Getting Social Security Disability Benefits for Chronic Fatigue Syndrome

Chronic fatigue syndrome is a condition characterized by severe and ongoing tiredness that isn't improved with rest and isn't caused by another underlying disease. Doctors aren't yet sure what causes chronic fatigue syndrome, but it may result from exposure to the Epstein-Barr virus or from a disruption in the body's immune system. Age, gender, and stress are also thought to play a role.

People with chronic fatigue syndrome and related diagnoses (such as chronic fatigue immune dysfunction or myalgic encephalitis) may find that their symptoms interfere significantly with their daily routine. If you can show that your chronic fatigue syndrome is a severe impairment that keeps you from working full-time for at least one year, you may qualify for disability benefits.

Is Chronic Fatigue Syndrome a Disability?

In 2014, the Social Security Administration (SSA) issued a policy interpretation ruling, SSR 14-1p, that addresses how the agency should evaluate disability claims based on chronic fatigue syndrome. Using guidance from the Centers for Disease Control (CDC), Social Security will look for a diagnosis of chronic fatigue symptom based on evidence of the following symptoms:

• feeling generally unwell ("malaise") for at least 24 hours after physical exertion
• impairment in memory or concentration that substantially reduces your activities
• frequent sore throat
• tender lymph nodes in the neck or under the arm
• muscle pain
• pain in multiple joints without redness or swelling
• headaches that are unlike those before the chronic fatigue began, and
• not feeling refreshed after sleep.

Under the CDC definition, chronic fatigue syndrome can be diagnosed when four of the above symptoms have been present for at least six months. However, the SSA needs to see that your chronic fatigue symptoms persist for at least twelve months in order to qualify for disability, so there may be a lag between when your doctor diagnoses you with chronic fatigue syndrome and the earliest date you can receive benefits.

Medical Records You'll Need to Get Disability for Chronic Fatigue Syndrome

Your medical records are the foundation of your disability claim. Social Security needs to see that your chronic fatigue syndrome is a medically determinable impairment, meaning that it's supported by evidence found in physical examinations, medical imaging, or lab results. The agency will be on the lookout for objective signs in your records, including:

• lymph nodes that are swollen or tender to the touch
• inflammation of the throat without mucus
• positive tender points (specific sites on the body that cause pain when pressed)
• presence of Epstein-Barr antibodies indicating a prior infection
• abnormal brain MRI
• positive tilt table testing, and
• psychological testing that shows neurocognitive impairments.

Provide the SSA with copies of your medical records that date back to when your symptoms of chronic fatigue syndrome first began. These records should include all lab test results, hospitalizations, doctor visits and reports, and a complete list of medications and their side effects.

Keep in mind that chronic fatigue syndrome can be difficult to document clinically, because medical tests and lab results don't always reflect how severe the symptoms are. You'll need to have some objective evidence that you have the impairment, however, because the SSA isn't allowed to approve disability claims based on your symptoms alone.

Proving That Your Chronic Fatigue Syndrome is a Disabling Impairment

Once you can show that your chronic fatigue syndrome is a severe, medically determinable impairment, the SSA will determine whether your symptoms prevent you from working full-time. First, the agency will review your medical records and self-reported daily activities to determine what functional limitations you have. Any limitations you have on your ability to work are then included in your residual functional capacity (RFC).

What's In a Typical RFC for Chronic Fatigue Syndrome?

Your RFC is a set of restrictions that indicate the most you're capable of doing at a job. For example, your RFC might state that due to persistent fatigue, you need to take frequent breaks throughout the day to rest. Or if your medical records show ongoing muscle pain and weakness, your RFC may say that you can't lift or carry anything weighing more than ten pounds. (Strength-related restrictions in your RFC are called exertional limitations.)

Any mental limitations you have should also be included in your RFC. Chronic fatigue syndrome can cause memory lapses and interfere with information processing. This might be reflected in your RFC with a restriction against performing complex or detailed tasks. Additionally, anxiety and depression are often associated with chronic fatigue syndrome, which can affect your ability to concentrate, maintain attendance, or get along with coworkers.

How Does Social Security Use Your RFC?

Social Security will compare your current RFC with the demands of your past work to see if you could still do those jobs today, despite the restrictions in your RFC. For example, if you previously worked as a firefighter and your RFC limits you to sit-down jobs, the agency won't expect you to return to your past work. Instead, Social Security will look to see whether you can do other, less demanding jobs.

For most disability claimants under the age of 50, the agency needs to see that they can't perform simple, sedentary work in order to qualify for disability. Whether or not you meet this standard depends on the limitations in your RFC. Examples of limitations that typically rule out the easiest, least demanding full-time jobs include:

• the maximum amount of weight you can lift or carry is less than ten pounds
• you're unable to sit or stand for two hours total in an eight hour workday
• you're more than 15-20% off-task during the workday
• you'd miss more than 1-2 days per month due to your symptoms, or
• you need to lay down, recline, or elevate your legs on the job.

Getting the documentation needed to support the above limitations can be challenging. You can strengthen your case if your doctor is willing to provide a medical source statement describing your disabling limitations. You can also ask your physician to complete a physical RFC form and submit it to Social Security. If you have mental restrictions, ask your psychologist or therapist to fill out a mental RFC form as well.

Basic Eligibility Requirements for Disability Benefits

Even if the SSA determines that you meet the agency's medical definition of disability, you'll need to meet some preliminary eligibility criteria in order to legally receive benefits.

If you're applying for Social Security Disability Insurance (SSDI), you must have enough work credits—determined by how much you've earned and paid in taxes—to be covered ("currently insured") under the program.

If you're applying for Supplemental Security Income (SSI), you don't need a qualifying work history, but you do need to meet the program's low earning and asset thresholds.

Both SSDI and SSI eligibility standards require you to have earned less than the substantial gainful activity amount—about $1,550 per month—for at least twelve months in order to qualify.

Applying for Disability Benefits for Chronic Fatigue Syndrome

You can start your application for disability benefits in several ways:

• Apply online at Social Security's website.
• Call 888-772-1213, between 8 a.m. and 7 p.m., Monday through Friday, to speak with a representative. (People who are deaf or hard of hearing can call the TTY number at 800-325-0778.)
• File in person at your local Social Security field office.

Getting approved for disability based on chronic fatigue syndrome can be tough. Consider contacting an experienced disability attorney to help you with your claim—our survey results show that your odds of winning increase considerably with representation.

Updated March 4, 2024