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Do I Qualify For Disability Insurance Benefits If I Have Chronic Fatigue Syndrome Fibromyalgia?

CaveyLaw.com > Practice Areas  > Long Term Disability & ERISA Lawyer  > Long Term Disability Disabling Conditions > Do I Qualify For Disability Insurance Benefits If I Have Chronic Fatigue Syndrome Fibromyalgia?

Disability insurance companies don’t always make it easy for policyholders who have chronic fatigue syndrome fibromyalgia to get the disability benefits they deserve. In fact, be prepared for a fight: Disability carriers hate these types of claims.

The Common Reasons Disability Carriers Deny Chronic Fatigue Syndrome Fibromyalgia Disability Claims

Many chronic fatigue syndrome/fibromyalgia claims are denied because the disability insurance company says:

(1) There is no objective basis of the chronic fatigue syndrome/fibromyalgia,

(2) There is no objective basis for the restrictions and limitations assigned by your physician,

(3) There is no causal relationship between your chronic fatigue syndrome fibromyalgia and/or your restrictions and limitations, and your inability to do your own or any occupation.

(4) There is no reason you can’t work in a sedentary capacity.

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with chronic fatigue syndrome fibromyalgia. She overcomes a claims denial by working closely with you and your physician.

If you are ready to file a disability application and want to improve your chances of getting disability benefits, or if your claim for chronic fatigue syndrome fibromyalgia disability benefits has been denied, it is time to call Nancy Cavey.

She offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

What Is Chronic Fatigue Syndrome Fibromyalgia?

There is no gold standard test for chronic fatigue syndrome/fibromyalgia. The diagnosis is based, in part, on subjective complaints. Many disability carriers have position papers on chronic fatigue syndrome/fibromyalgia that dispute the existence of these conditions, discount the subjective symptoms and reject any notion of disability.

That is why it is crucial that you have an attorney who understands chronic fatigue syndrome fibromyalgia and knows how to gather the necessary medical and vocational evidence required to approve a claim.

What Are The Symptoms of Fibromyalgia?

Fibromyalgia is a poorly understood medical condition that doctors once thought was “all in the head” of the patient. The American College of Rheumatology developed criteria for a diagnosis of fibromyalgia that includes widespread pain in all four quadrants of the body that has lasted for at least three months, 11 out of 18 trigger points and other symptoms that are typically seen.

These symptoms can include:

  • Chronic pain,
  • Sleeplessness,
  • Bowel irritation,
  • Chronic fatigue, and
  • Cognitive difficulties.

The American College of Rheumatology approved another set of guidelines in 2010 that includes widespread pain and a scale to measure the severity of symptoms. Physicians may use one or both tests in making the diagnosis.

Many carriers ultimately acknowledge a diagnosis of fibromyalgia but contend it is not disabling. A Functional Capacity Evaluation (FCE) or other test may provide objective evidence of how fibromyalgia affects your ability to work on both a physical and a cognitive basis.

What Are The Symptoms of Chronic Fatigue Syndrome?

Like fibromyalgia, there is no known cause or gold standard test for a diagnosis of chronic fatigue syndrome (CFS). The nine official signs and symptoms include:

  1. Fatigue,
  2. Loss of memory or concentration,
  3. Sore throat,
  4. Enlarged lymph nodes in the neck or armpits,
  5. Unexplained muscle pain,
  6. Pain that moves from one joint to another without swelling or redness,
  7. Headaches,
  8. Unrefreshing sleep, and
  9. Extreme exhaustion that lasts more than 24 hours after physical or mental exercise.

It is crucial that you provide the result of a Functional Capacity Evaluation or cognitive testing that objectively documents your functional limitations.

How Do I Get The Disability Insurance Benefits I Deserve?

Chronic fatigue syndrome/fibromyalgia can make it difficult, if not impossible, to do things around your home and work. If you no longer can work or your doctor has told you to apply for disability, before you apply for benefits, you should:

  1. Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove to get your benefits for chronic fatigue syndrome/fibromyalgia.

Your policy can include a self-reported limitation. It limits how long you can get benefits that result from self-reported symptoms, including problems with pain, memory loss or fatigue. You’ll want to know what’s in your policy before you apply for benefits.

  1. Look also for how your disability policy defines a mental/nervous condition. It is not uncommon for disability carriers to characterize your chronic fatigue syndrome/fibromyalgia as a mental condition. The carrier will attempt to limit your benefits to just two years.
  2. Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations. It is crucial that you have neuropsychological testing to document the reason for your symptoms and the severity of the symptoms.
  3. Get treated by a rheumatologist, who will follow established criteria for diagnosing chronic fatigue syndrome/fibromyalgia. Don’t forget to have neuropsychological testing to provide objective evidence of your cognitive problems.
  4. Obtain a copy of your personnel file to see whether your chronic fatigue syndrome/fibromyalgia has affected your work performance.
  5. Obtain a copy of your job description. Create your own description of your physical and cognitive duties with an explanation of how your symptoms impact your ability to do your occupation.
  6. Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
  7. Prepare a diary that explains your symptoms and the side effects of medication you are taking. Be sure to give examples of how your symptoms interfere with your ability to do things on a daily basis.
  8. Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
  9. Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits for chronic fatigue syndrome/fibromyalgia. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.

Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live

Chronic fatigue syndrome aka fibromyalgia can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits.  Call today for a free consultation at 727-894-3188.