Epstein-Barr virus (EBV), a member of the herpes family, is one of the most common viruses in the world. In the United States alone, 95% of adults from 35 to 40 years old have been exposed to the virus. But while most people recover fully in one or two months, the dormant virus remains in the body for life.
Clinical signs and symptoms like swollen glands, fever, and pharyngitis are sometimes adequate to diagnose an EBV infection, but serum tests that detect the presence of EBV antibodies are the most accurate method of diagnosis. EBV can sometimes cause mononucleosis and/or extreme fatigue that can linger for months.
Some people who have been infected with Epstein-Barr virus suffer from chronic fatigue, joint pain, or difficulty concentrating that renders them unable to work for a period of time. Because EBV is short-lived, it can be difficult to meet the Social Security Administration’s (SSA) requirement that your disability last, or be expected to last, at least 12 months.
If it has been less than a year since you were diagnosed with EBV, the SSA must determine whether it thinks your EBV will meet the duration requirement. To do this, the SSA will consider diagnostic tests, your response to treatments, whether you have had complications, and your doctors’ opinions about your prognosis. If the SSA decides that complications or symptoms from your EBV infection are not expected to last a year, your disability claim will be denied.
In addition to the SSA's 12-month duration requirement, there are a few other standard requirements. You cannot earn more than $1,260 a month from working (the substantial gainful activity level for 2020), and your disability must severely impact your ability to do work-related activities.
In addition, SSDI applicants must also have a significant work-history with employers that paid taxes to the SSA. (For more information see our section on eligibility for SSDI.) Alternatively, SSI applicants must fall under the income and asset limits set by the SSA. (For more information, see our section on eligibility for SSI.)
Before assessing whether your limitations make it impossible for you to work full-time, the SSA must find that your EBV has caused a "medically determinable impairment," or MDI. If your main symptom is chronic fatigue, the SSA will evaluate your condition similarly to how it evaluates chronic fatigue syndrome (CFS). In addition to the symptoms you report, the SSA wants to see some type of objective medical sign or lab result to prove that you have an MDI. One way to satisfy this requirement is by having an elevated antibody titer to Epstein-Barr virus capsid antigen (VCA) equal to or greater than 1:5120, or early antigen equal to or greater than 1:640.
If the SSA concludes that you have an MDI and your EBV symptoms are chronic and severe, and that you are not currently doing any substantial gainful activity, the agency will next determine whether your physical or mental limitations medically qualify you for disability.
The SSA will consider whether the limitations caused by your EBV infection are so severe that they prevent you from doing your old job, or any job. At this point, the SSA will prepare a residual functional capacity assessment (RFC) to evaluate how your EBV affects your ability to do work-related activities. For chronic EBV sufferers, the most debilitating symptom of EBV is severe fatigue. Chronic fatigue would make it difficult for someone to work a full eight hours without taking frequent breaks. It could also affect your reliability, which can result in frequent absenteeism. Your RFC should include fatigue as a factor that limits the number of jobs you could do.
People with chronic EBV also often experience pain in their muscles and joints. Ongoing pain will limit the ability to perform physical work-related tasks such as lifting, carrying, pushing, and pulling, and should be another factor included in your RFC that limits the types of jobs you can do.
Some EBV sufferers also have difficulty with focus and concentration; this would make it hard to complete tasks in an acceptable amount of time. In developing your RFC, the SSA will have to decide if you can do even unskilled work with your reduced ability to concentrate. According to the SSA, limitations that cause a 20% reduction in your productivity (or more) prevent employment. (For more information, see our article on qualifying for disability due to reduced productivity.)
It is important that you ask your doctor to prepare an RFC statement that describes these types of work-related limitations caused by the Epstein-Barr virus. Along with your doctor's RFC statement, you will need to provide the SSA with medical evidence to support your doctor’s opinion. If your doctor's opinion is properly supported by evidence, the limitations in your doctor's RFC should be incorporated into the RFC the SSA develops for you.
The SSA will then use your RFC to determine if there are any jobs you can be expected to do. For more information, see our articles on how the SSA uses the RFC to decide disability.