Twenty years ago, the term “brain fog” became synonymous with a diagnosis of fibromyalgia when physicians needed a term to describe a wide variety of general symptoms for a “syndrome” disease no one could prove actually existed.
In those early days FMS pain was treated with morphine drips, and not much was known about what caused the disorder. Patients complained of lacking an ability to think, being confused and disorganized, unable to focus, or having difficulties putting thoughts into words. Lacking a general term for the debilitating symptoms, physicians coined the phrase “brain fog” to pull together what otherwise couldn’t be specifically identified. Patients simply had “brain fog”, and everyone seemed to know what that meant.
In the past, “brain fog” was a term used to describe what was really medically identified as “mental fatigue” and was included in the category of “cognitive dysfunction/deficit.” This is why early on FMS gained a reputation of being “a mental disorder” with “brain fog” (cognitive deficit) as the center of symptomology. And, insurance companies got away with classifying FMS and many other physical diseases as mental disorders particularly when the term “brain fog” was used.
Today, for disability claim purposes, the term “brain fog is recognized as an archaic stereotype for a class of symptoms that is considered “subjective”, “all in your head”, or exaggerated and non-existent. If you think about it, the term “brain fog” doesn’t really describe anything specific that supports medical disability. For many insurance claims handlers, the term “brain fog” is laughable simply because the term has been so overused that it is more silly, than anything that could be used to support a disability claim. Again, the danger in saying you have “brain fog” risks the classification of a “mental and nervous” impairment, which we all know is limited to 24 months of benefits for most ERISA claims.
As a Consultant, my objection to the use of the term “brain fog” used as a symptom to support disability is that the term itself is vague, and non-specific, lending interpretation to what specific symptoms the term is actually describing. Some modern day physicians are equally to blame for using the term when potentially both patient and doctor are not describing the same set of symptoms.
Disability paperwork should not document old impairment stereotypes like “brain fog.” Instead of describing a category of symptoms using the term “brain fog”, specific symptoms should be put into the official record such as, “I have problems remembering short-term data and events”, or “I have difficulties speaking what I want to say”, and, “I am often confused about things and can’t seem to problem-solve situations in my every day life.” Using more specific terms to describe any medical impairment is so much better than simply saying, “I have brain fog.”
Today, using the term “brain fog” to describe symptoms severe enough to warrant disability isn’t going to result in paid benefits. More specific descriptions should always be used in support of medical disability.
As an aside, while I’m writing about FMS, patients who when asked about symptoms respond, “I hurt everywhere” is also making a similar mistake. A patient who has FMS shouldn’t hurt “everywhere”, but only in 18 specific “trigger point” locations. It is better to say, “I feel pain in my upper arms, lower back, and behind my shoulders”, just as one example.
My recommended best practice of making sure to describe impairments using specific terms is a good one. Over time, impairments, and how they are described changes with new discoveries and technologies, therefore it’s important to know how to support a disability by staying away from over-used terms such as “brain fog.”
If you have any questions concerning your claim and would like assistance please feel free to contact me at: lindanee.dcs@gmail.com or 207-793-4593. Everyday, insurance companies are working to deny claims unfairly. I am here to help.
