Do You Have A Case?

Fibromyalgia is a condition that can be difficult to deal with on a daily basis. It often causes those living with it to cope with debilitating chronic pain, fatigue, and poor concentration. Those living with this condition could be unable to work because of it.

Is Fibromyalgia Considered A Disability?

Because Fibromyalgia symptoms can often be subjective, getting disability approval for it could prove difficult. Long-Term Disability Insurance agencies can be quite dismissive of self-reported symptoms. Despite how debilitating your chronic pain and fatigue may be, insurance companies want more proof. Therefore, you will need to provide objective medical evidence in order to support your claim. Your disability attorney can help you step-by-step to build a strong claim in support of your disability.

Woman sitting on a couch holding her shoulder - fibromyalgia pain concept

Debilitating Symptoms of Fibromyalgia

Part of filing a claim for fibromyalgia disability includes proper documentation of all of your symptoms, and how they might limit your ability to perform at work. However, because fibromyalgia symptoms may vary from person to person, it is important to discuss with your doctor all of the symptoms you are experiencing. Common symptoms include:

  • Chronic widespread or whole-body pain
  • Extreme fatigue
  • Sleeplessness
  • Cognitive issues
  • Bowel irritation (IBS)
  • Tender or sore muscles

Additional symptoms may also be important to note, but these are less commonly occurring in Fibromyalgia sufferers. These symptoms include:

  • Numbness or tingling in extremities
  • Jaw and face pain, including the development of TMJ
  • Digestive issues
  • Depression
  • Anxiety
  • Arthritis

Proper documentation of your symptoms, including compounding conditions, can help you build a stronger case for long-term disability.

Diagnosing Fibromyalgia

Your doctor can help you obtain a proper diagnosis for your condition. Fibromyalgia is generally diagnosed through the individual’s history and physical examinations. X-rays and blood work can also help provide more objective proof that you are not suffering from a different condition.

Because the exact cause of Fibromyalgia is unknown, doctors may look towards other contributing factors to help make a proper diagnosis. Risk factors can include age, stress levels (including PTSD), repetitive injuries, family history, obesity, and more. Additionally, women are twice as likely to develop fibromyalgia than men. Other diagnoses, such as Lupus and Rheumatoid Arthritis can also be risk factors for developing this condition.

Proving your Fibromyalgia Disability Claim

While diagnosis is the first step in preparing a proper disability claim, you will likely need more than just that. Insurance companies will often require more proof than just a diagnosis from a primary care physician. Consider seeing a rheumatologist, who will be better able to provide a more concrete diagnosis of our condition. This includes trigger point testing, which is a test that rheumatologists use to identify Fibromyalgia.

Further Testing for Your Condition

In addition to diagnosis, there are a number of ways that you can help prove the impact of your condition to your disability insurance company. There are a number of tests that can help you acquire more objective medical evidence of your debilitating symptoms.

Functional Capacity Evaluation (FCE)

An FCE is an objective physical test that tests the claimant’s ability to lift, move, carry, push, pull, sit, and stand. This test can help identify limitations due to pain and fatigue. For conditions such as Fibromyalgia, a 2-day FCE test can be vital, as it gives a better indication of fatigue from day to day. FCE’s have indicators that help prove that you were putting in your maximum effort. This helps prevent people from purposefully failing the test. These validity indicators can be important in providing objectivity to your results.

Neuropsychological Evaluation

Neuropsychological evaluations are vital to objectively proving cognitive and emotional limitations in an individual. This can include memory, focus, attention span, and other conditions that can be affected by Fibromyalgia. The mental impact of Fibromyalgia can often be overlooked by insurance companies. This evaluation can help paint a better picture of the overall deficit this condition has on your quality of life. Like the FCE, this form of testing has validity indicators to help prove the objectivity of the evaluation.

Receiving Proper Treatment For Your Condition

Proper ongoing treatment for your condition is vital to continuing your long-term disability benefits. Without appropriate care, your disability insurance company may limit or end your benefits. While there is no cure for Fibromyalgia, there are ways to improve your quality of life through treatments. Medication to reduce the symptoms of your condition is a good first step in reaching proper treatment. When considering drug-related treatment options, be sure to discuss risk factors and side effects associated with these medications with your doctors.

Additionally, there are non-drug-related therapies, such as physical exercise and physical therapy. Even physical activities such as Tai Chi and Yoga have been shown to help those living with this condition. Whether or not your doctor recommends pharmaceutical treatments, increasing your physical activity can benefit you greatly.

Treatment for Cognitive Symptoms

Cognitive Behavioral Therapy (CBT) is a treatment method that helps identify how thoughts and behaviors are linked to physical symptoms. CBT and treatments like it can be an effective way to help you with the cognitive and emotional deficits of Fibromyalgia.

Insurers May Try To Apply Mental Illness Limitations on Your Long-Term Disability Claim

Your policy likely includes a Mental Illness Limitation. While policies may vary, it is common for a Mental Illness Limitation to limit your benefits to 2 years. However, some policies may have an even smaller limit. Because many of the symptoms of Fibromyalgia can be similar to depression, it can be a common tactic by insurance companies to attempt to apply a Mental Illness limitation to your disability claim. However, Fibromyalgia can be a lifelong condition of chronic pain and fatigue. It is vital that you and your disability attorney work to ensure that the full scope of your symptoms is accurately represented to protect your claim from being classified in this way.

If you are disabled solely due to your mental health condition and have no additional physical disability, your benefits may run out when you reach the Mental Illness Limitation. There are some exemptions to MIL’s, but they are generally reserved for specific conditions, such as bipolar disorder. However, if you can demonstrate objective proof of your cognitive limitations, such as with a neuropsychological evaluation, your benefits may extend past the limit.

Discuss with your disability attorney your options regarding your policy.

Can an Attorney Help Me Get Long-Term Disability for Fibromyalgia?

If you are looking to file a long-term disability claim for your condition, you should seek out an experienced attorney. At D’Agostino & Associates, we help people living with disabling conditions such as Fibromyalgia file long-term disability claims. We help you through the process step by step to help you build a strong case. Our law team is here for you.

At D’Agostino & Associates, our team of lawyers can help you sort through all the details, understand what you are entitled to, and fight to get what you deserve. D’Agostino & Associates P.C. has offices in New York and New Jersey. Contact us, or call us at 1-888-245-2924 to schedule a free consultation with our attorneys.

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