Chronic Fatigue Syndrome

April 29, 2015

A recent report from the Institute of Medicine (IOM) suggests new diagnostic criteria and a new name for this disease:  Systemic Exertional Intolerance Disease.  Why? The IOM indicates that the term “chronic fatigue syndrome” can result in stigmatization and trivialization and should not longer be the name of this illness.  Key messages in report include the fact that CFS is a serious, chronic, complex, multi-system disease that can profoundly limit the health and physical activities of affected patients.  and that a thorough history, physical exam and work-up are necessary to determine an appropriate diagnosis.

Proposed diagnostic criteria requires three symptoms:

1.  a substantial reduction/impairment in the ability to engage in pre-illness levels of occupational, educational, social or personal activities that persists for more than six months and is accompanied by fatigue, often profound and is of new or definite onset (not lifelong) and is not the result of excessive exertion, and is not substantially alleviated by rest;

2.  post-exertional malaise; and

3.  unrefreshing sleep.

Additionally, at least one of the following manifestations is required:

1.  cognitive impairment

2.  orthostatic intolerance

While many people believe the Social Security Disability Insurance program to be rife with fraud, a report from late 2014 reflects that 99.8% of of the payments made under the program were proper.

Independent auditors such as the Government Accountability Office have found problems may not be as dire as some critics suggest. A 2013 GAO report estimated the agency made $1.3 billion in overpayments to 36,000 people — roughly 0.4 percent of all beneficiaries. Most of the improper payments resulted from people exceeding wage limits before their benefits began.

For the more information:

The Baltimore Sun recently reported that the number of people receiving disability insurance payments from the Social Security Administration declined last year for the first time since 1983, a reduction that comes as Congress faces a deadline to fund the program or risk cutting benefits to millions of Americans.  The decline, attributed in large part to economic and demographic trends, follows years of staggering growth that made the nearly $140 billion program a target of criticism by Republicans.

Agency data show the number of beneficiaries fell by half a percent in 2014 to 10.9 million. The number of new applicants, meanwhile, dropped 14 percent from 2010.  If those reductions hold in coming months, it could quiet criticism of the program, which have become almost deafening in the past few years.

Experts predict the enrollment reduction will continue in the short term, putting a halt to the rise in the program’s costs through about 2035. The number of beneficiaries will begin to rise again after that, but at a rate consistent with overall population growth.

“The disability applications we have coming in now are even lower than we were assuming,” Stephen C. Goss, the chief actuary at the Social Security Administration, said in an interview. “We feel pretty confident about saying that, in the future, we’re going to have essentially stable growth.”  The decline in enrollment could give a political lift to Democrats’ arguments that the program is not as poorly managed as critics say and that the best way to address the looming shortfall is with a quick fix of the kind Obama is proposing.

Disability beneficiaries by year:

2010 — 10,185,886
2011 — 10,614,398
2012 — 10,890,896
2013 — 10,988,269
2014 — 10,931,092

Replacement Tax Forms!

If you didn’t receive or misplaced your SSA-1099 or SSA-1042S, you can now use your online my Social Security account to get an instant replacement for tax purposes.

You just need to go to and log in to your account. Once you log in, select the “Replacement Documents” tab. If you don’t remember your user name and password, we can help you. Just visit the link, select Sign In, and then select whether you forgot your user name, password, or both. After you answer questions to verify your identity, you will be all set.

Even if you don’t currently receive monthly benefits, or you receive benefits and don’t need a replacement SSA-1099 or SSA-1042S, I strongly recommend signing up for an account so that you can avail yourselves of the mervices available with your my Social Security account at

If you need assistance with a Social Security Disability claim, call the office at 1-904-981-9812.

The Senate Finance Committee considered gender disparities and Social Security at a meeting in December 2014.  “While Social Security benefits are gender neutral, life is not” stated one witness.  The committee heard from witnesses who reported that women often draw less income over their lives both and have earnings disrupted when they provide care for children and other relatives (presumably parents).  Often the facts of women’s lives lead them to lose insurability for benefits as families rely on women to provide care.  Overall, women have fewer savings which makes them more reliant on a reduced amount of Social Security benefits.

Policy suggestions were made such as a way for caregivers to ear qualifying credits or increasing benefits for surviving spouses.  Another suggestion was made to equalize benefits so that couples pay the same in Social Security taxes and then receive the same benefit amount.  Currently, a household where one spouse has always earned $50,000 and one the other did not work would receive substantially more in retirement benefits than a household where each spouse earns $25,000 per year.

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