Disability Benefits and Long-Term Effects of the Epstein-Barr Virus (EBV)

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.

While most people recover fully in one or two months, some develop chronic EBV with symptoms that come and go or get worse over time. The dormant virus remains in your body for life and may cause infrequent flare-ups.

What Are the Symptoms and Long-Term Effects of Epstein-Barr Virus?

EBV can sometimes cause mononucleosis and/or extreme fatigue that can linger for months. 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.

Although uncommon, EBV can have long-term effects on your health, including serious complications, such as:

• heart conditions like myocarditis
• pneumonia and other lung infections
• meningitis
• encephalitis
• Guillain-Barré syndrome
• pancreatitis, and
• cancers like lymphomas and nasopharyngeal (upper throat) cancer.

Researchers are still studying the links, but it's believed that EBV is a likely factor in the development of certain autoimmune disorders, such as:

• lupus
• multiple sclerosis (MS)
• type 1 diabetes
• inflammatory bowel disease
• celiac disease, and
• thyroid conditions, such as Hashimoto's disease.

Doctors do know that EBV can weaken your immune system, making it harder to fight off infection and leading to long-term, sometimes life-threatening health conditions like chronic active Epstein-Barr virus (CAEBV) disease. CAEBV is a rare, progressive condition that can cause immune dysfunction and multiple organ failures.

Even years after recovery from an EBV infection, the virus can reactivate. Hormonal changes, prolonged stress, and infections (including COVID-19) can cause your EBV to flare up, bringing on the same—or sometimes new—symptoms and complications. (Similarly, the chicken pox virus, varicella-zoster, can reactivate later in life and cause shingles, or herpes zoster.)

If you have chronic health problems due to EBV, you might qualify for disability.

Can I Get Disability for Epstein-Barr Virus?

Some people who've been infected with the Epstein-Barr virus suffer from chronic fatigue, joint pain, or difficulty concentrating that renders them unable to work for some time. They'll need to show the Social Security Administration (SSA) that their impairments severely impact their ability to do work-related activities. But because EBV infections are typically short-lived, it can be difficult to meet Social Security's requirement that your disability last, or be expected to last, at least 12 months.

Duration of Disability With EBV

If it's been less than a year since you were diagnosed with EBV, Social Security must estimate whether your limitations from EBV are likely to meet the duration requirement. To do this, the SSA will consider all of the following:

• your diagnostic test results
• your response to treatments
• whether you've had complications and how severe they are, and
• your doctors' opinions about your prognosis.

If Social Security decides that the complications or symptoms from your EBV infection aren't expected to last a year, your disability claim will be denied.

Social Security's Work and Work History Rules

In addition to Social Security's 12-month duration requirement, there are a few other standard requirements. You can't earn more than about $1,500 a month from working (the substantial gainful activity level).

Additionally, Social Security disability insurance (SSDI) applicants must also have a significant work history with employers that paid Social Security taxes. (See our article on SSDI's work requirements for more information.) Alternatively, Supplemental Security Income (SSI) disability applicants must fall under the income and asset limits set by Social Security. (For more information, see our section on eligibility for SSI.)

Do You Have a Severe Medically Determinable Impairment?

Before assessing whether your limitations make it impossible for you to work full-time, Social Security must find that your EBV has caused a "medically determinable impairment," or MDI. With long-term EBV, or EBV flare ups, you have to have objective evidence to prove that you have an MDI. If your main symptom is chronic fatigue, Social Security may evaluate whether you have an MDI similarly to how it assesses chronic fatigue syndrome (CFS).

In addition to the symptoms you report, Social Security wants to see objective medical signs or test results. 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 Social Security concludes that you have an MDI, your EBV symptoms are chronic and severe, and you're not currently doing any substantial gainful activity, the SSA will next determine whether your physical or mental limitations medically qualify you for disability.

Do Your Limitations Prevent You From Doing Any Job?

Social Security will consider whether the limitations caused by your EBV infection are so severe that they prevent you from doing your old job or any other 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.

How EBV Might Affect Your RFC

For chronic EBV sufferers, the most debilitating symptom of EBV is generally 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 can do.

People with chronic EBV also often experience pain in their muscles and joints. Ongoing pain will likely limit your ability to perform physical work-related tasks such as lifting, carrying, pushing, and pulling, and it 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—making it hard to complete tasks in an acceptable amount of time. In developing your RFC, Social Security will have to decide if you can do even unskilled work, with your reduced ability to concentrate. According to Social Security, limitations that cause a reduction in your productivity of 20% or more may prevent any type of employment. (Learn more about qualifying for disability due to reduced productivity.)

It's important that you ask your doctor to prepare an RFC statement describing the types of work-related limitations caused by your history of Epstein-Barr virus. Along with your doctor's RFC statement, you'll need to provide Social Security with medical evidence to support your doctor's opinion. If the evidence is there, the limitations in your doctor's RFC should be incorporated into the RFC Social Security develops for you.

How Social Security Uses RFCs to Determine Disability

Social Security will use the limitations in your RFC to determine what you can physically (and mentally) do, despite your EBV symptoms. Your RFC is expressed as the kind of work you can do, such as:

• sedentary work (like a desk job with no lifting)
• light work (jobs requiring frequent walking and standing and the ability to lift and carry lightweight items routinely), or
• medium work (all the job requirements for light and sedentary work, but you can lift more weight).

Social Security then compares your RFC to the requirements of your past jobs to determine if you can still do that kind of work. If you can't, the SSA then compares your RFC, education level, age, and job skills to other types of work to see if there are any jobs you can be expected to do.

If you can do any type of job that exists in the national economy, Social Security will deny your disability claim. But if the SSA determines that you can't do your past work, and there's no other work you can reasonably be expected to transition to, you could qualify for disability benefits through a medical-vocational allowance.

Learn more about getting a medical-vocational allowance, including how your age affects your chance of qualifying for disability this way.

How to Apply for Social Security Disability for EBV

Most adults are eligible to apply for SSDI and SSI disability benefits online at ssa.gov. You can also make an appointment to apply for benefits by phone by calling Social Security at 800-772-1213 (TTY 800-325-0778). You also have the option to apply in person at your local Social Security office. (Avoid long waits by contacting your local office to make an appointment).

Getting Social Security disability benefits for chronic EBV or Epstein-Barr virus complications can be a long and challenging process. The average SSDI claim takes six months for an initial decision—much longer if you have to wait for an appeal hearing. Filling out the application correctly and providing all the information Social Security requests right away will prevent unnecessary delays.

Learn more about what you can do to help speed up the disability claims process.