From: Kris Hopkins: kphopkins@cfids.org
Today (April 30, 1999), the Social Security Administration (SSA) issued a ruling
clarifying that persons with medically documented CFS can be found to have a
"medically determinable impairment." The ruling provides guidance to disability
claims processors for applying SSA policy to applications for Social Security Disability
Income (SSDI) benefits that result from disability due to CFS. While the new ruling will
hardly "open the floodgates" for CFIDS patients to garner disability benefits,
it should make it easier for disabled CFIDS patients to acquire benefits at an earlier
stage in the SSA appeals process.
The ruling had been in development for over a year. A unique aspect of this ruling was
that SSA's Office of Disability appropriately involved The CFIDS Association of America
from the earliest stages in drafting and refining the ruling. SSA became convinced of the
need for the ruling when an internal survey of CFS-related applications revealed that
numerous awards made at the hearing level could have been approved earlier in the review
process. The inappropriate delays not only posed serious problems for the applicant, but
created unnecessary expense for the agency. The POMS manual, the "bible" of SSA
adjudicators, will be revised soon to reflect the policy stated in the ruling. In July SSA
will begin training its personnel to ensure that the ruling is used correctly at all
stages of the disability process.
Overall the new Social Security Ruling should improve disabled CFIDS patients' outcomes in
the SSDI process. It is binding on adjudicators at all levels -- initial application,
reconsideration, and administrative law hearings -- and it applies when SSDI recipients
are periodically reviewed (for Continuing Disability Reviews or CDRs). "Social
Security Ruling, SSR 99-2p.; Titles II and XVI: Evaluating Cases Involving Chronic Fatigue
Syndrome (CFS)" should become a critical reference in any CFIDS patient's application
for federal disability benefits.
The full text of the Social Security Ruling appears below:
[Federal Register: April 30, 1999 (Volume 64, Number 83)]
[Notices]
[Page 23380-23384]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr30ap99-143]
SOCIAL SECURITY ADMINISTRATION
Social Security Ruling, SSR 99-2p.; Titles II and XVI: Evaluating
Cases Involving Chronic Fatigue Syndrome (CFS)
AGENCY: Social Security Administration.
ACTION: Notice of Social Security Ruling.
SUMMARY: In accordance with 20 CFR 402.35(b)(1), the Commissioner of Social Security gives
notice of Social Security Ruling, SSR 99-2p. This Ruling clarifies disability policy for
the evaluation and adjudication of disability claims involving Chronic Fatigue Syndrome
(CFS). This Ruling explains that, when it is accompanied by appropriate medical signs or
laboratory findings, CFS is a medically determinable impairment that can be the basis for
a finding of ``disability.'' This Ruling ensures that all adjudicators will use the same
policies and procedures in evaluating disability claims involving CFS, and provides a
consolidated statement of these policies and procedures.
EFFECTIVE DATE: April 30, 1999.
FOR FURTHER INFORMATION CONTACT: Carolyn Kiefer, Office of Disability,
Division of Medical and Vocational Policy, Social Security
Administration, 6401 Security Boulevard, Baltimore, MD 21235-6401,
(410) 965-9104.
SUPPLEMENTARY INFORMATION: Although we are not required to do so pursuant to 5 U.S.C.
552(a)(1) and (a)(2), we are publishing this Social Security Ruling in accordance with 20
CFR 402.35(b)(1). Social Security Rulings make available to the public precedential
decisions relating to the Federal old-age, survivors, disability, supplemental security
income, and black lung benefits programs. Social Security Rulings may be based on case
decisions made at all administrative levels of adjudication, Federal court decisions,
Commissioner's decisions, opinions of the Office of the General Counsel, and policy
interpretations of the law and regulations. Although Social Security Rulings do not have
the same force and effect as the statute or regulations, they are binding on all
components of the Social Security Administration, in accordance with 20 CFR 402.35(b)(1),
and are to be relied upon as precedents in adjudicating cases. If this Social Security
Ruling is later superseded, modified, or rescinded, we will publish a notice in the
Federal Register to that effect.
(Catalog of Federal Domestic Assistance, Programs 96.001 Social
Security--Disability Insurance; 96.006 Supplemental Security Income)
Dated: April 23, 1999.
Kenneth S. Apfel,
Commissioner of Social Security.
