Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME/CFS), is a complex and misunderstood condition that can make full-time work impossible. Unfortunately, many initial Social Security Disability Insurance (SSDI) claims are denied because of limited diagnostic testing. If your claim was rejected, PLBH can help you gather the right medical evidence and appeal the decision to secure the benefits you deserve.
Why CFS Claims Are Often Denied
Unlike conditions with clear diagnostic tests, CFS relies on symptom-based criteria. This can make it difficult to prove to the Social Security Administration (SSA) that you are disabled.
Common reasons for denial include:
- Lack of objective medical testing
- Inconsistent medical documentation
- Gaps in treatment history
- SSA examiners misunderstanding the condition
However, you can still win your appeal with consistent records, supportive physician statements, and proper legal representation.
Understanding How the SSA Evaluates Chronic Fatigue Syndrome
The SSA recognizes CFS as a legitimate medical impairment under Social Security Ruling 14-1p. This means the condition can qualify for disability if it prevents you from maintaining substantial gainful employment for at least 12 months.
Symptoms the SSA considers include:
- Persistent fatigue that worsens after exertion
- Muscle or joint pain
- Sleep disturbances
- Cognitive issues (known as “brain fog”)
- Chronic sore throat or swollen lymph nodes
- Headaches and dizziness
To qualify, you must show that these symptoms are severe, long-lasting, and supported by medical evidence.
Building a Strong Appeal with Limited Medical Testing
Even without definitive lab results, you can build a strong case by documenting consistent symptoms and functional limitations.
Effective supporting evidence includes:
- Medical notes from primary care doctors and specialists
- Reports from physical therapists, psychologists, or pain specialists
- Statements from friends or family describing your daily limitations
- Fatigue logs or symptom diaries
- Records showing treatments attempted (e.g., medication, rest therapy, or lifestyle adjustments)
PLBH can help you collect and organize this documentation to create a clear timeline of your condition and its impact on your life.
How to Strengthen Your Case on Appeal
When appealing an SSDI denial, the goal is to prove that your condition significantly reduces your Residual Functional Capacity (RFC)—your ability to perform basic work activities.
Steps that improve your chances of success:
- Continue medical treatment and maintain regular doctor visits.
- Ask your physician to complete an RFC assessment describing your physical and mental limitations.
- Update your medical evidence with any new test results or specialist evaluations.
- Keep detailed personal records of fatigue episodes, recovery time, and missed activities.
- Work with PLBH to prepare for your hearing and present expert testimony if needed.
What to Expect During the Appeals Process
The SSDI appeals process includes several stages:
- Reconsideration: Submitting updated evidence to the SSA for review.
- Administrative hearing: Presenting your case before an Administrative Law Judge (ALJ).
- Appeals Council or Federal Court review: If necessary, challenging the ALJ’s decision.
PLBH will represent you at every step, ensuring your claim is clearly presented and supported by persuasive medical and vocational evidence.
Get the Support You Deserve
Chronic Fatigue Syndrome may not show up on a simple test—but its effects on your life are real. If your disability claim was denied because of limited medical documentation, contact PLBH at (800) 435-7542. Our team will help you appeal the decision, gather the right evidence, and fight for the SSDI benefits you’re entitled to.