Many "burnt-out" workers planning to claim disability payouts for chronic fatigue syndrome (CFS), also called yuppie flu, may not qualify.
Stellenbosch University physician Paul van Zijl said most stressed-out and chronically tired people may not in fact be suffering from the syndrome, which has the scientific name myalgic encephalomyelitis (ME).
Specific symptoms and criteria made CFS/ME different from other illnesses, he said.
Leon Yankelowitz, a former University of Cape Town lecturer, was one of the patients positively identified by Van Zijl as having CFS/ME. Yankelowitz won a protracted battle against Old Mutual and was paid out a disability policy valued at more than R200 000.
Old Mutual's Trevor Pascoe said the company recognised CFS/ME and had paid out other permanently disabled sufferers. Yankelowitz won his case on a technicality regarding the notification of his claim.
Roy Moore, a Durban endocrinologist who has been treating CFS/ME patients for years, said many people had succeeded in being boarded and paid out for temporary disablement. "It is more difficult getting paid out for permanent disablement."
He said the illness was still under-diagnosed and for years sufferers had been dismissed as having psychological problems. But attitudes to the illness were changing.
The South African Medical Association and the World Health Organisation recognise CFS/ME as a "debilitating" condition and the association has set out specific guidelines for diagnosing the disease.
There must be persistent or relapsing, debilitating fatigue lasting for at least six months. The fatigue is not a result of exertion and is not substantially helped by bed rest.
Other conditions that have similar symptoms have to be excluded, such as major depression and multiple sclerosis. Although sufferers may get depressed as result of their condition, that differs from having a history of depression. Minor symptoms including headaches, dizziness, muscle and joint pain, memory loss and insomnia, need to be present.
Research suggests that triggers of the disease are viral infections such as glandular fever, exposure to toxins and a genetic predisposition.
Van Zijl warned patients against "unscrupulous" doctors who claimed they could cure the illness and subjected sufferers to a battery of expensive tests. He also stressed that there was no known cure.
"The prognosis is a vexed question and it appears that the majority of patients recover to the extent that they can cope with the illness and lead fruitful lives," he said.
The mainstay of treatment was mental and physical rest. Some patients had to stop working. Therapy included giving people a better understanding of their problem. Anti-depressants were of some benefit.
The ME Association of SA, which has 2 000 registered members, said the syndrome was not fully understood and its exact cause unknown. In a newsletter the association said CFS/ME affected people across all social classes and ethnic groupings and more women than men.
It has objected to the label "yuppie flu", which was coined by the media in the 1980s when increasing numbers of high-flying executives developed flu-like symptoms that confined them to bed.
The association said most sufferers were not yuppies and their illness was not simply "flu" but a serious debilitating illness that disrupted families, destroyed lives and seriously affected the economy.