Obligation to not negate ME/CFS legal status

These compliance documents are live pre-released drafts that are specifically not structured for scientific audiences. Specific scientific referencing can be provided in consulting contexts, not limited to practice management, claims management, underwriting or litigation support for professionals or organisations.

Copyright and redistribution rights are governed by our terms of site usage. Communication of factual or typographical errata or other suggestions is welcome. This content was originally contained here (external link), has been split into separate compliance sections on our website and is in need of significant ongoing update.

A journalistic summary of these documents for lay audiences will soon be published.

The absolute clarity of the legal status of /CFS is of immediate risk management importance, due its statutory, policy and third-party contractual implications frequently being ignored. These stem from habitually unlawful clinical judgement and arbitrarily discriminative administrative treatment that fail to account for the clarity of classification and associated lawful obligations.

The absolute clarity of /CFS legal status is of immediate risk management importance, due its statutory, policy and third-party contractual implications frequently being ignored and leading to habitually unlawful clinical judgement and arbitrarily discriminative administrative treatment

NHS SNOMED-CT officially and specifically classifies /CFS as a neurological disease under SCTID 52702003. The extreme physical nature of /CFS and irrelevance of non-biophysical assumptions have also resulted in 1) the removal of the term “benign” from in WHO ICD 10 2019 G93.9, in line with the empirical findings that it is unusually malign, and 2) somatic ‘Bodily Distress Disorder’ (BDD) has been marked as an express exclusion for /CFS in WHO ICD 11 (SNOMED CT is currently based on ICD 10 2016). This is in line with the consensus of neurological, immune, endocrine, metabolic and other biophysical abnormalities, which is corroborated by repeated findings that invalidate traditional non-biophysical explanations and treatments that are still marketed.

The material risk management and compliance significance of the above comes from normalised unlawful failures to implement consequent requirements in clinical and administrative decision-making. These failures are often aggressively persistent and thus further exacerbate reasonable claims of discrimination and reputational risk. The persistence of risk generation from unlawful misapplication of /CFS classification rules frequently forces NGOs to readdress discriminatory policy violations by frontline medical practice.

Unlawful failures are often aggressively persistent, pervasive and audacious, further exacerbating reasonable discrimination claims and reputational risks, in an unmanaged risk context of nullifiable indemnity insurance and materially significant risk of and loss

The pervasiveness and frequent audaciousness of unmanaged risk in this field is illustrated by 1) the minimal literacy needed to determine classification based requirements versus 2) the frequency of arbitrary misrepresentation of and/or literal mistruths about these requirements in communications to patients, clients or beneficiaries. The material significance of the above, duties of care and resultant liabilities are further informed by /CFS being empirically and repeatedly confirmed as more disabled than other maladies. The weight of the duty of care and consequent liabilities may scale with this and the impact of done, including claims for lifetime income lost/reduced with the possibility of nullified medical indemnification.

It is also key to highlight that once communication of facts regarding law, policy, clinical judgement or model limitations are communicated, the tenability of delaying or obfuscating terminal obligation/liability is negated further.

It must also be noted that the clarity of resultant obligations and implied liabilities can be further realised versus specific organisations by third parties’ targeted requests under the Freedom of Information Act (which can lead to poor reputational risk outcomes on public record).