Policy Interpretation Ruling Titles II and XVI: Evaluating Cases
Involving Chronic Fatigue Syndrome (CFS)
Purpose
To restate and clarify the policies of the Social Security Administration for developing
and evaluating title II and title XVI claims for disability on the basis of Chronic
Fatigue Syndrome (CFS), also frequently known as Chronic Fatigue and Immune Dysfunction
Syndrome.
Citations (Authority)
Sections 216(i), 223(d), 223(f), 1614(a)(3) and 1614(a)(4) of the Social Security Act, as
amended; Regulations No. 4, subpart P, sections 404.1505, 40404.1508-404.1513, 404.1520,
404.1520a, 404.1521, 404.1523, 404.1526-404.1529, 404.1560-404.1569a and
404.1593-404.1594; [[Page 23381]] and Regulations No. 16, subpart I, sections 416.905,
416.906, 416.908-416.913, 416.920, 416.920a, 416.921, 416.923, 416.924, 416.924b,
416.924c, 416.926, 416.926a, 416.927-416.929, 416.960-416.969a, 416.987, 416.993, 416.994,
and 416.994a.
Introduction
CFS is a systemic disorder consisting of a complex of symptoms that may vary in incidence,
duration, and severity. The current case criteria for CFS, developed by an international
group convened by the Centers for Disease Control and Prevention (CDC) as an
identification tool and research definition, include a requirement for four or more of a
specified list of symptoms. These constitute a patient's complaints as reported to a
provider of treatment.
However, the Social Security Act (the Act) and our implementing regulations require that
an individual establish disability based on the existence of a medically determinable
impairment; i.e., one that can be shown by medical evidence, consisting of medical signs,
symptoms and laboratory findings. Disability may not be established on the basis of an
individual's statement of symptoms alone. This Ruling explains that CFS, when accompanied
by appropriate medical signs or laboratory findings, is a medically determinable
impairment that can be the basis for a finding of ``disability.'' It also provides
guidance for the evaluation of claims involving CFS.
Policy Interpretation
CFS constitutes a medically determinable impairment when it is accompanied by medical
signs or laboratory findings, as discussed below. CFS may be a disabling impairment.
Definition of CFS
CFS is a systemic disorder consisting of a complex of symptoms that may vary in incidence,
duration, and severity. It is characterized in part by prolonged fatigue that lasts 6
months or more and that results in substantial reduction in previous levels of
occupational, educational, social, or personal activities. In accordance with criteria
established by the CDC, a physician should make a diagnosis of CFS ``only after
alternative medical and psychiatric causes of chronic fatiguing illness have been
excluded'' (Annals of Internal Medicine, 121:953-9, 1994). CFS has been diagnosed in
children, particularly adolescents, as well as in adults. Under the CDC definition, the
hallmark of CFS is the presence of clinically evaluated, persistent or relapsing chronic
fatigue that is of new or definite onset (i.e., has not been lifelong), cannot be
explained by another physical or mental disorder, is not the result of ongoing exertion,
is not substantially alleviated by rest, and results in substantial reduction in previous
levels of occupational, educational, social, or personal activities. Additionally, the
current CDC definition of CFS requires the concurrence of 4 or more of the following
symptoms, all of which must have persisted or recurred during 6 or more consecutive months
of illness and must not have pre-dated the fatigue:
Within these parameters, an individual with CFS can also exhibit a wide range
of other manifestations, such as muscle weakness, swollen underarm (axillary) glands,
sleep disturbances, visual difficulties (trouble focusing or severe photosensitivity),
orthostatic intolerance (e.g., lightheadedness or increased fatigue with prolonged
standing), other neurocognitive problems (e.g., difficulty comprehending and processing
information), fainting, dizziness, and mental problems (e.g., depression, irritability,
anxiety). Requirement for a Medically Determinable Impairment Sections 216(i) and
1614(a)(3) of the Act define ``disability'' as the inability to engage in any
substantial gainful activity (SGA) by reason of any medically determinable physical or
mental impairment (or combination of impairments) which can be expected to result in death
or which has lasted or can be expected to last for a continuous period of not less than 12
months. Sections 223(d)(3) and 1614(a)(3)(D) of the Act, and 20 CFR 404.1508 and 416.908
require that an impairment result from anatomical, physiological, or psychological
abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic
techniques. The Act and regulations further require that an impairment be established by
medical evidence that consists of signs, symptoms, and laboratory findings, and not only
by an individual's statement of symptoms.
\1\ Except for statutory blindness.
