Do I Qualify For Social Security Disability Benefits If I Have Chronic Fatigue Syndrome?
The Social Security Administration (SSA) doesn’t always make it easy for those with chronic fatigue syndrome (CFS) to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve. Many claims are denied because SSA says:
(1) You can return to the lightest job you held in the 15 years before you became disabled, or
(2) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
Not all cases of CFS are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with CFS. She works to overcome the claims denial by working closely with you and your physician to show that:
- Your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.
She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
What Is Chronic Fatigue Syndrome?
CFS, whose cause is unknown, is a condition that causes severe muscle pain and tiredness that does not improve with rest and does not result from another disease. There is no gold standard test for chronic fatigue syndrome; the diagnosis is based, in part, on subjective complaints.
CFS is not a Listed condition that would automatically qualify you for Social Security Disability benefits. You must have proof of the basis of the diagnosis; many Administrative Law Judges are skeptical about CFS and discount the impact the symptoms have on your ability to work.
That is why it is crucial that you have an attorney who not only understands chronic fatigue syndrome but knows how to gather the medical and vocational evidence that is required to approve a claim.
What Are The Symptoms of Chronic Fatigue Syndrome and How Does SSA View CFS Claims?
CFS is a poorly understood medical condition that doctors once thought was “all in head” of patients. The general symptoms of CFS can include:
- Chronic pain,
- Painful joints,
- Low grade fever,
- Generalized muscle weakness,
- Chronic fatigue, and
- Cognitive difficulties.
SSA defers, in part, to the Centers for Disease Control (CDC) diagnostic criteria for a diagnosis of CFS, which requires that you have at least four of the following symptoms for at least six months:
- Memory or concentration problems that cause a serious reduction in your activities,
- Frequent sore throats,
- Enlarged lymph nodes in the neck or armpits,
- Muscle pain,
- Pain in multiple joints without swelling or redness,
- Unrefreshing sleep, and
- Extreme exhaustion that lasts more than 24 hours after physical or mental exercise.
It is crucial that your medical records show that you meet the criteria for a diagnosis of CFS and that your symptoms did not begin before the onset of your CFS. You must submit medical records that date back to when your symptoms began and should include the results of lab work, hospitalizations, doctor visits and medication history, including side effects.
Abnormal sleep studies and exercise stress tests are helpful to document the basis of the CFS diagnosis.
Because there is no listing for CFS, SSA will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.
When Your CFS Makes It Impossible to Work
You must prove that you:
- Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
- There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your CFS.
Residual Functional Capacity For CFS
The SSA will review your medical records at the Initial Application and Reconsideration stages of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of a properly completed CFS RFC form, which explains:
- How far you can walk,
- How long you can stand and sit at one time and for an eight-hour day,
- How much and how often you can lift, stoop, squat, bend during an eight- hour day,
- Whether you have to alternate sitting and standing,
- Whether you have to take frequent as needed rest breaks throughout the day because of your persistent fatigue,
- Whether you have any problems with concentration or staying on task,
- Whether you have good days and bad days and how many days per month you would miss from work, and
- Whether you have psychological problems, such as depression or anxiety, that would interfere with your ability to work.
This is not an exhaustive list of all of the questions on a CFS or mental impairment RFC form. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.
How Your Residual Functional Capacity Is Used At A Social Security Hearing
Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
- Whether you can return to the lightest job you held in the last 15 years,
- Whether there is other work you can do or could learn to do.
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
How Do I Get The Social Security Disability Benefits I Deserve?
CFS can interfere not only with your daily activities but with your ability to work. If you can no longer work or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:
- File your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits.
- Appeal a wrongful denial of your Social Security disability application or Request for Reconsideration.
- File an Application for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.
The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by an experienced Social Security Disability attorney like Ms. Cavey.
Contact CFS Social Security Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live in Florida
You owe it to yourself and your family to get help today! Nancy Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits for CFS. Call today for a free consultation at 727-894-3188.