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.
Ethics Approval And Consent To Participate
The study protocol was approved by the Ethical Committee at Vall dHebron University Hospital, Barcelona, Spain . Before enrollment, all participants received a brief explanation of the aims, risks and benefits of the study and were informed that they could terminate the interviews at any time. The local Institutional Review Board approved the form of consent indicated by completing the survey. All participants gave their informed consent forms prior to enrollment. The work was carried out in accordance with the Code of Ethics of the World Medical Association for experimental studies involving humans.
Advances In Understanding The Pathophysiology Of Me/cfs
For a long time, many doctors have thought that there is nothing wrong in ME/CFS because routine testing does not reveal any abnormalities. However, over the past 35 years, thousands of studies using more advanced tests have documented underlying biological abnormalities involving many organ systems in patients with ME/CFS, as noted by Komaroff in a recent overview . These abnormalities include metabolic changes, immunological abnormalities in lymphocytesespecially in T cells and poorly functioning natural killer cellsand significant elevation of many blood cytokines especially in the first three years of illness which are correlated with the severity of the illness. These studies have also shown widespread neuroinflammation of the brain and cognitive impairments not explained by concomitant psychiatric disorders. Multiple studies demonstrate that during exercise the tissues of patients with ME/CFS have difficulty extracting oxygen leading to impairment of cellular energy production. This impairment is much more prominent during a second exercise tests repeated 24 h after the first . Due to all these abnormalities, the American National Academy of Medicine , formerly called the Institute of Medicine , concluded in 2015 that ME/CFS is a chronic and disabling multisystem disease and not a psychiatric or psychosomatic one . The Dutch Health Council came to the same conclusion in 2018 .
Also Check: What Medical Condition Causes Extreme Fatigue
Psychological Issues And Fatigue
Studies suggest that between 50 and 80 per cent of fatigue cases are mainly due to psychological factors. Suggestions include:
- Talk about it Theres some evidence that talking therapies such as counselling or cognitive behavioural therapy might help to fight fatigue. See your doctor for a referral for talking treatment.
- Reduce stress Stress uses up a lot of energy. Try to introduce relaxing activities into your day. This could be working out at the gym, or a gentler option such as meditation, yoga, listening to music, reading or spending time with friends. Whatever relaxes you will improve your energy.
- Assess your lifestyle for example, are you putting yourself under unnecessary stress? Are there ongoing problems in your life that may be causing prolonged anxiety or depression? It may help to seek professional counselling to work out family, career or personal issues.
- Learn to do nothing one of the drawbacks of modern life is the pressure to drive ourselves to bigger and better heights. A hectic lifestyle is exhausting. Try to carve out a few more hours in your week to simply relax and hang out. If you cant find a few more hours, it may be time to rethink your priorities and commitments.
- Have more fun maybe youre so preoccupied with commitments and pressures that you dont give yourself enough time for fun. Laughter is one of the best energy boosters around.
What May Cause Chronic Fatigue Syndrome
Why chronic fatigue syndrome occurs is unclear and complex. Researchers conclude that infections, like pneumonia and bronchitis, and other immune deficiencies can be related to chronic fatigue syndrome. Depression, pain, and sleep disturbances frequently occur with chronic fatigue syndrome.
If you suspect chronic fatigue syndrome, you should find a healthcare practitioner who can take a holistic approach to your health and uncover underlying health issues and lifestyle factors that may contribute to your fatigue.
Unfortunately, patients sometimes feel frustrated that they havent been able to get answers from their doctors or by asking . They might see symptoms like chronic fatigue as in their head or they lack motivation or willpower.
You May Like: Adrenal Fatigue The 21st Century Syndrome
Talking To The Doctor About Fatigue
Some fatigue may be inevitable with many chronic illnesses, but that doesnt mean you shouldnt talk to your doctor about it. I asked Dr. Bartlett when someone should bring up their struggles to their doctor.
Any time you feel that your fatigue is interfering with your life you have stopped doing things that you love like painting or gardening because you dont have the energy is an important signal. If you find yourself unwilling to make plans because youre not sure youll have enough energy on the weekend, that is an important sign, she says.
First, she recommends doing a thorough self-care inventory to make sure youre doing everything you can do to manage fatigue on your own.
- Make sure you are getting enough physical activity and maybe increase your activity if it is on the low end.
- Be sure you are getting to bed at a reasonable hour every night, no exceptions.
- Examine what youre eating and try to eat a lighter meal earlier in the evening.
- Limit how much news youre watching or how much time you spend in front of screens generally.
- Make sure you are taking all of your medications as prescribed.
- Assess your pain levels: Have you been in more pain recently? Are there things you can do to reduce your pain ?
- Consider your work schedule: Have you been working longer hours, or letting work spill over so its taking up too much of your evenings and weekends?
Schedule Injections For Weekends
My injections for my rheumatoid arthritis really kick my butt, like I cant get out of bed unless its to go to the bathroom, says Genevieve L., 30, of Melbourne, Australia. Thankfully the exhaustion is the worst on the first day and improves each day after. Ive learned to just schedule my injections for Fridays after work so I can sleep it off on Saturday, she says.
