Anothr one I hope it helps some one get SSD. Sue Available for download: The Provider Workbook on CFS Disability Workbook includes disability information and assessment tools in one convenient PDF. -------------- CFS and Disability By definition, all persons with CFS are impaired and studies have shown that approximately one-third of these persons are unable to maintain full-time employment after becoming ill. Some are able to continue to work full time; some are able to work only part time; and many are unable to work at all. Work is a source of identity and self-esteem for many people and the inability to work can have negative mental health consequences. Some people have difficulty accepting that they may have to discontinue working and rely upon insurance companies, government or family for financial support. Many grieve the loss of independence, financial security, self-sufficiency, social connectedness and sense of productivity that come with employment. The application process for disability benefits is often protracted and frustrating. In order to demonstrate their need for benefits, applicants must identify all the things they are now incapable of doing. Admitting their weaknesses and limitations can be emotionally difficult. Completing the application forms and gathering the information necessary to justify their application is a physically, cognitively and mentally draining process. Many applicants may choose to hire an attorney or rely on the assistance of a trusted family member or friend to help them though the process. If your patient is represented by an attorney in disability matters, it is advisable to obtain a release form from the patient allowing you to communicate with the attorney. Documentation Fundamentals Treating health care professionals are a major source of pertinent information required for the disability application. All members of the health care team can contribute useful information. For example, referrals to rehabilitation and physical therapists can provide constructive approaches that maximize medical improvement and assist with disability documentation. Information from relatives, friends, counselors, therapists and others can be used to illustrate the severity and nature of the patient’s impairments, as long as they are recorded by the treating physician and the information is justifiable and credible. Also, the patient or family may be able to provide a diary or summary of typical daily activities. Patients’ journals are also considered pertinent evidence. It is helpful to record supportive medical signs such as swollen or tender lymph nodes, pharyngitis and persistent reproducible muscle tenderness (e.g., the tender points of fibromyalgia). While there are no studies that are diagnostic for CFS, abnormalities in MRI, orthostatic dysfunction demonstrated by tilt-table testing, abnormal sleep studies, mental status or neuropsychiatric testing or functional capacity examinations can be supportive. The process of preparing letters or reports or filling out forms can be time consuming, but may be streamlined by maintaining adequate documentation, keeping detailed office notes and following an outline. Documentation needs to be as complete and specific as possible. Documentation of Impairment Impairments might include increased fatigue with physical or mental exertion (limits ability to function on a regular and sustained basis), pain (reduces mobility) and difficulty with concentration, comprehension of new information, recall or memory tasks and executive function (making calculations, handling money) or difficulty in driving. These may be documented by contemporaneous office notes detailing symptoms, treatments and how these impairments impact the patient’s activities of daily living and work. Next, it is necessary to establish that these impairments prevent even sedentary and light activities on a regular, predictable or sustained basis. Lastly, the provider must generally predict, based on experience and the patient’s response to therapy, how long would the impairments be expected to last.