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Appendix C: Disability in ME/CFS
Pages 257-268

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From page 257...
... provides guidance on how to develop evidence to establish that a person has a medically determinable impairment (MDI) of ME/CFS and explains how SSA evaluates disability claims and continuing disability reviews for ME/CFS under titles II and XVI of the Social Security Act.
From page 258...
... However, certain laboratory findings may support the finding of an MDI in people with ME/ criteria, as well as the objective tests mentioned in Chapter 7 (tilt table test, cardiopulmonary exercise test [CPET] , and neuropsychological testing)
From page 259...
... brain scan; •  eurally mediated hypotension as shown by tilt table testing or another n clinically accepted form of testing; or •  ny other laboratory findings that are consistent with medically accepted a clinical practice and are consistent with the other evidence in the case record (for example, an abnormal exercise stress test or abnormal sleep studies, appropriately evaluated and consistent with the other evidence in the case record)
From page 260...
... Third, disability, evidenced by the persistence of illness following optimal treatment, requires consensus regarding an optimal course of treatment. A lack of consensus regarding treatment efficacy persists in the research to date and further confounds efforts to assess disability status.
From page 261...
... Impairment and School Activity For children, adolescents, and young adults who are not yet engaged in full-time occupations, physical function, impairment, and disability are more appropriately evidenced by school attendance. Additionally, assessment of social, physical, emotional, psychosocial, and cognitive domains that reflect levels and quality of overall function in this age range are warranted.
From page 262...
... Children with ME/CFS scored substantially lower than controls on the global health item of the Child Health Questionnaire (CHQ) , as well as most other items, including physical functioning, social limitations due to emotional and health limitations, pain and discomfort, mental health, self-esteem, general health perceptions, and family activities.
From page 263...
... The brief global assessment was the most common outcome measure used to define recovery, although measures of recovery varied considerably among the studies. Overall, the review revealed widely varying estimates of recovery that ranged from 0 to 66 percent in intervention studies and 2.6 to 62 percent in naturalistic studies.
From page 264...
... The challenge of defining recovery in ME/CFS is further supported by a study of long-term health, symptom, and disability outcomes in ME/CFS patients diagnosed 25 years ago compared with healthy controls (Brown et al., 2012)
From page 265...
... Another systematic review found that the placebo response is lower in behavioral intervention studies than in medical intervention studies of patients with ME/CFS (Cho et al., 2005)
From page 266...
... 2005. A systematic review describing the prognosis of chronic fatigue syndrome.
From page 267...
... 2007. The effect of cognitive behaviour therapy for chronic fatigue syndrome on self-reported cognitive impairments and neuropsychological test performance.


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