\2\ For individuals under age 18 claiming benefits under title XVI, disability will be
established if the individual is suffering from a medically determinable physical or
mental impairment (or combination of impairments) that results in ``marked and severe
functional limitations.'' See section 1614(a)(3)(C) of the Act and 20 CFR 416.906.
However, for clarity, the following discussions refer only to claims of individuals
claiming disability benefits under title II and individuals age 18 or older claiming
disability benefits under title XVI. The concepts in this ruling, however, are also
intended to apply in determining disability based on CFS for individuals under age 18
under title XVI.
Under the CDC definition, the diagnosis of CFS can be made based on an individual's
reported symptoms alone once other possible causes for the symptoms have been ruled out.
However, the foregoing statutory and regulatory provisions require that, for evaluation of
claims of disability under the Act, there must also be medical signs or laboratory
findings before the existence of a medically determinable impairment may be established.
Establishing the Existence of a Medically Determinable Impairment The following medical
signs and laboratory findings establish the existence of a medically determinable
impairment in individuals who have CFS. Although no specific etiology or pathology has yet
been established for CFS, many research initiatives continue, and some progress has been
made in ameliorating symptoms in selected individuals. With continuing scientific
research, new medical evidence may emerge that will further clarify the nature of CFS and
provide greater specificity regarding the clinical and laboratory diagnostic techniques
that should be used to document this disorder. Because of this, the medical criteria
discussed below are only examples of signs and laboratory findings that will establish the
existence of a medically determinable impairment; they are not all-inclusive. As progress
is made in medical research into CFS, additional signs and laboratory findings may also be
found that can be used to establish that individuals with CFS have a medically
determinable impairment. The existence of CFS may be documented with medical signs or
laboratory findings other than those listed below, provided that such documentation is
consistent with medically accepted clinical practice and is consistent with the other
evidence in the case record.
[[Page 23382]]
Examples of Medical Signs That Establish the Existence of a Medically Determinable
Impairment For purposes of Social Security disability evaluation, one or more of the
following medical signs clinically documented over a period of at least 6 consecutive
months establishes the existence of a medically determinable impairment for individuals
with CFS:
\3\ There is considerable overlap of symptoms between CFS and Fibromyalgia
Syndrome (FMS), but individuals with CFS who have tender points have a medically
determinable impairment. Individuals with impairments that fulfill the American College of
Rheumatology criteria for FMS (which includes a minimum number of tender points)
may also fulfill the criteria for CFS. However, individuals with CFS who do not have the
specified number of tender points to establish FMS, will still be found to have a
medically determinable impairment.
Examples of Laboratory Findings That Establish the Existence of a Medically
Determinable Impairment
At this time, there are no specific laboratory findings that are widely accepted as being
associated with CFS. However, the absence of a definitive test does not preclude reliance
upon certain laboratory findings to establish the existence of a medically determinable
impairment in persons with CFS. Therefore, the following laboratory findings establish the
existence of a medically determinable impairment in individuals with CFS:
\4\ It should be noted that standard laboratory test results in the ``normal'' range are
characteristic for many individuals with CFS, and should not be relied upon to the
exclusion of all other clinical evidence in decisions regarding the presence and severity
of a medically determinable impairment.
Mental Findings That Establish the Existence of a Medically Determinable
Impairment
Some individuals with CFS report ongoing problems with short-term memory, information
processing, visual-spatial difficulties, comprehension, concentration, speech,
word-finding, calculation, and other symptoms suggesting persistent neurocognitive
impairment. When ongoing deficits in these areas have been documented by mental status
examination or psychological testing, such findings constitute medical signs or (in the
case of psychological testing) laboratory findings that establish the presence of a
medically determinable impairment.
Individuals with CFS may also exhibit medical signs, such as anxiety or depression,
indicative of the existence of a mental disorder. When such medical signs are present and
appropriately documented, the existence of a medically determinable impairment is
established.
Evaluation
1. General. Claims involving CFS are adjudicated using the sequential evaluation process,
just as for any other impairment. Once a medically determinable impairment has been found
to exist (see discussion above), the severity of the impairment(s) must be established.
The severity of an individual's impairment(s) is determined based on the totality of
medical signs, symptoms, and laboratory findings, and the effects of the impairment(s),
including any related symptoms, on the individual's ability to function.Also, several
other disorders (including, but not limited to, FMS, multiple chemical sensitivity, and
Gulf War Syndrome, as well as various forms of depression, and some neurological and
psychological disorders) may share characteristics similar to those of CFS. When
there is evidence of the potential presence of another disorder that may adequately
explain the individual's symptoms, it may be necessary to pursue additional medical or
other development.
