Case of the Week: Chronic Fatigue Syndrome

A woman came to us in June of 2021.  She was suffering from Chronic Fatigue Syndrome (“CFS”).  She had been denied disability benefits by Social Security.  As many of you know, Chronic Fatigue Syndrome (“CFS”) is a terrible systematic disorder with complex symptoms that may vary in frequency, duration, and severity.  The condition is misunderstood, and sometimes even family and friends believe that it is “all in your head.” This lack of understanding often extends to decision-makers at Social Security. In order to help their decision-makers, the Administration issued a policy ruling in 1999 and updated it in 2014  on how to properly evaluate CFS cases.   Despite this guidance, because of a general lack of understanding and skepticism about the condition, CFS cases are extremely hard to win.

Our client had been suffering from Chronic Fatigue Syndrome for many years and was essentially bed bound.  Despite reports and supportive medical opinions from her long-time treating family physician and a specialist at a prestigious chronic fatigue clinic, she was still denied twice by Social Security, once at the initial level and again later at the reconsideration level after filing her application.    At the reconsideration level, Social Security wanted her to be seen by two of their doctors.  The claimant’s fatigue was so profound that she could not attend the evaluations, and the doctors agreed to examine the claimant in her own home.  Both doctors agreed that the claimant could not work, and still, she was denied. 

We came on board at the hearing level, updated the medical reports, and secured opinions from our client’s doctors in a format that Social Security understands.  We then drafted a comprehensive brief summarizing the evidence that explained why the claimant was entitled to disability benefits.  In the brief, we asked the Administrative Law Judge to grant the case an “On the Record” without the need for a hearing.  I am happy to report that the client recently received a Fully Favorable “On the Record” decision, and she is now getting the monthly benefits she deserves.

Take-Aways

Do Not Give Up:  This claimant had an overwhelming amount of supportive evidence, including reports of her primary doctor, highly trained and respected specialists, and even Social Security’s own doctors.  Despite all that, she was still denied at the Initial and Reconsideration levels.  She did not give up and eventually won her much-deserved disability benefits.

Representation Matters:  Every case is unique and presents its own challenges.  Some cases are tougher because of the nature of the person’s disability.  We know what specific medical evidence is needed to prove a case of disability and know the rules and regulations concerning complex conditions.  Not everyone who “handles” disability cases know what it takes to win difficult cases.  At Binder & Binder, we are experienced in handling the most complex cases, and we work to resolve them as early as we can for the client.  We review our clients’ cases multiple times before they are ever scheduled for a hearing and develop the medical evidence that we know the Social Security Administration, and if necessary, a Judge will need to see to make a favorable ruling.  

If you have a complex case or would like to schedule a free consultation to discuss your situation, please contact us.