Don’t Miss: Army Fatigue Jacket Forever 21
Blood Test Might Diagnose Chronic Fatigue Syndrome
HealthDay Reporter
TUESDAY, April 30, 2019 Chronic fatigue syndrome is such a mysterious illness that it took years to be recognized as a legitimate ailment, and doctors still struggle to accurately diagnose it.
Now, an experimental blood test has successfully spotted the syndrome, also known as CFS, in a finding that hopefully provides new insights into the inscrutable illness.
The test tracks changes in the electrical pattern of a persons cells, and it accurately flagged all CFS patients in a small group of 40 people, researchers report.
When we stress the cells, we can easily differentiate them based on the signal they are showing, said lead author Rahim Esfandyarpour. Its a huge difference.
Esfandyarpour worked on the test with a team while at Stanford University in California. Hes now an assistant professor of electrical engineering and computer science at the University of California, Irvine.
Currently, doctors must diagnose CFS based on the symptoms a patient has developed. Theres no lab test that can provide a definitive diagnosis.
There is no biomarker or diagnostic tool, Esfandyarpour said. Its all based on the symptoms.
Sometimes people are even told its all in their imagination. As many as 2.5 million Americans suffer from CFS, and 9 of 10 have not been diagnosed, according to estimates from the U.S. Centers for Disease Control and Prevention.
So they created a way to track the metabolism of cells by observing their electrical activity.
Learn How To Balance Your Health And Your Job
Balance doesnt mean equal, says Beverly Beuermann-King, a stress and wellness specialist in Little Britain, Ontario. It means youre satisfied with how you spend your time, what your priorities are, and how you make decisions about what to prioritize.
Balance may mean simplifying your work tasks, decluttering your home space, or hiring someone to do chores. It may be a sacrifice to pay someone to do something you normally do yourself, but its worth it if it allows you to spend time the way you want.
How do you cope with the physical and emotional exhaustion that comes with chronic fatigue syndrome?
To learn how a medical writer lives with this chronic disease, read Chronic Fatigue Syndrome Maijas Tips for Coping With CFS/ME.
Recommended Reading: Anti Fatigue Mat That Chair Can Roll On
Benefits For Chronic Fatigue Syndrome
Chronic fatigue syndrome refers to several poorly understood medical conditions that can cause extreme fatigue for at least six months.
It is unknown what causes chronic fatigue syndrome, though researchers believe that the condition may be associated with viral infections or immune system issues.
The condition affects all genders, but women are more likely to be diagnosed than men. Many of those diagnosed with chronic fatigue syndrome are around forty to sixty years old.
You may have chronic fatigue syndrome if you experience mental and physical exhaustion frequently over long periods of time. This fatigue will likely interfere with sleeping and other daily activities, often resulting in reduced cognitive functions.
Other symptoms include muscle and joint paint, headaches, and depression. These other symptoms persist episodically for six consecutive months or longer.
Because so little is known about chronic fatigue syndrome, there is no definitive test to diagnose the condition. Doctors must first rule out other medical problems, including sleep disorders, mental disorders, and HIV/AIDS.
This also means that there is difficulty in getting individuals or their families to accept the existence of the condition. Yet the effects can be debilitating while some people with chronic fatigue syndrome can lead ordinary lives, others are unable to leave their bed and are left isolated.
Social Security Disability Insurance
If you are no longer able to continue working, you may qualify for Social Security Disability benefits. Going through the process of applying for SSD is generally not a simple task.
Therefore, its important to learn all you can about the process before you begin in order to maximize your chances of being approved.
The following information and especially the suggested articles can help you navigate the system as smoothly as possible.
There are two types of disability benefits available through the Social Security Administration :
Social Security Disability Insurance Pays benefits if you have worked long enough and have paid Social Security taxes within the past five years.
Supplemental Security Income Pays benefits based on your financial need.
If youre unsure which program best fits your situation, you can use the Benefits Eligibility Screening Tool to see which you may be eligible for. The tool is not an application, it simply helps you determine if you are eligible for benefits.
For more information about applying for SSI, go to the Supplemental Security Income Home Page. The Benefits Eligibility Screening Tool will also help you determine if you are eligible for SSI.
To determine whether or not you are disabled, the Social Security Administration asks five questions:
For answers to frequently asked questions about how the SSA determines the answers to questions four and five, read Work and Education Information the SSA Needs
Also Check: Constant Fatigue And Muscle Pain
Be Aware Of The Relationship Between Overwork And Illness
I once worked two jobs due to a takeover, says Calgary-based small business owner Susanne Alexander-Heaton. I was repeatedly promised extra help that never came, and I worked the hours it took to get both jobs done. After two back-to-back bouts of bronchitis followed by severe fatigue, my immune system was compromised. I burned out and had to ask for a leave of absence. If I didnt, my doctor said Id end up hospitalized. That was a huge piece of humble pie, as I had always been the energetic, enthusiastic one.
