Do you have chronic fatigue syndrome (CFT) and wonder about your eligibility for disability benefits?
Since there are no tests that directly evidence a person has CFT, this condition can be challenging to prove. And without solid medical backup, an SSDI case can become an uphill battle.
CFS claims rarely get approval at the initial stage. Even at hearings, Administrative Law Judges are reluctant to grant benefits solely on a chronic fatigue claim.
However, this condition can be mentally and emotionally debilitating, hindering one’s ability to work. In such cases, you may be eligible to receive financial assistance.
However, you must build a flawless case to win your claim and obtain your monthly checks.
In this article, our disability lawyers in Indianapolis will tell you the top 6 mistakes most applicants make when filing for SSDI for Chronic Fatigue Syndrome. We’ll also share our professional tips to improve your case and your chances of obtaining the monthly checks you deserve.
Can You Get SSDI for Chronic Fatigue Syndrome?
Chronic fatigue syndrome is not part of the “Blue Book”—a book that lists all the eligible impairments for Social Security Disability Insurance (SSDI).
However, according to federal regulations, all you need to qualify for disability benefits is to prove you have a medically determinable impairment.
What does having a medically determinable impairment mean?
Presenting one or more of the following symptoms (clinically documented) for no less than 6 months will generally be enough to consider your CFS a medically determinable impairment:
- Swollen or tender lymph nodes
- Nonexudative pharyngitis (dry, sore throat)
- Persistent muscle tenderness
- Other medical signs, such as:
- Frequent viral infections
- Sinusitis
- Ataxia
- Significant weight change
Evidence of CFS must come from a licensed healthcare professional for it to be valid. However, your doctor’s diagnosis of CFS won’t be enough to secure disability benefits.
The clinical notes and medical records must be consistent with the symptoms of chronic fatigue for the Social Security Administration (SSA) to determine that you have a medically determinable impairment.
What Disability Programs Can You Apply for If You Have Chronic Fatigue?
If you have chronic fatigue syndrome, there are two main SSA programs you can apply to: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Both programs have similar eligibility criteria; the main difference between SSDI and SSI is that they are meant to aid claimants with different work backgrounds and financial conditions.
SSDI and SSI joined criteria for chronic fatigue:
- Having CFS symptoms for at least 6 months.
- The condition is expected to last longer than 12 months.
- Your condition significantly affects your residual functional capacity (it prevents you from working and engaging in a substantial gainful activity).
SSDI eligibility criteria:
In addition to the mentioned rules, applicants must have enough work credits to qualify. You earn work credits by paying Social Security taxes or through your work/income.
The number of work credits you need to qualify for SSDI for chronic fatigue syndrome will depend on your age and how many years you have worked.
SSI eligibility criteria:
SSI was designed to financially aid disabled individuals with low to no incomes or scarce basic resources, such as food and shelter.
To qualify for this benefit, you don’t need enough work credits, but your monthly income must not exceed $1,971.
6 Top Mistakes That Can Cost You Your Disability Benefits
The SSA can be extra scrupulous about disabilities that are difficult to prove.
Therefore, when building a disability benefits case for chronic fatigue, there is no room for mistakes.
These are the 6 most common mistakes applicants make when filing a disability benefits claim for CFS:
Applying for Disability Benefits Too Soon
To be eligible for SSDI for chronic fatigue syndrome, you must have experienced the symptoms for at least 6 months. Additionally, the condition must be expected to last 12 months or longer to receive disability benefits.
Filing a claim too soon will make it more challenging to prove you have a permanent disability.
If the SSA employee in charge of your case determines your condition will improve, they might automatically disqualify your case.
Therefore, you should only apply once it has been 6 months since the onset of your CFS, and you already have enough medical evidence to support your claim.
No Providing Enough Medical Evidence
Medical evidence is the cornerstone of your chronic fatigue claim.
Never underestimate the importance of submitting enough relevant medical records. A simple diagnosis from your primary doctor will not suffice to convince the SSA you deserve disability benefits.
When gathering medical evidence, you must be as thorough as possible. Medical proof for CFS can include:
- Doctor’s clinic notes
- X rays
- Lab test results
- MRIs
- Records from hospitalizations
- List of medications
- Physical therapy or rehabilitation
If you fail to submit enough medical proof, or the evidence does not fully support your claim, the SSA might order extra consultative exams.
It’s a mistake to think the SSA gathering medical proof for you is an advantage. On the contrary, it can delay the process as the SSA has countless cases, and yours will not be a priority. Furthermore, the consultative exam findings may lead to the denial of your case.
The best thing to do is to submit enough medical evidence with your initial claim to accelerate the application process and increase your chances of winning SSDI.
Lying or Exaggerating About the Symptoms of Your Disability
While you must be detailed about your condition and how it impacts your life, you should never lie about your health status.
The SSA will quickly realize if you are lying about the severity of your symptoms or how they affect your daily life activities and ability to work.
If the SSA suspects you of lying, it will immediately reject your application, leaving you empty-handed.
