SSDI- CFS finally recognized As 'Medical Impairment' under guidelines

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Well! CFS finally recognized As 'Medical Impairment' under

guidelines

http://www.24- 7pressrelease. com/press- release-rss/ cfs-finally- recognized-

as-medical- impairment- under-guidelines -158002.php

One of the battles often fought by persons with CFS trying to obtain Social

Security Disability Insurance and SSI benefitswas resolved with the adoption of

Social Security Ruling 99-2p. In this binding Ruling the Social Security

Administration set out guidelines for adjudicators and judges to follow for

claims based upon Chronic Fatigue Syndrome. This Ruling removes at least one of

the barriers faced by Claimants.

What Was the

Issue?

The Social Security Act allows for SSDI or SSI benefits

to be paid to persons unable to work by reason of any medically determinable

physical or mental impairment (or combination of impairments) .... " (emphasis

added) The Act and Regulations define the phrase " medically determinable " as a

condition that can be established by medical evidence consisting of signs,

symptoms and laboratory findings. It cannot be based only on the Claimant's

description of symptoms.

In claims based upon CFS there are obviously a

lack of medical signs, symptoms and laboratory findings. Therefore many claims

were denied on the failure to prove the existence of a " medically determinable

impairment. "

What Does the Ruling Say?

The Ruling

states unequivocally that CFS can be a medically determinable impairment. It

specifies medical signs and laboratory findings that will now constitute proof

of a medically determinable impairment for persons suffering from CFS. However,

whether the Claimant is actually " totally disabled " is a separate determination

based upon the severity of functional limitations caused by the disease. That is

the same as in any claim based upon any other medical problem.

This

Ruling requires that any of the following medical signs, which

are clinically documented over a period of at least 6 consecutive months, can

establish a medically determinable impairment:

- 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; or,

- other medical signs consistent

with medically accepted clinical practice which are consistent with the other

evidence in the case record.

The following laboratory

findings can establish a medically determinable impairment for

individuals with CFS:

- an elevated antibody titer to Epstein-Barr virus

capsid antigen equal to or greater than 1:5120, or early antigen equal to or

great than 1:640;

- an abnormal MRI brain scan;

- neurally mediated

hypotension as shown by tilt table testing or another clinically accepted form

of testing; or,

- other laboratory findings consistent with medically

accepted clinical practice such as abnormal sleep studies and abnormal exercise

stress tests that are consistent with other evidence in the case

record.

Finally, mental impairments documented by mental status

examinations or psychological testing can also establish the presence of a

medically determinable impairment.

What Evidence Can Be Used to

Show these Signs and Findings?

As in any claim for disability

benefits the focus is upon the medical evidence, especially the clinical records

and test results from treating sources. SSA will try to obtain all medical

records, generally beginning 12-months prior to the month of application. The

Ruling notes that conflicts in the medical evidence are not unusual in cases

involving CFS and clarification should be sought first from the treating

sources. Treating source opinions about the severity of the impairment should be

given deference if they are well supported by medically acceptable clinical and

laboratory techniques and are not inconsistent with other evidence in the

records. It is noted that any information regarding functional abilities before

and after the onset of the impairment is helpful in evaluating the claim.

Finally third-party sources may be useful in determining the credibility of the

Claimant.

As in any claim, the focus is upon a longitudinal view of all

of the medical evidence. Claimants must be actively treating with medical

providers and must be completely describing all symptoms each time they see the

doctor. The doctors must keep careful, legible, notes during each visit so that

the signs and findings noted above can be documented. In addition, the physician

should be willing to provide a written opinion to SSA regarding the patient's

ability to sustain even sedentary work activity on an 8 hour per day, 5 days per

week basis.

SSR 99-2p does not provide that every claim based upon CFS

should be approved. It does, however, set forth guidelines for evaluation of

these claims so that Claimants, physicians and representatives can be assured of

a fair evaluation of the impairment and its impact on the

individual.

Article provided by A. Rabin & Assoc

Visit us

at www.rabinsslaw. com