Chronic Fatigue Syndrome Can Be Disabling

According to the Centers for Disease Control and Prevention[1], Chronic Fatigue Syndrome (CFS) is described as follows:

Chronic fatigue syndrome, or CFS, is a devastating and complex disorder. People with CFS have overwhelming fatigue and a host of other symptoms that are not improved by bed rest and that can get worse after physical activity or mental exertion. They often function at a substantially lower level of activity than they were capable of before they became ill.

Besides severe fatigue, other symptoms include muscle pain, impaired memory or mental concentration, insomnia, and post-exertion malaise lasting more than 24 hours. In some cases, CFS can persist for years.

Researchers have not yet identified what causes CFS, and there are no tests to diagnose CFS. Moreover, because many illnesses have fatigue as a symptom, doctors need to take care to rule out other conditions, which may be treatable.

Symptoms of CFS

The primary symptom of CFS is unexplained, severe fatigue lasting at least 6 months that is not improved by bed rest and that can get worse after physical activity or mental exertion. Individuals with CFS experience a fatigue so strong that their activity levels and stamina decline dramatically. However, fatigue is not the only symptom, and for some patients may not be the symptom that bothers them the most.

As stated in the 1994 case definition, the fatigue of CFS is accompanied by at least 4 of 8 characteristic symptoms lasting at least 6 months. These symptoms include:

  • post-exertion malaise lasting more than 24 hours
  • unrefreshing sleep
  • significant impairment of short-term memory or concentration
  • muscle pain
  • pain in the joints without swelling or redness
  • headaches of a new type, pattern, or severity
  • tender lymph nodes in the neck or armpit
  • a sore throat that is frequent or recurring

The symptoms listed above are the symptoms used to diagnose this illness. However, many CFS patients may experience other symptoms, including irritable bowel, depression or other psychological problems, chills and night sweats, visual disturbances, brain fog, difficulty maintaining upright position, dizziness, balance problems, fainting, and allergies or sensitivities to foods, odors, chemicals, medications, or noise.

Diagnosis of CFS

Because there is no blood test, brain scan, or other lab test to diagnose CFS, it is a diagnosis that can only be made after ruling out other possible illnesses. A doctor will first take a detailed patient history and then will conduct a thorough physical and mental health exam. Next, a series of laboratory screening tests will be ordered to help identify or rule out other possible causes of symptoms. There may also be additional tests to follow up on results of these tests. If a patient has had severe fatigue for 6 months or longer but does not does not have at least 4 of the 8 symptoms of CFS (and thus, does not meet the criteria for a CFS diagnosis), the doctor may make a diagnosis of idiopathic fatigue (fatigue with an unknown cause). As a practical matter, patients with idiopathic fatigue are managed like CFS patients.

A clinician should consider a diagnosis of CFS if these three criteria are met:

  1. The individual has unexplained, persistent fatigue for 6 months or longer that is not due to ongoing exertion, is not substantially relieved by rest, has begun recently (is not lifelong)
  2. The fatigue significantly interferes with daily activities and work
  3. The individual has had 4 or more of the following 8 symptoms:
  • post-exertion malaise lasting more than 24 hours
  • unrefreshing sleep
  • significant impairment of short-term memory or concentration
  • muscle pain
  • pain in the joints without swelling or redness
  • a sore throat that is frequent or recurring
  • tender lymph nodes in the neck or armpit
  • headaches of a new type, pattern, or severity

Because there is no blood test, brain scan, or other lab test to diagnose CFS, it is a diagnosis that can only be made after ruling out other possible illnesses. For this reason, establishing a diagnosis of CFS may take time. In addition, patients may not have the stamina to complete the grueling paperwork necessary to complete a Short or Long Term Disability application and/or appeal.

If you decide to apply for disability benefits, your doctor can help you by keeping good notes and using a simple assessment tool to track your health status. If you suffer from CFS have applied for disability benefits and your claim has been denied or you need assistance with your short or long term disability application, contact O’Ryan Law Firm immediately.

We recently represented a client who applied for Long Term Disability five years after his date last worked. He spent years treating with physicians, seeing specialists, and traveling across the country searching for answers to his symptoms. Without a confirmed diagnosis, in conjunction with the severity of his fatigue, the long term disability application was filed late. Due to the reasonable explanation of the untimely filing, the insurance company accepted his application and rendered a decision.  The client has a disability policy with Reliance Standard which promises to pay disability benefits if he is unable to work due to a serious illness.  Reliance Standard denied the claim arguing that the medical records did not support a functional impairment.  To the contrary, the medical records are over 1000 pages and the client has the support of 3 physicians.

If you have been diagnosed with CFS and are considering applying for short term or long term disability benefits, it may not be too late. It is important to obtain confirmation of the diagnosis and gather your supportive medical evidence.  Please contact the O’Ryan Law Firm if you need assistance in filing your claim.

 

 

[1] https://www.cdc.gov/cfs/general/index.html