It should be just a matter of time for independent insurers to also see it that way. Fibromyalgia is one of the most common wrongly denied disability claims, and if it continues to be denied, given the Social Security ruling and new medical evidence, an insurer could be acting in bad faith.
“While I am waiting for a decision from Social Security I am also looking into appealing my insurer’s decision,” says Cathy. “I was denied short term disability benefits last October and if I don’t get assistance soon I have no choice but to go back to work. I already exhausted my twelve weeks of FMLA benefits that I am entitled to for the year. Fibromyalgia is very painful and very debilitating and it keeps me from performing my job well so I am in panic mod--I’m sure that my employer will fire me. I know my pains will increase due to the long hours I have to work in the same position and not being able to move around.”
Fortunately for Cathy, fibromyalgia is now recognized as a disability unto itself. The Social Security Administration (SSA) published a ruling last July 2012 that provides guidance to disability claims examiners and administrative law judges on how to assess fibromyalgia cases. Despite this ruling, as evidenced by Cathy’s denial, some insurers still won’t recognize fibromyalgia as a disability. The good news is that most claimants who are initially denied, win disability benefits after they file an appeal.
Historically disability examiners have denied this condition because of its subjective nature, meaning that symptoms cannot be a “proven” impairment such as rheumatoid arthritis or degenerative disc disease, both of which can be diagnosed through testing. And it is only recently that physicians have recognized the disease as a legitimate disability. In the past it has been referred to as a “catchall” condition and doctors give a “catchall diagnosis”, which doesn’t bode well with disability examiners. Cathy’s family doctor may have hindered her claim.
READ MORE DENIED DISABILITY INSURANCE LEGAL NEWS
(A "medically determinable impairment” is an impairment that has been established by medical evidence and it must be established by medical evidence such as x-rays and lab tests. An impairment cannot be established on symptoms alone, so complaining about pain and fatigue, which are the typical symptoms of fibromyalgia, is not enough. Rather, the SSA needs to see medical signs of an impairment that could reasonably be expected to produce your symptoms.)
Despite the new SSA ruling, many claims examiners may not be up to speed and it will likely take some time to change the initial application approvals. In the meantime, the appeals process and an experienced disability attorney should be able to help Cathy.
READER COMMENTS
Michelle Zara
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Corey
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Lisa
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Ginger Conner
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Marianne
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Chronic tendinitis
Chronic muscle spasms
Chronic Migraines
Arthritis
Coronary Vasospasms
Supraventricular Tachycardia
Thoracic Outlet Syndrome
Depression
Anxiety
Fibromyalgia
I have been denied my insurer LTD benefits beyond 2 years-d/t ruling of my disability on depression exclusively.
The thing is-chicken and egg. I did not become depressed until the symptoms of Fibro were so out of control that I had to take leave and ultimately lost my job.
I can do things and appear functional to others at times. What others do not see is what my family sees. My 76 year old mother cooks and shops for me. My husband dx with cancer helps with all things physical. I miss family and friend events; forget skills to run a household. The shame of that is depressing enough. The pain and fatigue --- I have tried everything. PT, OT, yoga, walking, supplements, aromatherapy applications, chiropractic, medications (duh). I cannot tolerate anti-depressants what so ever.
Do I believe I will NEVER be able to function in an occupation-why would that even be a question. I can deal with now and the years past that brought me to the point I am disabled.
Most frustrating is some of the medical professions see Fibro and mental health and ignore the patient and the symptoms. I had a doctor walk in-shoot me with Botox outside of the area's my chiropractic suggested. No exam whatsoever-and he left before I even had my shirt buttoned. No questions - no follow-up like usual. THe result has been increased pain - because of weakening the incorrect muscles.
Good thing is that my family validates and sees the difference. I worked for 32 years. PLEASE- like this is a choice!
Thank you for reading
Marianne
Darlene Kavanagh
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KLL
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Needless to say, my lawyer filed an appeal, but he said the average response from the appellate judges is around 15months. So, we wait another year. Ugh!
Kata
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Pamela Dunklee
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Julie Shaw
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Denise Clepper
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Dee Wynette
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Leah
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I hate people that cheat the system, and make it so hard for me and others to get help. It makes me sick. Please turn the person in. By the way, the person will have to pay all of the money back. Thank you. :)
Anne G.
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Nanette Murray
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Laura
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LK Spalding
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In February 2014 I filed for Short Term Disability (STD). The company I work for gave me 5 days without pay for Family Medical Leave Act (FMLA) and then the STD kicked in at 70% of my pay. STD ended on August 23, 2014 and like an idiot, I naively expected to be approved for Long Term Disability (LTD) which would have been 60% of my pay. It is still better than Social Security Disability.
