Statistics[edit | edit source]
- 54% of ME/CFS patients reported being unemployed
- 25% of ME/CFS patients are housebound or bedbound at some point in their illness
Evaluation of Disability[edit | edit source]
Social Security Administration Evaluation of Disability
For the purposes of Social Security Disability evaluation, in addition to a diagnosis of ME/CFS that meets the Fukuda case definition, one or more of the following medical signs clinically documented over a period of at least 6 consecutive months is required to establish the existence of a medically determinable impairment (MDI) of CFS:
- palpably swollen or tender lymph nodes on physical examination;
- nonexudative pharyngitis;
- persistent, reproducible muscle tenderness on repeated examinations, including the presence of positive tender points; or
- any other medical signs that are consistent with medically accepted clinical practice and are consistent with the other evidence in the case record. For example, the Canadian Consensus Criteria (CCC) and International Consensus Criteria for ME (ME-ICC) explain that an acute infectious inflammatory event may precede the onset of CFS, and that other medical signs may be present, including
- – frequent viral infections with prolonged recovery,
- – sinusitis,
- – ataxia,
- – extreme pallor, and
- – pronounced weight change. [Gain or loss.]
Specific laboratory findings are not well established for ME/CFS. However, certain laboratory findings may support the finding of an MDI in people with ME/CFS even in the absence of the medical evidence listed above. It is not unusual to find standard laboratory tests in the normal range for many patients with ME/CFS, and SSA advises that such tests should not be relied upon to the exclusion of all other clinical evidence in decisions regarding the presence and severity of an MDI. The following laboratory findings establish the existence of an MDI in people with ME/CFS:
- an elevated antibody titer to Epstein-Barr virus (EBV) capsid antigen equal to or greater than 1:5,120, or early antigen equal to or greater than 1:640;
- an abnormal magnetic resonance imaging (MRI) brain scan;
- neurally mediated hypotension as shown by tilt table testing or another clinically accepted form of testing; or
- any other laboratory findings that are consistent with medically accepted clinical practice and are consistent with the other evidence in the case record (for example, an abnormal exercise stress test or abnormal sleep studies, appropriately evaluated and consistent with the other evidence in the case record).
New laboratory and clinical evidence may emerge with continued research in ME/CFS. According to SSA, these findings may be considered, in conjunction with laboratory findings discussed above, in the assessment of an MDI. Depending on the type of assessment, ongoing mental limitations or neurocognitive manifestations documented by a mental status examination or psychological testing may be considered medical signs or laboratory findings.
SOURCE: Social Security Ruling, 2014.
See also[edit | edit source]
Departments of Disability and Benefits
- Bell CFIDS disability scale
- International Consensus Criteria
- Severe and very severe ME
- Symptom scales
Learn more[edit | edit source]
- Feb 21, 2019. PIP appeals: 'I've been treated like a liar and a fake' (With video short)
References[edit | edit source]
- "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness". www.nationalacademies.org. 2015. pp. 260–261. Retrieved Feb 20, 2019.
- "Myalgic Encelphalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Key Facts" (PDF). nationalacademies.org. 2015.
- "Myalgic Encelphalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness". nap.edu. 2015. pp. 258–259.
- "Eiligibility for Disability Benefits and Mental Symptoms & Limitations". James Disability Law. Retrieved Feb 22, 2019.
- "Medical Definition of NEUROCOGNITIVE". www.merriam-webster.com. Retrieved Feb 22, 2019.
- "'I've been treated like a liar and a fake'". BBC News. Feb 21, 2018. Retrieved Feb 22, 2019.
Canadian Consensus Criteria (CCC) - A set of diagnostic criteria used to diagnose ME/CFS, developed by a group of practicing ME/CFS clinicians in 2003. The CCC is often considered to be the most complex criteria, but possibly the most accurate, with the lowest number of patients meeting the criteria. Led to the development of the International Consensus Criteria (ICC) in 2011.
myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.
chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.