2. Step 2. When an adjudicator finds that an individual with CFS has a medically
determinable impairment, he or she must consider that the individual has an impairment
that could reasonably be expected to produce the individual's symptoms associated with
CFS, as required in 20 CFR 404.1529(b) and 416.929(b), and proceed to evaluate the
intensity and persistence of the symptoms. Thus, if an adjudicator concludes that an
individual has a medically determinable impairment, and the individual alleges fatigue,
pain, symptoms of neurocognitive problems, or other symptoms consistent with CFS, these
symptoms must be considered in deciding whether the individual's impairment is ``severe''
at step 2 of the sequential evaluation process and at any later steps reached in the
sequential evaluation process. If fatigue, pain, neurocognitive symptoms, or other
symptoms are found to cause a limitation or restriction having more than a minimal effect
on an individual's ability to perform basic work activities, the adjudicator must find
that the individual has a ``severe'' impairment. See SSR 96-3p, ``Titles II and XVI:
Considering Allegations of Pain and Other Symptoms in Determining Whether a Medically
Determinable Impairment is Severe.''
3. Step 3. When an individual is found to have a severe impairment, the adjudicator must
proceed with the sequential evaluation process and must next consider whether the
individual's impairment is of the severity contemplated by the Listing of Impairments
contained in appendix 1, subpart P of 20 CFR 404. Inasmuch as CFS is not a listed
impairment, an individual with CFS alone cannot be found to have an impairment that meets
the requirements of a listed impairment; however, the specific findings in each case
should be compared to any pertinent listing to determine whether medical equivalence
mayexist.
\5\ In evaluating title XVI claims for disability benefits for individuals under age 18,
consideration must also be given to the possibility of functional equivalence. See 20 CFR
416.926a.
Further, in cases in which individuals with CFS have psychological manifestations related
to CFS, consideration should always be given to whether the individual's impairment meets
or equals the severity of any impairment in the mental disorders listings in 20 CFR, part
404, subpart P, appendix 1, sections 12.00 ff. or 112.00 ff.4. Steps 4 and 5. For those
impairments that do not meet or equal the severity of a listing, an assessment of residual
functional capacity (RFC) must be made, and adjudication must proceed to the fourth and,
if necessary, the fifth step of the sequential evaluation process. In assessing RFC, all
of the individual's symptoms must be considered in deciding how such symptoms may affect
functional capacities. See SSR 96-7p, ``Titles II and [[Page 23383]]
XVI: Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an
Individual's Statements'' and SSR 96-8p, ``Titles II and XVI: Assessing Residual
Functional Capacity in Initial Claims.''
\6\ These steps of the sequential evaluation process are not applicable to claims for
benefits under title XVI for individuals under age 18. See 20 CFR 416.924.
If it is determined that the individual's impairment(s) precludes the performance of past
relevant work (or if there was no past relevant work), a finding must be made about the
individual's ability to perform other work. The usual vocational considerations (see 20
CFR 404.1560-404.1569a and 416.960-416.969a) must be applied in determining the
individual's ability to perform other work. Many individuals with CFS are ``younger
individuals,'' ages 18 through 49 (see 20 CFR 404.1563 and 416.963). Age, education, and
work experience are not usually considered to limit significantly the ability of
individuals under age 50 to make an adjustment to other work, including unskilled
sedentary work. However, a finding of ``disabled'' is not precluded for those individuals
under age 50 who do not meet all of the criteria of a specific rule and who do not have
the ability to perform a full range of sedentary work. The conclusion about whether such
individuals are disabled will depend primarily on the nature and extent of their
functional limitations or restrictions. Thus, if it is found that an individual is able to
do less than the full range of sedentary work, refer to SSR 96-9p, ``Titles II and XVI:
Determining Capability to Do Other Work--Implications of a Residual Functional Capacity
for Less Than a Full Range of Sedentary Work.'' As explained in that Ruling, whether the
individual will be able to make an adjustment to other work requires adjudicative judgment
regarding factors such as the type and extent of the individual's limitations or
restrictions and the extent of the erosion of the occupational base for sedentary work.
