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Backing up Fibromyalgia disability claims

Thursday, January 25th, 2018

A diagnosis of fibromyalgia immediately sends up a red flag to disability insurance company claims adjusters and third party administrators. That’s because fibromyalgia has long been considered a condition by insurance companies, and not an illness.

If you live with fibromyalgia or Chronic Fatigue Syndrome (CFS), you know that these diseases can make even the simple task of getting out of bed virtually impossible. The relentless nerve pain, the inability to focus—so well known that it has a name-“fibro-fog— turn active, high functioning people into invalids. The physical symptoms, however, are not visible to the eye. And, what the disability insurance companies focus on, and have for many years, is that there is nothing that shows up in an x-ray or bone scan to show the cause of the pain and fatigue.

Today there are some blood tests that do show the presence of fibromyalgia, by looking at other conditions that may have similar symptoms – but insurance claims professionals are skeptical of these claims.

What can you do, when you have reached the point where you are no longer able to work?

Before filing a claim for fibromyalgia, it is recommended that you speak with an experienced disability insurance attorney. They will be able to work with your treating physicians to be sure that your medical record is properly prepared to pursue a claim.

Simply having your doctor note that you are suffering from the effects of fibromyalgia is not enough. Your medical records must clearly indicate the specific tasks and duties that you are no longer able to do as a result of fibromyalgia.

Also, it is very important that you see your treating physician on a regular basis. Having this kind of a chronic illness without regular care will raise a number of questions from the insurance company. If you see a doctor once and there is no follow-up care, the insurance claims adjuster will consider that proof that there is no care being given because there is no illness.

Fibromyalgia is a chronic disease that does make it difficult for people to work and enjoy an active lifestyle. If you have been diagnosed with fibromyalgia and are concerned about your disability insurance claim, call our office at 877-LTD-CLAIM (877-583-2524).

If you have already filed a claim and have received a denial letter, give us a call today. There are strict time limitations on the appeals process, so don’t delay.

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications



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This is about a Social Security Disability claim.

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