For many people diagnosed with chronic fatigue syndrome (CFS), gaining Social Security Disability Insurance (SSDI) and other medical benefits can be difficult and frustrating. Even though a Social Security Administration (SSA) ruling indicating that this syndrome presents a "medically determinable impairment" has existed for the last 12 years, CFS patients still face hurdles throughout the SSDI application process today. However, a recent case and legal advice may help people with CFS get SSDI and other benefit awards more quickly.
Chronic Fatigue Syndrome
Although doctors have yet to identify what causes CFS or how to effectively treat it, they do know that it greatly impairs the physical and mental activities of patients. Some symptoms of CFS include prolonged sleep, inability to stay awake, lack of concentration, short-term memory loss and pain in joints and muscles. These symptoms often worsen after even limited physical exertion, but the severity of CFS differs from patient to patient. According to one article about CFS, around 25 percent of those diagnosed with CFS are fully disabled by it.
Access to SSDI Benefits
After a year of development between the SSA and the Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) Association of America, the agency issued a ruling in 1999 that patients diagnosed with CFS had a "medically determinable impairment." This policy came out of an internal recognition that SSA claims processors were wasting agency money and applicant time by unnecessarily delaying SSDI benefit awards to CFS patients. This ruling has had an overall positive impact for CFS patients, but hurdles to SSDI still exist.
Salomaa v. Honda Long Term Disability Plan
The United States Court of Appeals for the Ninth Circuit issued its opinion in Salomaa v. Honda Long Term Disability Plan earlier this year. The case involved the wrongful denial of ERISA benefits to a worker diagnosed with CFS. The district court judgment upholding the denial of benefits was reversed, because the Court of Appeals found the ERISA plan administrator abused her discretion and acted arbitrarily and capricious when she denied the CFS patient's claim due to a supposed lack of scientific CFS evidence.
Slow Going
While access to SSDI and other medical benefits for people with CFS has improved over the last decade, shown by quicker SSDI awards and court opinions acknowledging the difficulties of the syndrome, the progress has been slow going and frustrating for CFS patients. To ensure that any application for SSDI or other medical benefits based on a CFS diagnosis is successful, people with CFS should continue to seek legal advice from experienced disability attorneys in their areas when applying for benefits.