\7\ However, ``younger individuals'' ages 45-49 who are illiterate in English or unable to
communicate in English, whose past work was unskilled (or who had no past relevant work),
or who have no transferable skills, and who are limited to a full range of sedentary work,
must be found disabled under rule 201.17 in Table No. 1 of appendix 2 of the
Medical-Vocational Guidelines in 20 CFR part 404.
5. Duration. The medical signs and symptoms of CFS fluctuate in frequency and severity and
often continue over a period of many months or years. Thus, appropriate documentation
should include a longitudinal clinical record of at least 12 months prior to the date of
application, unless the alleged onset of CFS occurred less than 12 months in the
past, or unless a fully favorable determination or decision can be made without additional
documentation. The record should contain detailed medical observations, treatment, the
individual's response to treatment, and a detailed description of how the impairment
limits the individual's ability to function over time.When the alleged onset of disability
secondary to CFS occurred less than 12 months before adjudication, the adjudicator must
evaluate the medical evidence and project the degree of impairment severity that is likely
to exist at the end of 12 months. Information about treatment and response to treatment as
well as any medical source opinions about the individual's prognosis at the end of 12
months are helpful in deciding whether the medically determinable impairment(s) is
expected to be of disabling severity for at least 12 consecutive months.
\8\ To meet the statutory requirement for ``disability,'' an individual must have been
unable to engage in any SGA by reason of any medically determinable physical or mental
impairment which is expected to result in death or which has lasted or can be expected to
last for a continuous period of not less than 12 months. Thus, the existence of an
impairment for 12 continuous months is not controlling; rather, it is the existence of a
disabling impairment which has lasted or can be expected to last for at least 12 months
that meets the duration requirement of the Act.
6. Continuing Disability Reviews. In those cases in which an individual is found to have a
disability based on CFS but medical improvement is anticipated, an appropriate continuing
disability review should be scheduled based on the probability of cessation under the
Medical Improvement Review Standard. This standard takes into account relevant individual
case facts such as the combined severity of other chronic or static impairments and the
individual's vocational factors.Documentation1. General. As with all claims for disability
under both title II and title XVI, documentation of medical signs or laboratory findings
in cases involving CFS is critical to establishing the presence of a medically
determinable impairment. In cases in which CFS is alleged, longitudinal clinical records
reflecting ongoing medical evaluation and treatment from the individual's medical sources,
especially treating sources, are extremely helpful in documenting the presence of any
medical signs or laboratory findings, as well as the individual's functional status over
time. Every reasonable effort should be made to secure all available, relevant evidence in
cases involving CFS to ensure appropriate and thorough evaluation.Generally, evidence for
the 12-month period preceding the month of application should be requested unless there is
reason to believe that development of an earlier period is necessary, or unless the
alleged onset of disability is less than 12 months before the date of the application.
2. Recontacting Medical Sources/Consultative Examinations. If the adjudicator finds that
the evidence is inadequate to determine whether the individual is disabled, he or she must
first recontact the individual's treating or other medical source(s) to determine whether
the additional information needed is readily available, in accordance with 20 CFR 404.1512
and 416.912.<SUP>9</SUP> Only after the adjudicator determines
that the information needed is not readily available from the individual's health care
provider(s), or that the necessary information or clarification cannot be sought from the
individual's health care provider(s), should the adjudicator proceed to arrange for a
consultative examination(s) in accordance with 20 CFR 404.1519a and 416.919a. The type of
consultative examination(s) purchased will depend on the nature of the individual's
symptoms and the extent of the evidence already in the case record.
\9\ We may not seek additional evidence or clarification from a medical source when we
know from past experience that the source either cannot or will not provide the necessary
findings.
3. Resolution of Conflicts. It should be noted that conflicting evidence in the medical
record is not unusual in cases of CFS due to the complicated diagnostic process involved
in these cases. Clarification of any such conflicts in the medical evidence should be
sought first from the individual's treating or other medical sources.Medical opinions from
treating sources about the nature and severity of an individual's impairment(s) are
entitled to deference and may be entitled to controlling weight. If we find that a
treating source's medical opinion on the issue(s) of the nature and severity of an
individual's impairment(s) is well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with the other substantial
evidence in the case record, the adjudicator
will give it controlling weight. (See SSR 96-2p, ``Titles II and XVI: Giving Controlling
Weight to Treating Source Medical Opinions,'' and SSR 96-5p, ``Titles II and XVI: Medical
Source Opinions on
[[Page 23384]]
Issues Reserved to the Commissioner.'')
