Can you claim disability benefits for chronic fatigue? This is a common question we hear from clients and claimants with CFS. The answer is “Yes,” but the process can be difficult because of the nature of the illness.
There is no specific test for CFS, which makes diagnosis challenging. It is often mistaken for other conditions that show similar signs and symptoms. A detailed physical and mental examination is needed to rule out other issues and confirm a CFS diagnosis. Both doctors and disability insurance providers may be skeptical of CFS claims.
At Marc Whitehead and Associates, we understand your concerns. Chronic fatigue can significantly impair your ability to earn an income and even care for yourself at home. You might be distressed about your diagnosis and worried about how it will affect your finances and future.
Like many others with CFS, you may wonder what disability payments are available and whether you are eligible. This article explains the fundamentals involved in securing these critical monthly disability benefits for chronic fatigue.
Call or text (800) 562-9830 or complete a Free Case Evaluation form
What Is Chronic Fatigue Syndrome?
CFS is a complex, long-lasting disorder that affects multiple body systems. “Chronic fatigue syndrome” is more commonly used in the U.S. Overseas, the condition has historically been referred to as Myalgic Encephalomyelitis (ME). This is why we often see these conditions labelled together as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
CFS affects multiple systems in the body simultaneously – the immune system, the nervous system, and the endocrine system – in ways that significantly alter normal bodily functions.
It is characterized by unwavering, debilitating fatigue that lasts for at least six months. CFS can make you feel so drained and exhausted that you can’t perform daily activities or even get out of bed. The disorder makes both physical and mental exertion difficult.
The overwhelming nature of CFS can disrupt all areas of life, making the simplest tasks exhausting, sometimes to the point of immobility. There is no cure, the cause remains undetermined, and treatment typically involves managing the symptoms.
For a free legal consultation, call (800) 562-9830
What Disability Benefits for Chronic Fatigue Are Available? How Can I Apply?
When CFS substantially limits your ability to function, you may be eligible for long-term disability benefits from the following sources:
- Social Security Disability Insurance (SSDI)
- Long Term Disability (LTD) insurance
- Veterans’ disability compensation through the Veterans Administration (VA)
Be aware, government disability programs and insurance companies each have their own definition of what it means to be “disabled” by chronic fatigue syndrome, along with their specific requirements for applying and proving that you are disabled.
This means getting disability benefits for chronic fatigue through any of these programs requires a clear understanding of each program’s criteria for:
- eligibility
- the application process
- essential documentation to support your claim
- how to appeal if your initial CFS claim is denied
Our team at Marc Whitehead & Associates has helped thousands of people across the country to file successful initial claims and overturn claim denials to secure these indispensable benefits. If you have questions or your claim was denied unfairly, call us for qualified assistance.
What Are the Signs and Symptoms of CFS?
- A key feature of CFS is the intense, overwhelming, long-lasting exhaustion that does not improve with rest or sleep. CFS exhaustion lasts for six months or longer, significantly damaging one’s ability to work or complete simple daily tasks. Even restful actions like talking or reading can leave a person drained;
-
- Problems being upright, including dizziness, fatigue, palpitations, and other forms of intolerance that occur when standing upright, that are relieved when reclining;
- Post-Exertional Malaise (PEM) that occurs after physical, cognitive, or emotional effort. Symptoms include increased fatigue and exhaustion, intensified pain, worsened mental difficulties, and an overall unwell feeling;
- Disturbed sleep patterns, such as insomnia or prolonged sleeping, and waking unrefreshed. Lack of sleep intensifies other CFS symptoms;
- Cognitive impairments play an essential role when seeking disability benefits for chronic fatigue. Work-related mental activities include problems processing information, short-term memory loss, trouble concentrating, lack of attention, and general “brain fog”;
- Recurring muscle pain, including tenderness, stiffness, or weakness;
- Recurring joint pain;
-
- Frequent sore throat and swollen lymph nodes;
- Frequent headaches, including migraines;
- Gastrointestinal discomfort;
- Respiratory difficulties, such as labored breathing or sudden breathlessness;
- Urinary or bladder problems, such as urinary frequency or bladder pain;
- Visual problems, including trouble focusing, problems with depth perception, or photosensitivity;
- Cardiovascular problems, such as palpitations.
Chronic fatigue syndrome is also erratic, where symptoms come and go, may vary in duration, or get better and then deteriorate.
CFS patients tend to lead a very limited lifestyle, carefully regulating activities to prevent symptom flare-ups. Even with careful planning, exhaustion, malaise, and other symptoms persist as debilitating struggles.
