Fibromyalgia and Long Term Disability Insurance Claims

Fibromyalgia and Long Term Disability Insurance Claims

Do you suffer from chronic, widespread pain and a heightened response to pressure on your body? Do you feel tired all the time and have difficulty sleeping on a regular schedule? These are just some of the symptoms that characterize fibromyalgia. Many people suffering from fibromyalgia report unclear thoughts or “brain fog.” The cause of fibromyalgia is unknown. However, it is clear these symptoms can interfere with someone’s ability to work.

Fibromyalgia Difficult to Objectively Document

If fibromyalgia symptoms become so severe that a person is not able to continue working, it may be possible to secure long term disability insurance benefits. Because fibromyalgia is not completely understood, however, many long term disability insurance companies wrongfully deny claims based on fibromyalgia. Insurance companies often demand “objective” evidence of a disabling diagnosis. For example, if someone claims a disability based on a back injury, the insurance company will often require an MRI or other objective diagnostic testing. In the case of fibromyalgia, such objective evidence is more difficult to provide because the illness cannot be documented visually.

Fibromyalgia Claims Require Objective Evidence of Limitations

Courts have rejected unreasonable requests for objective diagnostic evidence when reviewing claims for long term disability based on fibromyalgia. Courts have started to recognize that some conditions, such as fibromyalgia, do not lend themselves to objective diagnostic testing. “While the diagnosis of chronic fatigue syndrome and fibromyalgia may not lend themselves to objective clinical findings, the physical limitations imposed by the symptoms of such illnesses do lend themselves to objective analysis.”); Cook v. N.Y. Times Co. Long–Term Disability Plan, 2004 WL 203111, at *4 (S.D.N.Y. January 30, 2004). However, courts have required objective evidence of the claimant’s physical or cognitive limitations as a result of this condition. See Williams v. Aetna Life Ins. Co., 509 F.3d 317, 322-23 (7th Cir. 2007).

Careful Documentation Can Result in Successful Fibromyalgia Disability Benefits Claims

It is possible to receive long term disability benefits based on a diagnosis of fibromyalgia. The key is to document as much evidence of the symptoms and limitations caused by fibromyalgia. For example, provide the insurance company with a pain log, or a diary of situations where fibromyalgia impacted your ability to work (or to perform tasks similar to work, such as working on a computer or remembering to do chores around the house). Additionally, it may be helpful to obtain cognitive testing, such as a neuropsychological exam. These types of tests can reveal cognitive deficits, which provide objective evidence of the disability.

Appeals Often Necessary in Long Term Disability Cases

As with all long term disability claims it is important to remember the appeal process is critical to securing benefits. If your claim is denied, you will want to file a strong appeal. A long term disability attorney can help maximize your chance for winning the appeal. Additionally, a strong appeal will put you in the best position for success if you need to sue the disability insurance company. If you have a long term disability insurance claim based on fibromyalgia, please contact one of our experienced disability attorneys today for a free consultation.