The Pros and Cons of a Two-Day CPET

The CPET is a test used by some people to document ME and Chronic Fatigue Syndrome. There are two kinds of CPETs: one day and two day.

Two-day CPETs are run by the Workwell Foundation in California and by Betsy Keller in Ithica New York.

CPETS are most commonly used for disability through your employer. They are sometimes used by people applying for Social Security disability, but this is less common.

The Upside of the Two-Day CPET

💮 The people who perform the test have detailed knowledge of ME and Chronic Fatigue Syndrome. They produce a detailed report that analyzes your level of disability, and describes your limitations based on their medical evidence.

💮 Many people report that this test was a big help for their disability cases – especially for people applying for disability through an employer (LTD).

💮 Because it is a two day test, it may show your symptoms were worse the day after exercise (post exertional malaise).

💮 Because it is a two day test, it may be able to more accurately show the full severity of your condition.

The Downside of the Two-Day CPET

💮 There is a health risk in taking this test. For some people, the risk is minor and temporary, but for others it is serious. The two-day test may have a greater risk than the one-day test.

💮 Some people report that they were not warned ahead of time about the health risks. Before going forward, please learn as much as you can: Real Life Stories from CPETs

💮 This test is not covered by insurance and generally costs $2,000.

💮  You may need to travel to take this test.

💮 There is a misconception that the two-day CPET is a “Gold Standard” or “Guaranteed win” for disability. The CPET has certainly helped many people, however some readers here got a CPET and were still denied. It is not a guaranteed win.

Important Consideration About Social Security

💮 This section only applies to Social Security. If you are applying for a different form of disability, the rules will be different.

💮 At this time, the groups that run the two-day CPET test do not follow the Social Security regulations for  acceptable medical sources. Perhaps this will change in the future, but as of this writing none of the reports we saw followed these regulations.

💮 If you have a CPET report that is not signed by an Acceptable Medical Source, it can still be a great help to your case, but there is also a chance Social Security will give this report a low priority or little consideration.

💮 There is a way to magically turn your CPET results into evidence from an Acceptable Medical Source: You can ask your doctor if she can write a medical opinion statement supporting or repeating the results of the CPET (if your doctor is already writing a support letter for you, this can just be one paragraph included in the letter). If your doctor agrees with the conclusions of the CPET report, she should be able to simply quote these conclusions directly without needing to write something

💮 Alternately, if your doctor is completing an RFC form for you, she can include this test in response to the question that asks for a list of “objective medical evidence”.


More Options

💮 Learn more about the CPET: How to Get a CPET (maybe)

💮 Wondering why some people had such bad reactions to a CPET? Learn More about How Exercise Can Affect People with ME and CFS



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