Many CFS symptoms resemble those of other illnesses.
Your doctor will need to differentiate chronic fatigue syndrome from other conditions such as:
- fibromyalgia
- Lyme disease
- Addison’s disease
- Lupus
- Gulf War Illness
- long COVID
- multiple sclerosis
- certain sleep disorders, and
- certain psychiatric conditions.
People with CFS may have co-occurring impairments such as:
- fibromyalgia
- migraines
- PTSD
- orthostatic intolerance (trouble standing)
- chronic inflammation of the prostate gland
- chronic pain in the bladder and pelvic floor
- irritable bowel syndrome
- autoimmune disease
It is essential to document all co-occurring conditions.
The cumulative impact of all conditions matters:
- When evaluating a claim for disability benefits for chronic fatigue, the SSA and other disability insurers consider the combined effect of all your conditions on your ability to work and perform daily activities. Even if one condition alone isn’t enough to qualify you for benefits, the combined effect of several conditions might be.
- The combined impact provides a clearer picture of your limitations: Documenting all impairments co-occurring with CFS paints a more comprehensive picture of the challenges you face due to your health. This helps disability evaluators understand the full extent of your limitations and how they impact your daily life and work performance.
- You strengthen your claim by showing a documented history, over time, of multiple medical conditions that contribute to your disability.
How to Win Social Security Disability Benefits for Chronic Fatigue
SSA does not list chronic fatigue syndrome in its official listing of impairments. However, the agency has adapted the CDC’s criteria for chronic fatigue and considers it a disabling condition.
Social Security may consider you disabled if you are no longer able to do any substantial gainful work activity because your medical condition has lasted, or is expected to last, for at least 12 months, or is expected to result in death.
The claim you submit must have enough medical and vocational evidence to enable Social Security to find in your favor. That is, due to the existence, severity, and duration of your chronic fatigue syndrome, you can no longer work and earn a living.
What Information Should Be Included in a Chronic Fatigue SSDI Claim?
- Medical reports describing your medical history about diagnosis, onset, duration, and prognosis of your CFS, as well as any other impairments you have.
- Clinical records and medical history that show the course of your CFS, with prescribed treatment and your response to that treatment over time.
- Physician’s opinions and statements regarding clinical findings and descriptions of any functional limitations noted throughout treatment.
- Clinical findings from physical exams and mental status exams, blood tests, MRI, or other appropriate clinical tests.
- Evidence of any co-occurring impairments.
Of great importance to the SSA is your account of all symptoms and work efforts over time, such as a daily journal. Just as important is your treating doctor’s statement and medical opinion of your functional limitations, including daily activities and work-related physical and mental activities.
- Physical functions include walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, and handling.
- Mental functions include the ability to understand, remember, follow simple instructions, use judgment, and respond appropriately to supervision, co-workers, and usual work situations.
Remember, your inability to perform “substantial gainful work” due to CFS is directly related to SSA concluding that you are disabled. You want a legal team in your corner with the experience to develop your initial application or appeal a denied SSDI claim to achieve that conclusion.
Having a skilled Social Security disability lawyer advising you provides several invaluable advantages:
We avoid mistakes others make with their CFS disability claims, such as knowing when to file for SSDI with chronic fatigue. We make sure our clients meet all of the SSA’s requirements, including that you have:
- suffered CFS exhaustion for at least 6 months, and
- are expected to experience CFS for at least 12 months or more (which means we supply SSA with medical evidence sufficient to uphold your claim to this end, and much more.)
We provide dedicated representation at every stage of the appeal process. If denied again, we persist strongly with an Appeals Council review and, if necessary, pursue potential federal lawsuits.
Whether you’re applying for disability benefits for chronic fatigue syndrome for the first time or the SSA has denied your claim, you want to be sure you get it right this time. Founding attorney Marc Whitehead is Board Certified in Social Security Disability Law. We’ll be with you every step of the way.
Winning a Long-Term Disability Insurance Claim for Chronic Fatigue
The procedures and laws followed by the SSA differ from those followed by insurance companies. Getting approved by the SSA does not guarantee that an insurance company will approve your LTD claim.
However, the depth of medical and vocational criteria required to establish disability based on chronic fatigue syndrome in a Social Security claim serves as a good guideline for preparing a solid chronic fatigue-based LTD insurance claim or an appeal that will withstand court scrutiny.
Your employer can offer LTD insurance as a job benefit known as “group disability,” or you may have purchased your own “private disability” insurance policy.
The remedies that are available to you as a claimant appealing a denied group policy claim are very different than if your claim is under a private policy.