My company uses one Third Party provider for STD and yet another Insurance Provider for the LTD. I have not received one red cent from either my company or the LTD Insurance provider since August.
Two of my three physicians agree I have FM and the stress of working exacerbates the condition. One of the three, a Rheumatologist stated to my face and to the LTD provider that I am capable to go back to work. She told me, (paraphrasing), 'you don't have Rheumatoid Arthritis (RA), you have Osteoarthritis and we all get aches and pains as we get older.' She originally diagnosed me with FM back in 2010. Now my other two physicians (my primary care and my Neurologist) are telling me that (most likely) because of her (Specialist) statement, it appears I am going to be denied LTD. They each received a letter from the Insurance Provider stating that because they cannot provide clinical tests to PROVE I have FM, it is in their opinion that I should report back to the office.
OMG!!! I can barely get out of bed on some days. I cannot shampoo my hair much less shower on a regular basis because it is exhausting. I've lost my husband (divorce) and my home (settlement), my friends and family because of this disease.
Forget trying to cook, I cannot remember if I put an ingredient in or not. I've gone down the WRONG lane of traffic on more than one occasion so now I only feel safe driving in the general vicinity of my home. If and when I get out the vacuum, I can barely catch my breath afterwards, forget doing anything else!
I cannot keep track of my bills, I either pay late or forget to pay altogether. I went from a credit score someone would brag about to a score of shame.
Are they serious? Who would live like this for close to FIVE years just to avoid getting out amongst the living? Who would want to live like this while their life falls apart around them?
I've moved into a home (first floor master) that I thought I could take care of but it's still too much for me. I have no yard, it's a condo townhome association but I struggle to walk my little dog. I have to come home and catch my breath after the little guy has done his business.
This isn't a choice I made.
Now I guess I need to find an attorney.
More stress!!!!
Can someone tell me please, where do I go from here?
Jane Mckenna
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James Fenton
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Second hearing four years later, the judge receives a "Hate letter" from my attorney, and enters that into the record, and I was denied again. "The letter said that this Judge would never approve my claim" and the Judge said "my attorney was right and it says I would never approve you, so I will deny your claim"
Hearing three 2012, my lawyer says nothing while the Judge proceeds to yell at me about what I am able to do and he concludes that I am not a Fibromyalgic patient, and do not qualify for SSD, I take 40mg of Methadone daily just to walk, and get fed, maybe some chores like turning the dishwasher on.
This has been the most unsettling experience realizing that the SSD system is a corrupt system bent upon refusing real qualified people with real serious medical problems from their rightful benefits, through any means available.
This is very disturbing, I do have all the symptoms and am actually a textbook case, another reason used to be refused it seems they think I studied all the available information and fooled all my doctors including the reumatologist that diagnosed me in the first place. It is utter nonsense, anyone getting the kind of medications that I do would never be allowed to "Fool with them" not ever. Methadone is a class two drug and I react very well to it, I can't get through the day without these pain meds and have been using them with good effect since 2006.
All I can say is the SSD system really wants me dead, to "Dry up and Blow away"so to speak. they are evil little pawns in a game, and I am a real person that is disabled, with no recourse left to me.
They owe me 14 years of back pay, and they will never let me rest while alive, this is the most corrupt system ever devised, short of the Nazi extermination efforts back in world war two. I will do my best to expose them for the fraudulent system they are, I am so thankful that I found this site. If we all could get together and speak as one we might have a chance against the governments systematic denial of all the people that suffer daily with this ailment. James Fenton Keno Oregon, stay tuned for my detailed book on this very case, I have one last task and that is to expose the Government for the most corrupt, "Bad faith" wielding organization on this planet.
erin smith
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erin smith
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Connie
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cyndi
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IBS..migraines...depression..anxiety..bilateral carpal tun.i ve tested positive ANA three times..i have extream low vitamin D..and B12 and often lukopenia (low white blood) .. I am progressively becomimg worst. Im 52yrs old worked since i was 16 ..i just cant believe that i was denied..by time this is over i will have had lost everything. our savings..my retirement..and my home.. God help me.
Carolina Aitken
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At the last hearing the judge didn't even see me, he stated to my attorney; "if I agreed to take back payments of only 5 years he would grant my case". I was so desperate, I agreed. Long story short they ripped me off for over one hundred thousand dollars and fifteen years of medical benefits. So, my advice to anyone applying don't give up, but don't hold your breath either!
