January 1998
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Fatigue Syndrome?
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January 1998
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Is it Really Chronic
Fatigue Syndrome? |
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Is it Really Chronic Fatigue Syndrome? is a special internet version of a newsletter scheduled to be mailed to our list of insurers and adjusters in January 1998. It is authored by Leonard Grossman, Ph.D., a psychologist and diplomate of The American Board of Forensic Examiners.
 The answer to this question can have a major impact on treatment efficacy and long term disability benefit liability, particularly when the primary diagnosis turns out to be a psychiatric rather than medical one.
"Diagnosis by Default"
The CDC's criteria for CFS is a "diagnosis-by-default" proposition which is complicated and cumbersome to apply. For the average private practice physician this is a challenging -- if not overwhelming -- diagnostic task, as there are numerous medical and psychiatric conditions which can produce CFS-type symptoms which may need to be ruled out.
In practice, many physicians lack the time or training (or their patients lack sufficient funds or health insurance coverage) to perform a "forensic level" CFS diagnostic assessment. The end result: Most CFS claims are submitted to insurers without adequate medical documentation and corroboration, and many fail to meet official CDC criteria when held to closer scrutiny.
In Search of a Psychiatric Diagnosis
Unfortunately, many attending physicians are reluctant to investigate or emphasize psychiatric explanations for chronic fatigue, and default to an often unsubstantiated medical diagnosis of CFS. However well-intentioned, such practices can undermine recovery prospects and discourage patients from seeking much-needed psychiatric consultation and treatment.
Yet another cause for confusion is the difficulty in determining the precise nature of psychiatric symptoms sometimes associated with CFS. For example, a finding that a claimant suffers from a bi-polar disorder, depression with melancholic features, or a schizo-affective disorder would definitely rule out a CFS diagnosis.
Updated CDC Criteria for CFS
Given such complexities, great care must be taken before arriving at a definitive diagnosis. For insurers, these complications often allow unsubstantiated CFS claims, or psychiatric claims presented as CFS claims, to tumble through the cracks.
Conversely, misinformation and misunderstandings regarding the diagnostic criteria for Chronic Fatigue Syndrome can also lead insurers to deny benefits to claimants who actually meet the updated CDC criteria for CFS -- a most unfortunate and equally unacceptable outcome.
 That's what we do. We'll thoroughly review your CFS claims, and tell you whether they appear to stand up to official CDC criteria. When they don't, we tell you why in language you can understand.
If a claim appears to have a psychiatric rather than a medical etiology, we'll advise you on the steps you'll need to take to corroborate this. When additional clinical information is required to make a determination, we'll tell you what you need and help you get it. If an IME is indicated, we'll select an appropriate specialist from our nationwide provider network.
Don't Settle for Less Of course, there's considerably more to tell you than can be detailed here. So, if you'd like more information on CFS, or have a case you'd like reviewed or IMEd, please contact me at our toll free number (888) 779-2524.
Sincerely,
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