\10\ A medical source opinion that an individual is ``disabled'' or ``unable to work,''
has an impairment(s) that meets or is equivalent in severity to the requirements of a
listing, has a particular residual functional capacity (RFC), that concerns whether an
individual's RFC prevents him or her from doing past relevant work, or that concerns the
application of vocational factors, is an opinion on an issue reserved to the Commissioner.
Every such opinion must still be considered in adjudicating a disability claim; however,
the adjudicator will not give any special significance to such an opinion because of its
source. See SSR 96-5p, ``Titles II and XVI: Medical Source Opinions on Issues Reserved to
the Commissioner.''
4. Assessing Credibility. In accordance with SSR 96-7p, if the existence of a medically
determinable impairment that could reasonably be expected to produce the symptoms has been
established, as outlined above, but an individual's statements about the intensity,
persistence, or functionally limiting effects of symptoms are not substantiated by
objective medical evidence, the adjudicator must consider all of the evidence in the case
record, including any statements by the individual and other persons concerning the
individual's symptoms. The adjudicator
must then make a finding on the credibility of the individual's statements about symptoms
and their functional effects. When additional information is needed to assess the
credibility of the individual's statements about symptoms and their effects, the
adjudicator must make every reasonable effort to obtain available information that could
shed light on the credibility of the individual's statements.Treating and other medical
sources. In evaluating credibility, the adjudicator should ask the treating or other
medical source(s) to provide information about the extent and duration of an individual's
impairment(s), including observations and opinions about how well the individual is able
to function, the effects of any treatment, including side effects, and how long the
impairment(s) is expected to limit the individual's ability to function. Opinions from an
individual's medical sources, especially treating sources, concerning the effects of CFS
on the individual's ability to function in a sustained manner in performing work
activities or in performing activities of daily living are important in enabling
adjudicators to draw conclusions about the severity of the impairment(s) and the
individual's RFC. In this regard, any information a medical source is able to provide
contrasting the individual's impairment(s) and functional capacities since the alleged
onset of CFS with the individual's status prior to the onset of CFS will be helpful in
evaluating the individual's impairment(s) and its functional consequences.Third-party
information, including evidence from medical sources who are not ``acceptable medical
sources'' for the purpose of establishing the existence of a medically determinable
impairment, but who have provided services to the individual, may be very useful in
deciding the individual's credibility. Information other than an individual's allegations
and reports from the individual's treating sources helps to assess an individual's ability
to function on a day-to-day basis and to depict the individual's capacities over a period
of time. Such evidence includes, but is not limited to:
The adjudicator should carefully consider this information when making findings
about the credibility of the individual's allegations regarding functional limitations or
restrictions.
EFFECTIVE DATE: This Ruling is effective on April 30, 1999.
CROSS-REFERENCES: SSR 96-2p, ``Titles II and XVI: Giving Controlling Weight to Treating
Source Medical Opinions,'' SSR 96-3p, ``Titles II and XVI: Considering Allegations of Pain
and Other Symptoms in Determining Whether a Medically Determinable Impairment is Severe,''
SSR 96-4p, ``Titles II and XVI: Symptoms, Medically Determinable Physical and Mental
Impairments, and Exertional and Nonexertional Limitations,'' SSR 96-5p, ``Titles II and
XVI: Medical Source Opinions on Issues Reserved to the Commissioner,'' SSR 96-7p, ``Titles
II and XVI: Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an
Individual's Statements,'' SSR 96-8p, ``Titles II and XVI: Assessing Residual Functional
Capacity in Initial Claims,'' and SSR 96-9p, ``Titles II and XVI: Determining Capability
to Do Other Work--Implications of a Residual Functional Capacity for Less Than a Full
Range of Sedentary Work.''
[FR Doc. 99-10840 Filed 4-29-99; 8:45 am]
BILLING CODE 4190-29-P
Kristina P. Hopkins
Operations Manager
The CFIDS Association of America, Inc.
PO Box 220398
Charlotte, NC 28222-0398
Email: kphopkins@cfids.org
Phone: 800/442-3437
Fax: 704/365-9755
The CFIDS Association of America
Advocacy, Information, Research and Encouragement for the CFIDS Community
PO Box 220398, Charlotte NC 28222-0398
Voice Mail: 800/442-3437
Fax: 704/365-9755
WWW: http://www.cfids.org
General E-mail: info@cfids.org
Social Security Ruling approved]