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DISABILITY LAWYERS REVERSE DENIAL OF AN AETNA DISABILITY CLAIM FOR CHRONIC FATIGUE SYNDROME PATIENT

Thursday, November 10th, 2011

After a diagnosis of Chronic Fatigue Syndrome (CFS) and fibromyalgia in his late 30’s, our client spent more than fourteen years fighting to keep working. To us, that is a sign of determination and commitment.

To Aetna disability insurance, filing a claim for disability many years after the diagnosis was a red flag, and they denied his claim based on one cognitive study. Their attitude – what had changed that led him to file a claim now, when he had managed his conditions for so long?

The cumulative effects of his conditions over time had simply become too much, despite his resolve to keep going. Chronic Fatigue Syndrome and Fibromyalgia weren’t his only challenges. He also suffered from muscle twitching and severe muscle spasms, sleep problems (insomnia, non-restorative sleep), headaches, and costochondritis (rib pain). He endures chronic widespread pain from the Fibromyalgia, severe fatigue, and the cognitive side effects of his medications.

It probably would have been easier for him to file for disability years ago. But he loved what he did – it was challenging, afforded a comfortable lifestyle for his family, and he was good at it.

As Chief Financial Officer for a large retail furniture store, our client was responsible for directing and coordinating all financial affairs, negotiating contracts, preparing and analyzing budgets, and preparing reports outlining the company’s financial position in areas of income, expenses, and earnings based on past, present and future operation. This position required strong cognitive and mathematical skills and a high level of performance and management abilities.

Aetna relied upon some cognitive testing to claim he was malingering. We developed an aggressive attack that brought together reports from many of his health care providers. This included his therapists, who proved their observations of deteriorating cognitive and memory skills, paired with other doctors who supported this position.

We were successful in getting him the payments that he should have received when the claim was initially filed, and he is being paid on claim, as he originally should have.

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Frankel & Newfield does not currently handle any Social Security Disability Insurance claims.

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