Avoid exaggerating or submitting untruthful information. Instead, on your application, carefully detail how your impairment has negatively impacted crucial aspects of your life.
For example, state that CFS muscle pain is so severe that it prevents you from standing for long periods, compromising your ability to perform your job.
Forgetting to Check Work Credits
Remember that if you are applying for SSDI, you must have enough work credits to qualify.
One of the leading reasons for disability claim denials is that the applicant has not acquired enough work credits.
Generally speaking, you need at least 40 credits to be eligible, 20 of which you must have earned in the past 10 years. However, younger claimants may qualify with fewer work credits.
Giving Up After Initial Denial
About 70% of disability claims get rejected at the initial instance.
Does that mean the game is over? No, giving up after facing rejection is one of the most common mistakes applicants make.
After getting denied, you have the option to appeal and have an Administrative Law Judge review your case.
Another big mistake claimants make is waiting too long to appeal and missing the deadline. Notice that once you get the rejection letter, you only have 60 days to file for appeal. If that timeframe goes by, you must file a new claim from scratch, which will delay the process even further.
Assuming You Can’t Afford a Disability Lawyer
Who wouldn’t like to have a professional and experienced attorney handling complex paperwork and legal matters for them?
However, many applicants don’t even consider hiring a lawyer because they believe they will not be able to afford their services.
What most people don’t know is that disability law firms typically work on contingency. That means you don’t patonless you win your case.
After winning disability benefits, the law firm will wait until you receive your first disability check to charge their fees. This arrangement allows attorneys to provide legal representation to clients who can’t currently work due to their impairment.
Therefore, regardless of your employment status, you can hire an attorney to help you with your case. Since your chances of winning disability with a lawyer significantly increase, this is an option worth considering.
Is It Difficult To Get Approved for Chronic Fatigue Syndrome?
Sadly, winning a CFS disability claim is not a walk in the park.
Since no medical test can diagnose this health condition, the SSA can be very skeptical about chronic fatigue claims. That’s why strong medical evidence is crucial for CFS disability claims.
Additional Testing That Can Support Your CFS Claim
Beyond your regular visits to your primary healthcare provider, there are additional tests that can substantially strengthen your chronic fatigue disability case:
- Neuropsychological testing: This test, performed by a neuropsychologist, can shed valuable medical evidence of cognitive dysfunctions. You can use this evidence to prove your cognitive deficits due to chronic fatigue syndrome.
- Cardiopulmonary exercise testing (CPET): If your work ability is drastically affected by fatigue, this test can objectively determine your health impairment and help you gain disability benefits.
- Functional Capacity Evaluation (FCE) test: The FCE test measures your ability to sit, stand, lift heavy objects, pull, push, and other physical functions necessary to perform your previous job. When your symptoms are severe, this test is crucial to showcase how chronic fatigue hinders your ability to work.
Knowledgeable Advice To Enhance Your Case and Win SSDI
Here are 4 professional tips to help you build a strong SSDI case:
Don’t Wait Too Long to Apply
We mentioned above that one common mistake claimants make is applying too soon (before their impairment is considered a disability).
Well, waiting too long to apply for SSDI can also compromise your case.
One of the main problems with waiting too long to file a claim is that the SSA uses the most current medical evidence to review your case. If you delay applying for too long, you risk losing your case due to outdated information.
The best is to apply when you have a wealth of up-to-date medical records that support your case.
Continue Seeing Your Doctor and Stick to Your Medical Treatment
Once you apply, never stop attending doctor visits and seeking medical assistance.
If you neglect your doctor appointments, taking your medications, and treatment plans, the SSA might consider your chronic fatigue disorder has improved and deny your disability benefits.
Therefore, you must keep seeing your healthcare providers and getting treatment while waiting for a reply from the SSA.
Another way to enhance your case is to show the SSA that you are doing your best to improve your health. This includes seeing a CFS counselor, seeking alternative treatments, and committing to healthier lifestyle changes.
Keep A Journal of Your Daily Activities
The next tip to enhance your chances of winning SSDI is to keep a journal of your daily life activities.
Sit down and write down how chronic fatigue limits you on a daily basis.
You can write about how brain fog stops you from concentrating at work or how muscle pain makes you too weak to get out of bed on your own.
Work with a Professional Disability Attorney
Having a lawyer leading the way can smooth out your journey, especially since CFS is a difficult disorder to prove.
How can a disability attorney help you?
These are some of the many tasks an attorney can help you with:
- Filing complex and extensive paperwork so you don’t have to.
- Keeping track of important deadlines.
- Contacting physicians to obtain medical records.
- Represent you at the hearing stage if your claim gets rejected.
Disability lawyers’ legal knowledge and years of experience are valuable assets that can turn our claim into a winning case.
Final Thoughts
Winning SSDI for chronic fatigue syndrome can be challenging, but as long as you build a strong case and avoid the mistakes mentioned in this guide, you will have a good chance of winning disability benefits.
Do you have more questions about disability benefits for CFS? Don’t hesitate to contact us. Our dedicated lawyers will help you secure the benefits you deserve.
