mental limitations in the following areas:
- lifting, carrying, pushing, and pulling
- standing, sitting, and walking
- maintaining concentration for extended periods
- maintaining adequate attendance and punctuality, and
- understanding, remembering, and carrying out simple and complex instructions.
A good supporting opinion from a treating doctor listing deficits in these areas can quickly turn a losing disability case into a winning one.
Some lawyers also recommend that their clients keep a daily log of the nature and severity or their symptoms, and submit a copy to Social Security prior to the hearing. Statements from third parties, including family members, neighbors, or former co-workers, can also prove helpful in documenting the extent of your impairments.
But It Shouldnt Stop You From Describing These Factors In As Much Relevant Detail As Possible
- The ME Association Guide to Reconsideration and Appeals for ESA and PIP provides information about the options you have and tips on making the most of your appeal
To end on a positive note, the ME Association and I are currently taking cases forward to Parliament that have not been assessed correctly, either by the DWP or at tribunal, to demonstrate that this is a common failure of the assessment process across the board, not just a few isolated incidents in certain localities.
I hope this blog will help you to put your condition across in a way that will get you the rate of benefits to which you are entitled, and we wish you all the best of luck with your application or renewal.
- Anns Top Tips are now .
Privacy Overview
Cumulative Cost to Jan 31, 2022: $1.3B
% of Population with Long Covid: 7.7%
% of Population with Disabling Long Covid: 2.6%
# of Individuals with Long Covid: 73,000
# of Individuals with Disabling Long Covid: 24,000
Cumulative Cost to Jan 31, 2022: $9.8B
% of Population with Long Covid: 8%
% of Population with Disabling Long Covid: 2.7%
# of Individuals with Long Covid: 554,000
# of Individuals with Disabling Long Covid: 184,000
Cumulative Cost to Jan 31, 2022: $2B
% of Population with Long Covid: 6.7%
% of Population with Disabling Long Covid: 2.2%
# of Individuals with Long Covid: 113,000
# of Individuals with Disabling Long Covid: 37,500
Cumulative Cost to Jan 31, 2022: $43B
% of Population with Long Covid: 6.3%
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V How Do We Find A Person Disabled Based On An Mdi Of Cfs
Once we establish that a person has an MDI of CFS, we willconsider this MDI in the sequential evaluation process todetermine whether the person is disabled. As we explain insection VI below, we consider the severity of theimpairment, whether the impairment medically equals therequirements of a listed impairment, and whether theimpairment prevents the person from doing his or her pastrelevant work or other work that exists in significantnumbers in the national economy.
Chronic Fatigue Syndrome Va Disability Ratings
When you apply for VA disability benefits for chronic fatigue syndrome, your symptoms will be given a rating. That rating will decide how much money you get each month from the VA for your disability.
| Symptoms of Chronic Fatigue Syndrome | VA Rating and Monthly Compensation |
|---|---|
| Nearly constant symptoms and so severe that you cant do routine daily activities. You cant even take care of yourself, your health needs, or your social needs. | 100% Rating$3,332.06 per month |
| If the symptoms reduce your daily activities to less than 50% of what they were before you were sick. This level also has symptoms come and go but wipe you out at least 6 weeks out of the year total. | 60% Rating$1,214.03 per month |
| Nearly constant but only restrict your daily routine to 50%-75% of what it was before. If you total about 4 weeks per year of being down, you are in this category. | 40% Rating$673.28 per month |
| If you are down for 2-4 weeks out of a whole year and your daily activities are only about a fourth of what they used to be, youre in this Chronic Fatigue Syndrome Disability rating. | 20% Rating$301.74 per month |
| If your symptoms come and go but can mostly be controlled by continuous medications and youre only down for a total of a couple of weeks out of the year, you are at this level. | 10% Rating$152.64 per month |
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Inability To Work Due To Chronic Fatigue Syndrome
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis can be extremely disabling. However, your insurance company may not understand the nature and severity of your symptoms or the impact they have on your job. To increase your chances of approval, you can explain how and why each of your symptoms prevent you from performing your job duties.
For example, your fatigue, exhaustion, and general malaise may make it impossible for you to carry out your activities of daily living let alone your work-related tasks. You may not have enough energy to stay awake or alert during an important meeting, or you may have difficulty completing a normal 8-hour workday without excessive breaks.
Your cognitive deficits also may make it very difficult to concentrate or focus on conversations with co-workers or on preparing that important memorandum within a strict deadline. Your inability to quickly process information may prevent you from understanding complex matters and cause you to work at a slower, unsatisfactory pace.
Medically Documenting A Social Security Disability Claim
It is especially important to ask patients, including children and adolescents about orthostatic symptoms. At a minimum blood pressure and pulse should be documented lying down, sitting, immediately after standing, and then after remaining upright without moving for 2 to 5 min. Patients with orthostatic symptoms and/or substantial declines in blood pressure and/or tachycardia should be considered for specialty referral.
Physicians should also note symptoms or other effects of ME/CFS including: persistent or relapsing fatigue resulting in reduction or impairment in the ability to carry out daily or work-related activities post exertional malaise waking unrefreshed disturbed sleep patterns cognitive impairments persistent muscle pain, tenderness, stiffness, or weakness, multi-joint pain without swelling or redness headaches of a new type, pattern or severity frequent or re-occurring sore throats cardiovascular abnormalities such as palpitations gastrointestinal discomfort such as nausea, bloating, or abdominal pain respiratory difficulties such as labored breathing or sudden breathlessness urinary or bladder problems such as urinary frequency, nocturia, dysuria or pain in the bladder region or visual difficulties such as difficulty with focus, impaired depth perception or severe photosensitivity6.
