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I have been diagnosed with Fibromyalgia and Chronic Fatigue Syndrome. I am not able to work and have not worked for several months. Am I eligible for Social Security Disability?
This is a good question. The Social Security Administration (SSA) does recognize Chronic Fatigue Syndrome (“CFS”) and Fibromyalgia Syndrome (“FMS”) as disabling impairments according to Social Security Policy Interpretation Ruling SSR 99-2p. Any recognized impairment, including CFS and FMS, are grounds for a finding of “disabled” if the impairment limits a person’s ability to engage in substantial gainful activity (employment) for at least 12 months or results in death. However, as with all impairments, objective medical evidence must support the SSA’s finding that the claimant’s impairment is sufficiently severe to render him or her “disabled.”
Though no specific single test can definitively indicate whether an individual suffers from CFS or FMS, both syndromes are demonstrable by a collaboration of objective medical evidence and the claimant’s subjective indications. Under Social Security Rules, a claimant (1) must meet the 1994 Center for Disease Control and Prevention (“CDC”) criteria for CFS (or the American College of Rheumatology criteria for FMS), (2) must have medical signs of the impairments, supported by objective laboratory findings, and (3) the severity of the impairment must be such that the claimant either meets or medically equals a listing of impairment, or the severity of the impairment substantially reduces the claimant’s Residual Functional Capacity so that he or she is unable to perform past relevant and other available suitable vocations.
According to the CDC definition, CFS is characterized by clinically elevated, persistent or relapsing chronic fatigue that is of new or definite onset (not 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. SSR 99-2p. According to the Social Security rules, in addition to the above criteria, the claimant must suffer from additional symptoms for at least 6 or more consecutive months.
FMS is characterized by tenderness in eleven (11) of eighteen (18) specific locations on one’s body. The remaining aspects of FMS overlap with CFS. Therefore the two syndromes are similar and difficult to distinguish at times. An individual that meets the minimum number of tender points for FMS may also meet the requirements for CFS. To distinguish the two impairments, CFS is characterized by fatigue, while FMS is characterized by pain and soreness.
Note that a diagnosis of CFS and/or FM is not appropriate if there is a different medically known cause of the claimant’s fatigue or pain such as lupus, for example.
The second aspect of a successful claim under CFS or FMS requires that the claimant have medical signs of the impairment supported by medical findings. The required medical findings include MRIs and various other objective laboratory findings that are established indications of CFS and FMS. The claimant’s subjective complaints must be supported by objective laboratory findings consistent with established CFS and FMS objective laboratory research. For example, post-exertional malaise is demonstrable by performing an exercise test and a follow up exercise test within a two to three day period. This laboratory test provides objective medical evidence that the claimant has not recovered from the initial exertion in contrast to a person without FMS.
To answer your question, the SSA does recognize both CFS and FMS as impairments that will lead to a finding of “disabled” if your symptoms are objectively indicated at the requisite severity and duration. If you have been diagnosed with CFS or FMS then it is important that you seek medical attention and work with your doctor to ensure proper diagnosis. Additionally, proper testing should be done and the doctor should determine whether your laboratory findings are consistent with established CFS and FMS research.
Should you have any questions regarding social security benefits, or if you would like to consult with an attorney, please contact our office.