How to Document Chronic Fatigue Syndrome for Six Months

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Artwork: Zeraph Dylan Moore

The Social Security ruling on Chronic Fatigue Syndrome notes that signs and symptoms can be documented over a period of at least six months.

It is important to keep in mind that this ruling is not a requirement. Most people are not approved based on rulings or listings, but if you are able to document signs and symptoms that may be helpful for your case.

Documenting these symptoms yourself will not be very significant. Social Security would like them to be documented by a doctor. The doctor needs to be an MD or another kind of acceptable medical source. A doctor who is a specialist is great, but not required. Realistically many people cannot afford, or cannot access, a specialist in CFS/ME. Any doctor who supports you and supports your application can help you with this step.

Also please always remember: Your doctors probably will not know anything about Social Security policies if you do not show them. Even many specialists do not know. They don’t teach this stuff in med school!

If you would like to go over the ruling with your doctor you can print out a copy of the Medical Signs & Symptoms to show your doctor or you can ask your doctor to complete an RFC form for Chronic Fatigue Syndrome. The signs and symptoms are included on this form.


Medical Signs & Symptoms for Chronic Fatigue Syndrome

From Social Security Administration Ruling SSR 14-1p: Titles II and XVI

Diagnostic Symptoms

Four or more specific symptoms that persisted or recurred during six or more consecutive months of illness and did not pre-date the fatigue:

  • Postexertional malaise lasting more than 24 hours
  • Self-reported impairments in short-term memory or concentration severe enough to cause substantial 
reduction in previous levels of occupational, educational, social, or personal activities
  • Sore throat
  • Tender cervical or axillary lymph nodes
  • Muscle pain
  • Multi-joint pain without joint swelling or redness
  • Headaches of a new type, pattern, or severity
  • Waking unrefreshed

Medical Signs

One or more medical signs clinically documented over a period of 6 or more consecutive months:

  • Palpably swollen or tender lymph nodes on physical examination
  • Nonexudative pharyngitis
  • Persistent, reproducible muscle tenderness on repeated examinations, including the presence of 
positive tender points
  • Any other medical signs that are consistent with medically accepted clinical practice (for 
example: Frequent viral infections with prolonged recovery; Sinusitis; Ataxia; Extreme pallor; and Pronounced weight change, other symptoms).

Other Symptoms

Other symptoms a person with Chronic Fatigue Syndrome may exhibit: Muscle weakness; Disturbed sleep patterns; Visual difficulties; Orthostatic intolerance; Respiratory difficulties; Cardiovascular abnormalities; Gastrointestinal discomfort (for example, nausea, bloating, or abdominal pain); Urinary or bladder problems.

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