Diagnosis of Chronic Fatigue Syndrome-Reply

My commentary¹ concerning CFS was not written from the traditional role of a physician as a patient advocate. My opening statement was that "increasing administrative and legal responsibilities have been added to the traditional roles of physicians." I was functioning as a medical advisor to an administrative law judge who was considering the appeals of claimants with CFS who had previously been denied total disability benefits under Social Security regulations. I did not examine these patients but heard their testimony and reviewed the medical record prior to the hearing. In most of the situations, the claimants were represented by attorneys.

My comments also indicated that the Centers for Disease Control and Prevention and the Office of Disability of the Social Security Administration recognized CFS as an entity. Lapp and Hyman write from the standpoint of a CFS advocate and, I suspect, treat a large number of patients with CFS.