Chronic Fatigue Syndrome (ME/CFS) can be debilitating, but getting disability approval can be challenging. Here's what you need to know about qualifying for SSI or SSDI with CFS.
In this article, we'll cover:
- Can CFS qualify for disability?
- How SSA evaluates CFS
- Evidence needed
- Tips for approval
1. Can CFS Qualify for Disability?
Yes, CFS can qualify:
- SSA recognizes ME/CFS
- Has published guidance (SSR 14-1p)
- Can be basis for disability
- If severe enough
The challenges:
- No definitive diagnostic test
- Invisible disability
- Fluctuating symptoms
- Often misunderstood
When it qualifies:
- Severe, persistent fatigue
- Not relieved by rest
- Significantly limits function
- Despite treatment
2. How SSA Evaluates CFS
SSA's criteria (SSR 14-1p):
- Must be medically determinable impairment
- Not just self-reported symptoms
- Must have medical signs and findings
- Rule out other causes
Medical documentation needed:
- Formal diagnosis from acceptable source
- Consistent clinical signs
- Other conditions ruled out
- Longitudinal treatment record
Signs and symptoms considered:
- Post-exertional malaise (PEM)
- Cognitive dysfunction
- Unrefreshing sleep
- Orthostatic intolerance
- Widespread pain
- And others
No specific listing:
- CFS has no numbered listing
- Evaluated through RFC
- May meet related listings
- Combined with other conditions
Important: Post-exertional malaise (PEM) is a hallmark of ME/CFS. Document this thoroughly.
3. Evidence Needed
Diagnosis:
- From physician or psychologist
- Using recognized criteria
- CDC, IOM, or other accepted criteria
- Rule out other explanations
Medical records:
- Consistent treatment history
- Physical exam findings
- Lab work ruling out other causes
- Longitudinal documentation
Documenting PEM:
- What happens after exertion
- How long recovery takes
- Delayed onset (often 24-72 hours)
- Severity of symptoms
Functional limitations:
- Activity diary
- What you can/can't do
- Rest requirements
- Good days vs. bad days
Other symptoms:
- Sleep disturbance details
- Cognitive problems
- Pain locations and severity
- Orthostatic symptoms
Doctor's statement:
- Detailed RFC assessment
- Specific functional limitations
- Response to treatment
- Prognosis
4. Tips for Approval
Find knowledgeable doctor:
- One who understands ME/CFS
- Will document thoroughly
- Take your symptoms seriously
- Provide detailed opinions
Document thoroughly:
- Keep symptom diary
- Track activity and crashes
- Note all limitations
- Record what triggers PEM
Show consistency:
- Consistent treatment seeking
- Consistent symptom reports
- Long-term medical record
- Shows chronic nature
Explain PEM specifically:
- Describe the delay
- How long to recover
- What activities trigger it
- How it prevents work
Include all symptoms:
- Cognitive problems
- Sleep issues
- Pain
- Orthostatic intolerance
- Don't focus only on fatigue
Describe daily life:
- What a typical day looks like
- Rest requirements
- Activities you've given up
- Help you need
Common Challenges
Lack of objective tests:
- SSA may question validity
- Document clinical signs
- Get specialist evaluation
- Consistent medical record helps
"Good days" problem:
- Some days are better
- Doesn't mean you can work
- Activity causes crashes
- Explain the pattern
Skepticism:
- Some providers don't believe CFS
- Find knowledgeable doctor
- Multiple sources help
- Consistent record
Prior functioning:
- Contrast with before illness
- What you could do
- How life has changed
- Dramatic difference supports claim
Related Conditions
Often co-occurring:
- Fibromyalgia
- Depression
- POTS (postural orthostatic tachycardia)
- IBS
- Document all conditions
Combined impact:
- All conditions considered together
- Even if none alone qualifies
- Total functional impact
- Don't omit anything
How Purple Helps
Purple supports those with chronic illness:
- Simple banking interface
- Track benefit deposits
- Easy money management
- Less cognitive load
- Reduce stress