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The original was posted on /r/cfs by /u/TheGreatK on 2025-01-29 23:29:23+00:00.
Hello! My name is Andrew and I'm a private disability attorney who has developed a niche representing claimants with ME. I wanted to share some basic information I often share when I consult with people who are considering filing for disability benefits. I hope you find this helpful - if you do, please let me know and I will post more as time allows!
First, it is important to define "disability benefits" in this context.
There are multiple sources of disability benefits, and the availability of such benefits depends on several factors.
The most commonly known source of disability benefits is Social Security Disability Insurance (SSDI). These benefits are provided by the federal government and are available to any American who has paid taxes long enough to earn eligibility. In order to file a claim, you must be out of work for five months and expect to be out of work for at least a year. To qualify, you basically need to prove you are unable to work in any capacity. The amount you receive depends on your income level, with the maximum individual amount being $4,018 per month, with a 50% bonus on top if you have dependents. It is generally very difficult to obtain SSDI benefits, and can take several years if you are required to appeal an initial denial, which required for most applicants.
Certain states also offer State Disability. California, for example, pays up to $60,000 for 52 weeks if you are unable to work in your own occupation due to an injury or illness.
If your are disabled due to a work related injury, you can file for worker's compensation (WC) benefits. While most assume this wouldn't apply to people with ME, it can apply in certain circumstances. For example, many cases of ME are linked to Long Covid, and if the Covid exposure can be linked to the workplace, you are at least eligible to file a WC claim.
The final source of disability benefits come from private disability insurance, either in the form of Short Term Disability (STD) or Long Term Disability (LTD). Most people get this coverage through their employer, though insurance companies also offer individual LTD policies. (This is my primary area of legal expertise.)
Second, there are some universal steps you can take which will help you prepare for filing any (or all) of these claims:
-Make sure your physician is supportive. If you haven't spoken with them about your concerns, make sure to do so explicitly. Don't be a superhero - if you don't share the extent of your suffering, it won't be reflected in the records, and it will be harder to get your claim paid. Your claim will not get off the ground without a supportive physician.
-If you don't have a supportive physician, find one now. You don't need to abandon your current physician if they provide good care but are merely unwilling to support disability. Just find another one (a specialist, if possible) who will support you. Be careful trying to convince your current physician if they are steadfastly opposed - this could just as easily make them double down and record objections to your disability rather than get them to change their opinion.
-Check your medical records before you submit them. If there are any inaccuracies, ask that they be corrected, as you have a right to correct records under HIPAA. If there is insufficient support for disability, make sure your doctor is willing to provide additional information via letter or future medical records. - In regard to private disability, make sure to request and review your policies before you file any claims. Pay special attention to any exclusions or limitations, especially for pre-existing conditions and/or "Fatigue Related Illnesses."
-Assume what you tell your employer about temporary leave or accommodations will eventually be shared with whomever is assessing your disability; so be careful not to try to downplay your disability to your employer in order to maintain employment, as it may undermine your disability status down the road. This is especially important when dealing with private insurance, which will do whatever it can to undermine your claim at every opportunity.
-Get a free consultation from a lawyer. I give free consultations, as do pretty much every LTD and SSDI lawyer I know. There's never a reason to pay a lawyer for a consultation in this niche, and we can often provide important info which will help you navigate your claim in its initial stages.
-Finally, research yourself on social media. I'm sure your account is private, but 1) your friends' accounts often are not private, and 2) insurers and claim reps love to impersonate random "friends" in the hope you mindlessly accept, and gain access (legally) to your profiles that way. Assume everything you post on any social media platform will be seen - including this one!
Thanks for taking the time to read this, and best to all of you!
