4/30/2014, Social Security Ruling on Chronic Fatigue Syndrome


Evaluating Claims Involving Chronic Fatigue Syndrome (CFS)

CFS is a systemic disorder consisting of a complex of symptoms that may vary in frequency, duration, and severity. In 1994, an international panel convened by the Centers for Disease Control and Prevention (CDC) developed a case definition for CFS that serves as an identification tool and research definition. [2] In 2003, an expert subcommittee of Health Canada, the Canadian health agency, convened a consensus workshop that developed a clinical case definition for CFS, known as the Canadian Consensus Criteria (CCC). [3] In 2011, a private international group developed guidelines, known as the International Consensus Criteria (ICC), [4] for diagnosing myalgic encephalomyelitis (ME). [5] Members of this international group and other medical experts consider ME to be a subtype of CFS. [6] We adapted the CDC criteria, and to some extent the CCC and ICC, when we formulated the criteria in this SSR. [7]

We consider a person to be “disabled” [8] if he or she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) [9] which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. We require that an MDI result from anatomical, physiological, or psychological abnormalities, as shown by medically acceptable clinical and laboratory diagnostic techniques. [10] The Act and our regulations further require that the impairment be established by medical evidence that consists of signs, symptoms, and laboratory findings; therefore, a claimant may not be found disabled on the basis of a person’s statement of symptoms alone. [11] In this SSR, we explain that CFS, when accompanied by appropriate medical signs or laboratory findings, is an MDI that can be the basis for a finding of “disability.” We also explain how we evaluate CFS claims.

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