On this page, BHC offers comprehensive resources, tools, and guidance for assisting patients with disability claims, as well as supporting the diagnosis, treatment, and management of various diseases.
Diagnostic Criteria
Quick Access
Top Resources
Disability Resources
Top Provider Videos
Assessing Impairment
ME/CFS Diagnostic Criteria
Mayo Clinic Proceedings (2021)
U.S. ME/CFS Clinician Coalition (2021)
- Testing Recommendations for Suspected ME/CFS
- ME/CFS Treatment Recommendations
- Basics of diagnosis & treatment of ME/CFS (2020 guidelines)
- Caring for People with Severe ME/CFS
Top Resources
- ER and Urgent Care Considerations for ME/CFS (Bateman Horne Center)
- Information about ME/CFS for Providers
- Good Day/Bad Day Questionnaire: Hours of Upright Activity (HUA) and level of impairment
- Health Assessment Worksheet
Post-Exertional Malaise (PEM)
- ME/CFS Crash Survival Guidebook (Bateman Horne Center)
- PEM Patient Handout (Workwell Foundation)
Orthostatic Intolerance (OI)
- Orthostatic Intolerance (basics, symptoms, interventions)
- 10-Minute NASA Lean Test (assessing for OI, provider instructions)
Quick Access: Diagnostic Tools
Mental Health Screen
Orthostatic Screens
- Orthostatic Hypotension (Intolerance) Questionnaire (OHQ)
- 10-Minute NASA Lean Test (provider instructions)
- 10-Mintue NASA Lean Test (patient instructions)
Pain Screens
- Fibromyalgia Impact Questionnaire-Revised (FIQR)
- 2016 FM Diagnostic Criteria
- Symptom Impact Questionnaire-Revised (SIQ-R)
Somnolence Screen
- Epworth Sleepiness Scale (ESS): score of 0-7 suggest patient is not abnormally sleepy.
Top Provider Videos
- Long COVID & Post-Viral Syndromes ECHO (with University of Utah Health) ME/CFS (Bateman Horne Center)
- Long COVID & Fatiguing Illness Recovery Program ECHO
Additional Videos
- Unraveling the Complexity of Chronic Pain & Fatigue (3-part series)
- What is ME/CFS? (diagnostic criteria- 6 minute video)
- What is Orthostatic Intolerance in ME/CFS Part 1 (assessment- 6 min video)
- What is Orthostatic Intolerance in ME/CFS Part 2 (management -5 minute video)
ME/CFS & long COVID Disability Resources
ME/CFS and FM
- Documenting disability in ME/CFS (Podell, Dimmock, Comerford, 2019)
- Medically Documenting Disability in ME/CFS Cases (Frontiers in Pediatrics, 2019)
- Disability in ME/CFS (National Academy of Medicine Report, Appendix C.)
- Disability Resources on ME/CFS (CDC)
- Providing Medical Evidence for Individuals with ME/CFS (SSA)
- Evaluating Disability for Patients with Fibromyalgia (SSA)
Long COVID
Assessing Impairment
U.S. ME/CFS Clinician Coalition
Objective tests are a critical part of a successful disability case. Two tests that have been particularly helpful include:
– Neuropsychological evaluation to evaluate neurocognitive impairment
– 2-day cardiopulmonary exercise testing to evaluate functional impairment and postexertional malaise (Stevens)
Note: that these tests have distinctive findings for ME/CFS and need to be interpreted by someone knowledgeable about both the test and ME/CFS. These tests are expensive, can trigger an episode of post-exertional malaise, and may not be covered by insurance. But the tests are objective and have been successfully used in disability cases when other parts of the medical record were questioned.
Other objective tests that have been used as evidence in disability cases include Tilt Table test, EEGs, QEEGs, SPECT scans, PET scans, and MRIs (Podell).
Bateman Horne Center
Good Day/Bad Day Questionnaire: Communicating impaired function can be challenging for people ME/CFS, FM, OI, and long COVID. In addition, clinicians often lack the time and tools to fully grasp the extent of impairment.
BHC developed a simple questionnaire that helps patients to communicate the frequency, severity, and nature of their activity limitations. Estimating the number of better (GOOD) versus worse (BAD) days and listing specific examples communicates the range of function.
Hours of Upright Activity (HUA), or time spent with feet on the floor (sitting, standing, walking) versus time spent with feet elevated in 24 hours, takes a little thinking but clearly communicates tolerance for upright activity.
Resources
Media Center
Business Model
Organization
Lucinda Bateman, MD, is a renowned clinician, researcher, and educator. Her Johns Hopkins University Medical School training instilled an approach to care that she has employed throughout her career - the patient comes first and the unknown or unexplained does not equate to a lack of proper and compassionate care. Since starting her own practice in 2000, she has served on six boards or committees, been the principal investigator for 45 studies, authored/coauthored 40 journal articles, served as adjunct instructor and adjunct assistant professor in the University of Utah Departments of Preventative Medicine, Internal Medicine, and Anesthesiology, and lectured around the world.