Tampa Chronic Fatigue Syndrome Attorneys
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In cases involving CFS it is particularly important to develop a longitudinal record. This is because there is not test for CFS. It is a diagnosis of exclusion. So the complaints of fatigue must be evidenced in the medical records over a period of time and consistently. This is because the Social Security Act itself requires that an individual establish disability based on the existence of a medically determinable impairment; i.e., one that can be shown by medical evidence, consisting of medical signs, symptoms and laboratory findings. Disability may not be established on the basis of an individual's statement of symptoms alone.
1. How is CFS defined for disability purposes?
CFS is a systemic disorder consisting of a complex of symptoms that may vary in incidence, duration, and severity. It is characterized in part by prolonged fatigue that lasts 6 months or more and results in substantial reduction in previous levels of occupational, educational, social, or personal activities. In accordance with criteria established by the Center for Disease Control or CDC, a physician should make a diagnosis of CFS ``only after alternative medical and psychiatric causes of chronic fatiguing illness have been excluded."
2. What symptoms are typically reported with CFS?
The current CDC definition of CFS requires the concurrence of 4 or more of the following symptoms, all of which must have persisted or recurred during 6 or more consecutive months of illness and must not have pre-dated the fatigue:
Self-reported impairment in short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities;
- Sore throat;
- Tender cervical or axillary lymph nodes;
- Muscle pain;
- Multi-joint pain without joint swelling or redness;
- Headaches of a new type, pattern, or severity;
- Unrefreshing sleep; and
- Postexertional malaise lasting more than 24 hours.
3. What laboratory findings support the diagnosis of CFS?
At this time, there are no specific laboratory findings that are widely accepted as being associated with CFS. However, the absence of a definitive test does not preclude reliance upon certain laboratory findings to establish the existence of a medically determinable impairment.
But the following laboratory signs will be used to document a medically determinable impairment with persons with CFS:
An elevated antibody titer to Epstein-Barr virus (EBV) capsid antigen equal to or greater than 1:5120, or early antigen equal to or greater than 1:640;
An abnormal magnetic resonance imaging (MRI) brain scan;
Neurally mediated hypotension as shown by tilt table testing or another clinically accepted form of testing; or,
Any other laboratory findings that are consistent with medically accepted clinical practice and are consistent with the other evidence in the case record; for example, an abnormal exercise stress test or abnormal sleep studies, appropriately evaluated and consistent with the other evidence in the case record.
4. What mental findings support a diagnosis of CFS?
Some individuals with CFS report ongoing problems with short-term memory, information processing, visual-spatial difficulties, comprehension, concentration, speech, word-finding, calculation, and other symptoms suggesting persistent neurocognitive impairment. When ongoing deficits in these areas have been documented by mental status examination or psychological testing, such findings constitute medical signs or (in the case of psychological testing) laboratory findings that establish the presence of a medically determinable impairment.
Individuals with CFS may also exhibit medical signs, such as anxiety or depression, indicative of the existence of a mental disorder. When such medical signs are present and appropriately documented, the existence of a medically determinable impairment is established.
5. How long must my symptoms have been present to qualify for disability?
The medical signs and symptoms of CFS fluctuate in frequency and severity and often continue over a period of many months or years. Thus, appropriate documentation should include a longitudinal clinical record of at least 12 months prior to the date of application, unless the alleged onset of CFS occurred less than 12 months in the past, or unless a fully favorable determination or decision can be made without additional documentation. The record should contain detailed medical observations, treatment, the individual's response to treatment, and a detailed description of how the impairment limits the individual's ability to function over time.
6. Can statements from other sources help my claim?
As with all Social Security claims, the rules of evidence in Social Security cases is very relaxed. You can typically submit records from any source about your case. Information from neighbors, friends, relatives, or clergy about your condition is helpful. Statements from your past employers, rehabilitation counselors, or school teachers about your impairment(s) and the effects of the impairment(s) on your functioning in the work place, rehabilitation facility, or educational institutions can also be helpful.
Contact Our Firm for Help In Your Case
If you would like to discuss your chronic fatigue claim with us, contact the attorney's at the Tampa office of Harris & Riviere at (813) 669-2080 or fill out one of our case evaluation claim forms.
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