How to Collect Medical Evidence for Chronic Fatigue Syndrome

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Artwork by Elizabeth D’Angelo

It will help your application a great deal if you can collect at least one piece of medical evidence.

Medical evidence is something that shows your illness exists in the world.

The Social Security ruling on Chronic Fatigue Syndrome includes a list of medical evidence that can help your case. In the ruling, they call this “establishing a Medically Determined Impairment.”

I’ve seen a lot of people with Chronic fatigue Syndrome lose their minds with worry trying to get more and more tests or trying to get the “right” test to prove they are disabled. I want to reassure you that that is not how Social Security Disability works. There are many parts of the process and getting tests is just one part. You can’t get approved off of tests alone. Please don’t lose your mind (or your pocketbook).

You are not required to have a million pieces of medical evidence, but you do want at least one. One or more of the following tests may help establish a Medically Determined Impairment:

  • An abnormal magnetic resonance imaging (MRI) brain scan
  • Neurally mediated hypotension (through Tilt table testing)
  • Neurally mediated hypotension (through other forms of testing)
  • An abnormal exercise stress test
  • Abnormal sleep studies appropriately evaluated
  • Psychological testing showing neurocognitive impairment
  • Mental status exam showing neurocognitive impairment
  • Medical findings showing neurological impairment or other mental problems
  • An elevated antibody titer to Epstein-Barr virus (EBV) capsid antigen equal to or greater than 1:5120, or early antigen equal to or greater than 1:640
  • Any other laboratory findings consistent with medically-accepted clinical practice

Social Security will also accept medical signs as a way to establish a Medically Determined Impairment:

  • Physical exam by a doctor showing palpably swollen or tender lymph nodes (documented over 6 consecutive months)
  • Physical exam by a doctor showing nonexudative pharyngitis (documented over 6 consecutive months)
  • Physical exam by a doctor showing persistent, reproducible muscle tenderness on repeated examinations, including the presence of positive tender points (documented over 6 consecutive months)
  • Other medical signs. For example: Frequent viral infections with prolonged recovery; Sinusitis; Ataxia; Extreme pallor or Pronounced weight change. An acute infectious inflammatory event may precede the onset of Chronic Fatigue syndrome
  • Any other medical signs consistent with medically accepted clinical practice

Sleepy Girl Tips for Testing for Chronic Fatigue Syndrome

🌸 The ruling states that the tests on this list are “only examples” and “they are not all-inclusive.” The ruling allows for “any other laboratory findings consistent with medically-accepted clinical practice.” Here is a long list of other types of tests that may be helpful for documenting Chronic Fatigue Syndrome.

🌸 Luckily, this ruling recognizes that many people with CFS or ME test show normal results on tests. The ruling include this sentence: “Standard laboratory test results in the normal range are characteristic for many people with Chronic Fatigue Syndrome, and they should not be relied upon to the exclusion of all other clinical evidence”

🌸 If your test results come back normal, it is still possible to get approved. It is great if you can take steps to make the rest of your application strong. Learn more: How Peony Won Her Case Despite “Normal” Test Results and How Jasmine Got Approved Despite “Normal” Test Results

🌸 How many tests should you get? Are your test results “good enough”? What do I do with my test results after I get them? I get asked these questions a lot. Here are some answers.

🌸 Collecting medical evidence is just one part of the process. Learn more about The Social Security ruling on Chronic Fatigue Syndrome

Updated April 2017. Please comment below with suggestions or ideas. 

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