Group Disability Insurance Claims:
The laws that govern most group policies are federal laws known by the acronym “ERISA” – The Employee Retirement Income Security Act.
When you file a group disability claim and ERISA laws take over, your claim is suddenly subjected to stringent, complicated federal laws. If your claim is denied, you must follow rigid legal procedures and obey strict deadlines as you appeal your case.
In cases of group disability claims for chronic fatigue, it’s crucial to have a qualified ERISA attorney fighting the claim denial on your behalf. You can be sure the insurance companies have legal teams experienced in this area who are ready to oppose you.
Insurers often appear helpful, telling you or implying you don’t need an attorney and can handle the appeal alone. Vague instructions, confusing appeal forms, and misleading information only result in inadequate documentation and often lead to a claim or appeal being denied.
Private or Individual Insurance Claims:
Coverage you purchase from an insurance company is referred to as individual disability insurance (IDI) or private disability insurance. These policies are regulated under state insurance laws regarding bad faith and contract law. The laws are better designed to protect the insured and beneficiaries from unfair practices by insurers.
A Successful Claim for Long-Term Disability Benefits for Chronic Fatigue Requires Building a Strong Case
Insurance companies don’t always act reasonably. Our attorneys have extensive experience dealing with insurers and their tactics for denying insurance payments. When you follow the rules but your insurer wrongfully denies your claim, this is where we excel.
Consider consulting an experienced disability insurance lawyer about your CFS disability claim and its impact on your ability to work. Our skilled legal team will develop your case to ensure it is strong enough to prevent denial based on allegations that you are not disabled under the policy’s terms, or due to insufficient or partial information.
If you’ve already received a denial letter from your insurance company, contact us right away for a free case review. A long-term disability insurance lawyer can increase your chances of a successful appeal in many ways.
VA Disability Benefits for Chronic Fatigue Syndrome
If you have been denied VA disability compensation for chronic fatigue or are dissatisfied with the disability rating the VA awarded for CFS, we can assist you. Marc Whitehead & Associates are veterans’ claims attorneys serving U.S. veterans who have been denied the compensation they deserve from the VA disability program.
VA recognizes chronic fatigue syndrome as a “medically unexplained chronic multi-symptom illness” (MUCMI), and as follows:
- Chronic fatigue syndrome, or myalgic encephalomyelitis, is presumptively service-connected for veterans who served in combat deployment in specific locations, notably the Gulf War.
- If you served in Desert Shield, Desert Storm, Operation Iraqi Freedom, or Operation New Dawn, you do not have to prove a connection between your illnesses and service to be eligible to receive VA disability compensation. CFS must have emerged during active duty in the Southwest Asia theater of military operations or by December 31, 2026, and be at least 10% disabling.
- Veterans can also file for chronic fatigue as a secondary condition to an already service-connected disability, such as PTSD, fibromyalgia, or sleep apnea.
To obtain VA disability compensation, you would file a claim under VA Diagnostic Code 6354. VA ratings for chronic fatigue syndrome depend on how severe your symptoms are and how they affect your daily life.
Disability ratings for CFS are awarded as follows:
- 10% Rating: This rating is assigned for symptoms that are intermittent and do not significantly hinder your ability to carry out daily tasks.
- 20% Rating: Assigned if you have more frequent symptoms, with incapacitation lasting one to two weeks each year.
- 40% Rating: Awarded when more serious symptoms result in incapacitation for at least four weeks each year.
- 60% Rating: Awarded when symptoms are severe enough to cause incapacitation for six weeks or more annually.
- 100% Rating: Reserved for the most extreme cases where symptoms prevent you from performing daily activities for six months or longer.
Also, be aware that, as a veteran, you may qualify for both Social Security and veteran’s disability benefits for CFS. If you have enough work credits, you can apply and collect both.
For veterans of the Gulf War and many other service members, facing denials or delays in disability claims related to chronic fatigue happens far too often. This occurs because diagnosing the condition is challenging, claims are usually poorly presented, and the VA system is overwhelmed with thousands of pending disability claims.
Contact Marc Whitehead & Associates to be represented by an accredited veterans’ claims attorney. Our firm represents veterans nationwide, and we would be honored to represent you, regardless of your location.
Living with CFS shouldn’t mean losing your peace of mind.
Is chronic fatigue an actual disability? Yes, a very real one. We specialize in helping disabled claimants receive the benefits they deserve. Having experienced lawyers work on your behalf as early in the process as possible is in your best interest.
Please call our attorneys toll-free at 800-562-9830 and see how we can help you secure disability benefits for chronic fatigue now. We welcome your call.
