Chronic Fatigue Syndrome (CFS) and Social Security Disability

Social Security Disability claimants should know that on April 3, 2014, the Social Security Administration published Social Security Ruling (SSR) 14-1p, “Evaluating Claims Involving Chronic Fatigue Syndrome (CFS)” rescinding SSR 99-2p. SSR 14-1p is effective April 3, 2014. For the full text, go to SSA’s website.  Pertinent parts follow below:

The Act and our regulations further require that the impairment be established by medical evidence that consists of signs, symptoms, and laboratory findings; therefore, a claimant may not be found disabled on the basis of a person’s statement of symptoms alone.

In accordance with the CDC case definition of CFS, a physician should make a diagnosis of CFS “only after alternative medical and psychiatric causes of chronic fatiguing illness have been excluded.”

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.

The CDC case definition requires the concurrence of 4 or more specific symptoms that persisted or recurred during 6 or more consecutive months of illness and did not pre-date the fatigue:

  • Postexertional malaise lasting more than 24 hours (which may be the most common secondary symptom);
  • Self-reported impairment(s) 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; and
  • Waking unrefreshed.

Other Symptoms. Within these parameters, the CDC case definition, CCC, and ICC describe a wide range of other symptoms a person with CFS may exhibit:

  • Muscle weakness;
  • Disturbed sleep patterns;
  • Visual difficulties;
  • Orthostatic intolerance;
  • Respiratory difficulties;
  • Cardiovascular abnormalities;
  • Gastrointestinal discomfort; and
  • Urinary or bladder problems.

A person can establish that he or she has an MDI of CFS by providing appropriate evidence from an acceptable medical source. A licensed physician (a medical or osteopathic doctor) is the only acceptable medical source who can provide such evidence. We cannot rely upon the physician’s diagnosis alone.

For more information on how the SSA determines disability claims, click here.

If you need more information about a Social Security Disability or SSI, personal injury, EEOICPA, long term disability or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611 or through our website.




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