We often wait until its too late a diagnosis of lupus or other chronic disease, a doctors dire threats, a hasty decision that has nasty consequences before realizing the importance of prioritizing what matters most.
Your work directly affects your health.
How To Cope With Chronic Fatigue At Work
- Category: Blog about Productivity
When we get a new interesting job, we are always full of enthusiasm and start solving even the most difficult tasks. But when a favorite business ceases to bring former joy, we risk adding to the ranks of “burned out” employees. At best, we lose the desire to work, and at worst – get a chronic fatigue syndrome.
Recommended Reading: Sudden Extreme Fatigue In Elderly
What You Can Spend Your Ssdi Money On
The reason people apply for Social Security disability benefits is so that they can pay their living expenses while being unable to work. There are no limits to how you can spend your disability benefits, but they should be used to pay rent, buy food and cover the costs of your treatment, including doctor co-pays, prescription medications and any other associated costs.
Chronic Fatigue Cause No : Food Allergies
While food is supposed to give us energy, some doctors believe hidden food intolerances — or allergies — can do the opposite. According to Rudy Rivera, MD, author of Your Hidden Food Allergies Are Making You Fat, even mild food intolerance can leave you feeling sleepy. Eat the offending food long enough and you could find yourself feeling continually exhausted.
“Evidence indicates food intolerance as a cause of fatigue, and even suggests that fatigue may be an early warning sign of food intolerance,” Rivera says.
If you suspect that food may be behind all that yawning, Rivera says to start with an elimination diet, cutting out foods that cause you to feel sleepy within 10 to 30 minutes of eating them. You can also talk to your doctor about a food allergy test.
Recommended Reading: What Helps With Fibromyalgia Fatigue
What Home Remedies Treat Chronic Fatigue Syndrome
Physical activity performed at a comfortable pace is important for everyone to maintain good health, including people with chronic fatigue syndrome. People with CFS need to learn how much activity is helpful and when to stop, so they do not increase their level of fatigue.
In general, people with CFS should pace themselves carefully and avoid excessive physical or emotional stress. Remember, the goal is to avoid increasing fatigue or pain. Maintain a regular and manageable daily routine to avoid a relapse or increase of symptoms. Exercise should be supervised by a knowledgeable health-care provider or physical therapist.Total rest should also be avoided as it may make your fatigue worse. You should maintain physical activity at a comfortable pace. If you increase your level of physical activity, do so gradually.Decreased consumption of alcohol and caffeine at night may help you sleep.Try to minimize social isolation.
Always ask your doctor about any new treatment, including herbal supplements.
Read Also: What Causes Fatigue And Sweating
How Social Security Evaluates Chronic Fatigue Syndrome Cases
Social Security does not have a Blue Book listing for chronic fatigue syndrome, a fact that shouldn’t surprise the many sufferers of CFS used to dealing with suspicion about their disease. In rare cases, Social Security may find that your CFS is medically equivalent to a Blue Book-listed impairment, such as Listing 14.06B for undifferentiated or mixed connective tissue disease.
The vast majority of successful disability applicants with CFS, however, are awarded benefits based on a “medical-vocational allowance,” which considers one’s age, education, work history, and residual functional capacity in deciding whether full-time work is possible. Your RFC is a description of the maximum physical and mental abilities you retain in spite of your impairments.
Social Security Ruling 14-1p, issued in April 2014, prescribes how claims for CFS should be evaluated. The ruling states that although CFS can be a disabling condition, it first must be established as a “medically determinable impairment” by appropriate medical signs or laboratory findings.
Read Also: How To Get Tested For Adrenal Fatigue
Me/cfs Classification Model Based On Raman Spectral Fingerprints
To further investigate the power of Raman spectroscopy to differentiate patients from healthy subjects, we used again PLS-DA as a classifier solely based on the whole Raman spectra. We also compared PLS-DA with a modified version of the LDA, RF, and SVMs to evaluate if there were more suitable techniques to classify individuals using only the Raman spectra as an input.
PLS-DA Model
To evaluate the biomarker value of the observed differential Raman peaks we applied PLS-DA analysis to Raman data. Complete spectra of individuals within each group are represented in Supplementary Figure 4 . As it can be appreciated, signals were already preprocessed and can be directly used for their further analysis with multivariate statistics techniques. Due to a slight mismatch in the wavelengths of different records, abscises axes in Supplementary Figure 4 are representing wavelength bins that contain the signal recorded for wavelengths within each interval.
Figure 4. Summary of the b PLS coefficients , the VIP coefficients , the scores , the observed vs. predicted values . and ROC curve of the depurated PLS-DA model with the Raman spectroscopy data. The red cross locates the optimal performance point using the classification threshold at 0.3935. Data set legends can be consulted on Supplementary Table 1. Black triangles represent healthy controls, whereas orange triangles represent ME/CFS cases.
Comparison of PLS-DA Model to Other Classification Models
