Chronic Fatigue - The Law Office of Nancy L. Cavey

Have Your Lawyer Review These Before You Send Them to Your Doctor or the Disability Carrier

Keeping a diary can help you, and it can hurt you if you say the wrong thing. Your doctor will rely on the diary in rendering opinions about you, and the diary must document the right things in the right way.

Your diary also must be consistent with the Activities of Daily Living forms you are preparing. If not, you could be setting yourself up for surveillance. Disability carriers love to deny claims on the basis that you said one thing about your symptoms and functionality in your medical records, your logs, and your diary – but the surveillance film is the “accurate” picture of your symptoms and functionality.

Your diary should be reviewed by your lawyer.

The Two Things You Should Track in Your Chronic Fatigue Diary to Win Your Long-Term Disability Chronic Fatigue Claim

Disability insurance carriers hate subjective medical condition disability claims like chronic fatigue syndrome claims. They will demand objective evidence of the diagnosis when none may exist – because there are no gold standard diagnostic studies.

They will also demand objective evidence of your restrictions and limitations, which, of course, is predicated on your subjective chronic fatigue symptoms and how those symptoms limit your ability to perform the material and substantial duties of your own occupation or any occupation.

One of the most important tools that you can use to help quantify your symptoms and the impact of your chronic fatigue symptoms is a diary. The diary will help your doctor render an opinion about your restrictions and limitations that prevent you from performing your own or any occupation. In other words, it can help explain the nature of your symptoms, how those symptoms impact your ability to work, and document relapses.

There are, of course, other purposes for keeping a diary of your symptoms and your activity. You can document your symptoms and look for patterns of activity that increase your symptoms, or you can determine when during the course of a day you are more functional. This type of tracking may also offer insights into your functionality.

What You Must Document in a Winning Chronic Fatigue Diary

The disability insurance carrier wants to know what your symptoms are on a daily basis, how long those symptoms last, what you do to try to control or reduce the symptoms, what side effects you have with medication, how these symptoms or treatment impact your ability to function, and whether you have relapses or good days and bad days.

You can start by keeping a paper diary or getting an app. If you aren’t sure, ask your doctor what they recommend.

What Are the Two Things You Should Track?

There are two primary things you are tracking in your diary. The first is your symptoms, which include:

Your symptoms.
The most disabling symptoms (which can vary with activity and are day to day).
Changes in your symptoms from day to day.
Interaction with other symptoms.
Waxing and waning or recurring symptoms.
Relapsing symptoms during the course of the day or week.

I think each symptom needs to be addressed using these criteria.

The second thing you are tracking is your activity level. This should include:

What activity causes symptoms.
What are the symptoms.
How long you are doing the specific activity.
How the activity changes your baseline symptoms.
How long it takes you to recover from that activity.
Whether you must increase your medication.
How that activity impacts your sleep.
How that activity impacts your concentration or cognitive abilities.

How Do I Use My Chronic Fatigue Diary to Prove My Long-Term Disability Case?

You have the burden to prove that you meet the policy or plan definition of disability. The starting point is to understand the definition of “occupation,” as you want to work backwards into the definition of “disability.” For example, if your policy or plan defines “occupation” as the occupation you do for your employer, write down what the material and substantial duties are of that occupation. Next, write down the symptoms that interfere with or prevent you from doing those duties.

Now you have a guide as to what symptoms you should record and how those symptoms might have changed in the course of a chronic fatigue episode.

The key is to tie these symptoms to functionality issues. What is it about these symptoms – or how do these symptoms – prevent you from doing the material and substantial duties of your occupation? If you aren’t working anymore, use examples of activities of daily living that are impacted and would prevent you from doing your own occupation or any other occupation.

I don’t recommend you rate the pain on a scale of 1 to 10, as disability carriers will always say your pain couldn’t be a 10 or that your symptoms aren’t as bad as you claim.

Have Your Lawyer Review Your Chronic Fatigue Diary Before You Send It to Your Doctor or the Disability Carrier

Your diary also must be consistent with the Activities of Daily Living forms you are preparing. If not, you could be setting yourself up for surveillance. Disability carriers love to deny claims on the basis that you said one thing about your chronic fatigue symptoms and functionality in your medical records, and something different in your log or diary – but the surveillance film is the “accurate” picture of your symptoms and functionality.

Your diary should be reviewed and approved by your lawyer.

Why You Shouldn’t Track Your Daily or Weekly Schedule in Your Chronic Fatigue Long-Term Disability Claim

Disability carriers demand all sorts of proof in a chronic fatigue Long-Term Disability claim. You have the burden to prove that you are disabled, as that term is defined in your disability policy or plan.

One of the things that your disability insurance carrier will demand is objective evidence of your restrictions and limitations. The issue is: what are your symptoms, and how do those symptoms impact your ability to perform the material and substantial duties of your own occupation or any occupation?

That can be hard to prove without a Functional Capacity Evaluation (FCE) or CPET test.

However, you may be tempted to supplement this with a daily or weekly schedule log and submit it to the disability carrier as proof of why you can’t work a full day or a full week.

I think that is a bad idea.

Why You Shouldn’t Track Your Daily or Weekly Schedule in Your Chronic Fatigue Long-Term Disability Claim

Your diary also must be consistent with the Activities of Daily Living forms you are preparing.

Often your daily and weekly activity will vary based on your symptoms and activity level. There might not be a rhyme or reason to your daily or weekly schedule. You might have one good day and one bad day – or a cluster of bad days.

Disability carriers see daily or weekly schedule logs or diaries as a golden opportunity to assign surveillance. They may first want to take your statement about any inconsistencies in your medical records, your Activities of Daily Living forms, and your logs.

These inconsistencies are a perfect setup for surveillance. Disability carriers love to deny claims on the basis that you said one thing about your chronic fatigue symptoms and functionality in your medical records and something different in your log or diary – but the surveillance film is the “accurate” picture of your symptoms and functionality.

The disability carrier isn’t done. They will take your logs, the Activities of Daily Living forms, and the surveillance to your doctor and try to get your doctor to change their opinions about your restrictions and your ability to work. After all, your doctor probably relied on your history about your symptoms and functionality when filling out the Attending Physician form. The disability carrier will try to paint you as a liar, fraud, or even a malingerer.

Don’t even think about creating and submitting a daily or weekly activity diary or log to your disability carrier.