How to Use the Social Security Ruling for Chronic Fatigue Syndrome (SSR 14-1p)

Social Security has a special ruling for Chronic Fatigue Syndrome. This ruling is a great tool you can use to help your case.

While reading this ruling, it may be helpful to keep in mind that following this ruling is not a requirement. You do not need to exactly meet everything in this ruling in order to get approved. This ruling is just one of many, many tools you can use to improve your application.

The Ruling!

🌸 Here’s where you can find the complete Social Security ruling. Unfortunately, it can be a bit long and confusing. Don’t worry if you can’t understand everything in the full ruling. You can still use it to help your case.

🌸 Here’s a shorter version that includes the key points about diagnosis and medical criteria: Medical Criteria from The Social Security Ruling. This includes just the important medical information, without all the confusing Social Security policy language!

What Do You Have?

🌸 You can also use this ruling if you have been diagnosed with Myalgic Encephalomyelitis, or ME/CFS, or if this is how you identify your illness.

🌸 Social Security uses the term “Chronic Fatigue Syndrome” so some people choose to include this term throughout their application and in their medical records, so that they will have the best chance of making sure the ruling gets applied to their case.

Using the Ruling With Your Doctor

🌸 It is a good idea not to rely on the doctors hired by Social Security. If at all possible, work with your own doctors to get the documentation you need.

🌸 If you are looking for a doctor: How to Find a Doctor to Help With Disability Documentation

🌸 It’s a great help if you can talk with your doctor about your disability application and make sure you have their full support. Here’s How to Have “The Talk”

🌸 Doctors recommended by readers: What Doctor Was the Most Helpful for Documenting Your Disability?

🌸 Many of our readers with ME/CFS report feeling shy or embarrassed at their doctors office, or taking a long time to understand and accept how ill they were. Sadly, this can create great problems for your disability case: How to Stop Hiding From Your Doctor

Print and Bring

🌸 Doctors are not trained in Social Security policies. It is very unlikely that your doctor will know this ruling.

🌸 Here’s where you can find a printable version of the medical criteria from the ruling Overview of Social Security Ruling (version you can print) to bring to your doctor to review and discuss.

🌸 If you feel comfortable, you can ask your doctor their medical opinion, “Do you think I meet the criteria in this ruling?” If your doctor says, “Yes,” this is a great time to request a letter including the language from the ruling.

🌸 If your doctor is willing to read more, you can also share this excellent Social Security fact sheet on Providing Medical Evidence for People with ME/CFS.

Forms and Letters from Your Doctor

🌸 It is a HUGE help if you can work with your doctor to collect a letter including details on how your condition matches this ruling. Social Security will not ask your doctor to do this. It will only happen if you ask your doctor yourself. How to Get a Great Disability Letter from Your Doctor

🌸 Instead of a letter (or in addition to a letter) many people ask their doctor to fill out an RFC function form. This page has a special Chronic Fatigue Syndrome form that includes exact language from the Social Security ruling. Sample Residual Functional Capacity Forms

🌸 If your doctor hates paperwork: How To Get Your Doctor to Fill Out Disability Paperwork

🌸 Here’s how Zinnia worked with her doctor to get approved: Zinnia Uses the Social Security Ruling for Chronic Fatigue Syndrome

Sample Letters

• Doctor Lapp’s Amazing Chronic Fatigue Syndrome Letter
• Zinnia’s Super Great Chronic Fatigue Syndrome Letter
• Lotus’ Letter for Lyme and Chronic Fatigue Syndrome
• Dr. Rowe’s Letter for POTs, Migraines, ME and CFS 
• Dr. Fein’s Medical Summary for CFS and Lyme Disease
• Dr. Lange’s Neuropsychological Report
• Gentian’s 14-Page Super Awesome Disability Letter

Collecting Medical Evidence

🌸 One of the key parts of this ruling is collecting medical evidence and tests for your condition. Here’s an overview of how to use this ruling to Collect Medical Evidence for Chronic Fatigue Syndrome.

🌸 Luckily, the ruling is a bit flexible. They will also recognize other medical tests, including new tests developed after the ruling was written. If you like to learn more about other forms of testing here’s How to Get Tested for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

🌸 Which tests helped the most for disability applications? Good question. We took a survey of our readers.  What medical test was the most helpful for your disability approval?

🌸 Spoiler alert: The most common test readers reported finding helpful was neuropsychological testing.

Documenting Functioning

🌸 The ruling and fact sheet also describe the importance of documenting your ability to function, and your limitations.

🌸 Physical functioning includes how well and how long you can walk, sit, stand, stoop, bend, twist, turn, grasp, lift and other physical activities.

🌸 Mental and cognitive functioning includes how well you can focus, concentrate, follow directions, and remember things. It can also be your ability to have interactions with other people.

🌸 The best way to prove functioning is to follow the steps above for RFC function forms, doctor’s letters, neuropsychological testing, and doctor’s office visit notes that discuss functioning. More ideas on this page: How to Prove Functioning.

Other Conditions

🌸 Many people with ME or CFS find that documenting mental health can be a great help to their case. How to Document Mental Health

🌸 If you are also applying for disability through private insurance or through your employer’s policy, learn more about How Documenting Mental Health Can Help Your Disability Application (Sometimes!)

🌸 You can also check out these pages about Lyme Disease, Fibromyalgia, and POTS 

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LEARN MORE

🌷 This page is part of the free online guide: The Sleepy Girl Guide to Social Security Disability 

🌷 Good article written by disability lawyers: Medically Documenting Disability in ME/CFS (Important: This article has two sections one for Social Security Disability and one for “long term disability.” Long Term Disability is private disability through an employer. If you are applying for just Social Security, this section won’t apply to you.)

🌷One of our writers created this great guide for physical and occupational therapists: Documenting disability for patients with ME/CFS: A guide for PT, OT, and SLP

🌷 You can learn a whole lot more about this topic here: How to Use the Social Security Blue Book and Rulings.

🌷 And here: Disability for MEeps (ME)

🌸 Here is an article by attorney Ken Casanova that reviews and describes the ruling.

🌸 If you are also planning to apply for Long Term Disability (private disability through your employer) please take a look here:  How to Get LTD for ME and Chronic Fatigue Syndrome

🌷 Art on this page by Robin Mead and Elizabeth D’Angelo.

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