Children and adolescents can be diagnosed with ME/CFS if they suffer from the following symptoms:
severe disabling fatigue that lasts for at least 3 months
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Things That May Count Legally That You Wont Be Asked About
Two things that I never see assessors ask about during a PIP assessment are prescribed home therapies that you might need assistance with or whether you use any aids to drink.
For example, pacing is a prescribed home therapy for M.E. which many people need support with, such as prompting to take regular rests.
Explain how much support you need with your therapies as you will be scored points according to the length of time that support takes throughout the week.
With drinking, I see many people with Severe M.E. that have to use a straw as they feel too weak to pick up a glass.
I also see people whose coordination is affected, and they have to use special mugs with lids on so that if they drop a drink, they wont spill the contents.
Unfortunately, the reality is that while many of these kind of things should be considered, they rarely, if ever, are.
I never see variability interpreted correctly, nor people with M.E. scoring points for cognitive tasks or needing help with pacing, for example.
This is in part due to the stigma and/or ignorance still surrounding the condition and the guidance that assessors are given by the DWP.
What’s A Medically Determinable Impairment
One or more of the following medical signs, clinically documented for no less than six consecutive months, will generally be considered evidence that CFS is a medically determinable impairment:
- tender or swollen lymph nodes on exam
- nonexudative pharyngitis
- chronic and reproducible muscle tenderness over multiple exams, with positive tender points
- positive mental status exam findings, and/or
- any other indicators of CFS that are medically accepted and consistent with the evidence in your case.
Although the ruling notes the absence of any definitive lab testing for CFS, it provides that any of the following laboratory findings will establish the presence of a MDI:
- elevated antibody titers to Epstein-Barr virus
- abnormal MRI brain scan
- tilt table testing showing neurally mediated hypotension, and/or
- results of psychological testing.
Under Social Security Ruling 14-1p, medical evidence of CFS must come from a licensed medical or osteopathic doctor. However, your doctor’s diagnosis of CFS will not, by itself, prove the existence of a medically determinable impairment. The clinic notes must show that your physician reviewed your medical history and performed a physical exam. If your doctor’s records aren’t consistent with a diagnosis of CFS, Social Security may decide you don’t suffer from a MDI.
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Does Chronic Fatigue Make You Feel Incapacitated
Sometimes associated with myalgic encephalomyelitis, chronic fatigue symptoms usually show up the day after a lot of exertion or concentration. Beyond aches and pains that come from getting old, ME/CFS is the next level of weakness, pain, and inability to go about your regular daily activities. While you might feel incapacitated, the VA only considers you incapacitated if you require bed rest and treatment from a doctor. If you just cant get out of bed they may not consider you incapacitated. When you fill out your claim for chronic fatigue syndrome VA disability benefits, make sure you document the days you were stuck in bed. Keep a list of the days that you called the doctor if you can, and be prepared to list it all out when you go for your C& P Exam.
Achy joints, exhaustion, and other flu-like symptoms are some of the core symptoms of Chronic Fatigue Syndrome. Veterans with written documentation of the days when the symptoms hit will have a stronger case. Getting disability benefits for chronic fatigue syndrome is harder than getting the diagnosis, so mark down every incapacitated day on your calendar as soon as you can.
Conflict Of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The handling Editor declared a shared affiliation at the time of review, though no other collaboration, with one of the authors RP.
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Additional Testing Can Help Support Your Claim
Beyond your regular office visits with your treating doctor, there are additional testing options that can substantiate your Chronic Fatigue Syndrome diagnosis and symptoms. Additional testing can include:
- Neuropsychological testing can document your cognitive deficits due to CFS
- Cardiopulmonary exercise testing measures post-exertional malaise and can objectively determine your capacity for activities and work
- A Functional Capacity Evaluation tests your ability to push, pull, sit, stand, and other physical functions necessary to your occupation. When fatigue is significant, these evaluations can be especially useful in proving how your symptoms affect your ability to work.
What Causes Chronic Fatigue
The cause of Chronic Fatigue Syndrome is unknown however, there are a few theories as to what may cause this condition. Some people have developed CFS after having a viral infection like Epstein Barr virus, Herpes virus 6, and mouse leukemia virus, but there has been no conclusive evidence. Most people with CFS seem to have an impaired immune system which is thought to possibly be the cause of having CFS. Another theory is a hormonal imbalance because elevated hormones are seen in the blood work of those who have CFS, but the importance of this is unknown as well. Even without a definitive cause of the disorder there are noted risk factors including being between the ages of 40-50, difficulty managing stress, and women are more commonly diagnosed .
Living with Chronic Fatigue Syndrome can have a huge impact on a persons life and those around them. Simple tasks that we take for granted every day may cause great exhaustion for those with CFS. This disorder can also lead to more complications like depression, social isolation, lifestyle restrictions, and an increase in absences from work/school.
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Your Diagnosis Is Key
The first step in filing a Chronic Fatigue Syndrome long term disability claim is to secure a diagnosis with your treating doctor. Your insurance company will require proof of your diagnosis in order to approve your claim.
The problem with Chronic Fatigue Syndrome is that there is no single test that can confirm a diagnosis. Therefore, it is often difficult to objectively verify its symptoms.
When applying for disability, it can be helpful to prove the Chronic Fatigue Syndrome diagnosis using the criteria established by the Institute of Medicine of the National Academies, which requires:
- At least a 6-month history of a substantial reduction/impairment in the ability to engage in pre-illness levels of activities accompanied by profound fatigue of new or definite onset that is not the result of ongoing excessive exertion and that is not substantially alleviated by rest AND
- Post-exertional malaise AND
- Cognitive impairment OR orthostatic intolerance.
