Is chronic fatigue syndrome a disability?

chronic fatigue, disability

An increasing number of medical evidence is suggesting that chronic fatigue syndrome is a physical disability.

How do you define being disabled? In my opinion, "disability is when you are not able to do what others are doing." But, the definition is overly simplistic. With increasing disability claims, the social security administration may find this definition insufficient to claim social security disability benefits.

According to the Social Security regulations, a person will be regarded as disabled if they cannot engage in some form of productive work because of mental, physical or medical problems. The ailment must have persisted for a year, be expected to remain for a year, or be likely to result in death.

Now, in the context of this definition, we'll see if chronic fatigue can be considered a disability. Let's begin with what chronic fatigue is, how it is caused, and its effects on a person's health and well-being.

What is Chronic Fatigue?

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis, is a multifactorial disease that is defined by three key symptoms (along with other symptoms);

  1. Severe fatigue lasts for at least six months. It is brought on neither by an ongoing activity nor strenuous physical exercise.
  2. The fatigue intensifies after engaging in a physical or mental effort, or the patient may "crash." This condition is also called Post-exertional malaise (PEM), and different cognitive symptoms can also be noted.
  3. Sleeping and drained out, even after lengthy bed rest.

CFS is a common disease accompanied by substantial illness and a heavy financial burden. According to a report published in British Medical Journal, it affects 2-4 people every 1000 population. Usually, the illness burden is directly proportional to how severe the condition is. In most severe cases, the person cannot carry out routine activities, like getting dressed, preparing a meal, visiting others, etc... In addition to physical symptoms, it may also involve severe mental dysfunction like the inability to remember things, brain fog etc...

Causes of Chronic Fatigue

Chronic fatigue has numerous causes. Although the exact aetiology of this ailment is still unknown, it may result from several factors, including infections, immune disorders, genetic causes, metabolic disorders, etc... Two or more such causes may add up to aggravate the disease even more.


Chronic fatigue is seen in some patients who have just recovered from an infection. A few chronic bacterial infections and many viral infections are known to do so. For example, Ross River Virus, Epstein Barr Virus, Coronavirus, etc..., are responsible for such symptoms.

Genetic Causes

Studies have also demonstrated a genetic component to chronic fatigue. These reports claim that chronic fatigue typically runs in families, suggesting that it may also be hereditary. The data supporting this explanation is still insufficient to be accepted as evidence—environmental variables and heredity influence the onset of the symptoms.

Weakened Immunity

Impaired immune systems and autoimmune disorders also lead to chronic fatigue. For example, cytokine levels may increase continuously, natural killer cells stop combating infections, or T-cells may become hyperactive or inactive. If any of these is prolonged, it may result in chronic fatigue.

Extreme Stress

Extreme stress, also known as Post Traumatic Stress Disorder (PTSD), or an emotional breakdown may also result in chronic fatigue. The hyperactivity of stress-handling glands (pituitary, hypothalamus, and adrenal glands) causes an imbalance of hormones in the blood. If stress remains persistent, it may disturb the hypothalamic-pituitary-adrenal axis (HPA axis), leading to chronic fatigue. Some specific medical evidence, including case studies and published reports, has confirmed it.

Is Chronic Fatigue a Disability?

Yes! In most cases, it is. The Centers for Disease Control and Prevention (CDC) defines chronic fatigue syndrome as "a disabling and complex illness." Even if some patients with CFS can live normally, many of them cannot carry out their daily chores. It depends on how severe the cases are. Patients with debilitating chronic fatigue syndrome may also have other diseases that worsen their condition.

Patients with highly severe conditions often cannot dress, cook, or take a bath due to cognitive impairment. In such cases, it forces patients to stay in bed and do nothing. They become socially isolated as a result of their disease. There is excessive fatigue that even a long rest cannot cure. The symptoms worsen, especially after engaging in physical or mental activities (Post-exertional malaise). They can no longer pursue their prior careers or educational goals because of their illness. So what other phrase would you use to describe this condition if it wasn't a disability?

How do Patients feel about chronic fatigue?

Some patients suffering from chronic fatigue are resilient enough to provide for themselves. Others are no longer able to work. Many such patients have shared their stories with the CDC. Some of these show that chronic fatigue is not always a disability.

Katherine has familial chronic fatigue syndrome. Her friends and family are encouraging and never let her feel like she is "not enough." Ben, her husband, is her biggest supporter and is responsible for planning every aspect of her health recovery. She is content and making progress, and her worries have become her strengths.

Adhira and Neel, mother and son, both experience chronic fatigue. Their condition is genetic and is due to autoimmune disorders. Neel cannot lead a regular life since he is disabled, confined to bed, and financially dependent. Adhira is also weak and spends most of her time in bed. However, they both have loving families who inspire them to live each day with optimism.

Max works in an insurance company. No doctor made a diagnosis of her ailment. She initially attributed her symptoms to her demanding job but later learned she had chronic fatigue syndrome. She often finds it so difficult to complete even the most straightforward duties. However, she is fighting the disease while maintaining her reputation as a strong woman.

Disability in Chronic Fatigue

The extreme conditions of chronic fatigue syndrome often result in complete disability. Some major symptoms which prove disability in the case of chronic fatigue syndrome are:

  • Orthostatic intolerance is the inability to stand for even a short period
  • Constant muscle aching and tenderness
  • Persistent fatigue
  • Post-exertional malaise
  • Sleepiness or insomnia
  • Brain dysfunction
  • Extreme weakness
  • Cardiovascular disorders


Chronic fatigue or myalgic encephalomyelitis is a condition that leads to disability sooner or later. The severity of this disease is due to co-occurring conditions like autoimmune disorders, cognitive impairments, infections, etc... The more severe the disease, the greater the disease burden and the greater the chances of disability. Various treatment options (e.g., graded exercise therapy etc...) are available. You can choose anyone after consulting your physician.

While chronic fatigue is a serious condition and concern, there may be other factors that are impacting your ability to get quality sleep. Welzo offers an Energy and Fatigue at-home blood test that may be able to determine any other underlying concerns.

Our online pharmacy also has products that may be able to assist in getting a good night's sleep. See them here.

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