Richard Hudon
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It is now accepted in Ontario, that generalized and/or whole body pain lasting more than 6 months as detected by any treating physician qualifies as Fibromyalgia and this is accepted by all insurers of Canadian patients.
Claudine Fourie
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IN 2005 I MANAGED WITH DIFFICULTY AND MY COLLECTED RESEARCH I HAD DONE AFTER BEING DIAGNOSED BY ONE OF VERY FEW DECENT SPECIALIST RHEUMATOLOGIST IN LONDON IN 2004, HAVING BEEN AFFECTED BY TOXIC ENVIRONMENTAL AND A STINT OF HEAVY AND REPETITIVE, LIFTING & STANDING WORK AND I THEN CONVINCED THE BRITISH AUTHORITIES WHILE I WAS IN IMMENSE PAIN AND MENTAL FATIGUE HEREOF.
Florence Leon-Paul
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Tina M Barrett
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Deah
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I agree with Jennifer though, that without a viable test for Fibromyalgia there will be those people who fake the symptoms so they don't have to go to work and can play and vacation the rest of their lives. This is a discredit to those of us who are symptomatic and scientists need to got on the stick to find a test for diagnosising and a cure.
I would rather be working with a $4,000.00 per month Administrative Assitant income than trying to live off $800.00 per month.
Good luck to us all. At least I have found some relief through drinking green and eating a healthier and on the most part gluten free meals.
barbara hill
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Pam
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My own is something I have to consciously make a choice for it not to consume me.
If you get nothing else from this discussion.......
Ian is right on the money. Its show me the data type thing.
However, there are data, if documented accordingly, a differential diagnosis can be made as to number of tender points, etc., and then there is data, albeit subjective, yet, substantiated by the MD, there is ,little room to guess or wonder anymore.
The government is the government. Social security is the government.
They are bland, and do not care what you say or how its said. They simply want the information, the data, or signatures.
So, consider the source. Logical end? The attorney you've seen who has a good track record, and one you can trust as your advocate.
You need an advocate. Youre dealing with courts and magistrates so you need an attorney, which may also charge you fees.
That's dependent on the individual attorney.
Get what you deserve.
Go to work and keep at it because the initial increased pain fades a bit more with each time youre exposed to that stressor. Before you know it, itmay not be as bad as it was in the beginning.
But if you can't work, and I've been in that situation too, but was blessed with three years of support from my employer, then you have no choice but to navigate the legal system.
I've really fallen through the cracks. I was let go for a stupid reason and haven't worked in 6 months looking for a good job. I did staff nursing. Its time to either teach nursing or return to staff development departments in hospitals. I was denied unemployment because they accused me of not following policy. However, I was the highest paid, and most degreed. The place was sold and the consensus is they were threatened by me. And now, they've given out 2 very important references, which one said they simply didn't believe!!! I would think this is against the law. It sent me into a downward spiral.
But, I got a gift from all this. I've decid d to go back into doctoral studies to get my PhD. So, I'm not allowing them to define who I really am.
I am showing who I really am, despite the fact I'm not perfect.
No one ever said we had to all be the same or be perfect.
This is life. What's the alternative? Been there too. Not good. Dark.
So turn around and be thankful you lived another day.
Your beliefs become your thoughts. Your thoughts become your actions
Do what you can, and give the rest to God..
My husband left me then destroyed my relationship with someone I really loved. Then he turned around and married a physician...for her money.
5 years later, I am still alone. After 30 years of marriage & 4 kids. Kids.....my kids have been my refuge. Theyre all close in age & are best friends with each other me and best friends with me. They have been my haven. But they're also burdensome and I worry a lot.
I have constant panic attacks. I don't know how to live alone but I've managed to for the last two years in a houseive leased. I thought I might buy it but the owner showed up and is waiting for me to move in the next three months. I hate moving. Plus, I had fixed this house up & personalized it so much. Now, I don't know where I'm going to be working , nor where I am going to be living.....My security... my basic primal need, that I'm so insecure about, is crumbling all around me.
But in have faith. Something is about tho turn things around.
We all must have hope. Faith in things unseen...like fibromyalgia.
Its there, you just can't always see it.
Hope is faith in things unseen.
I hope the rapture comes soon & there won't be asny more pain.
In the meantime......massage, hot tubs, avoiding triggers, like cold weather....ouch!!!! Do what you can & give the rest to God and your attorney!
I love attorneys. They are some of my best friends for advice about my security. There are people out there that care. It may not necessarily be your family that does. Seek professionals that can help you, not family or friends that get frustrated because they front know how to. And that's the essence of what can threaten relationships.
Be realistic. But don't expect pity parties or a lot of sympathy.
Others think, Wow...they look good. They don't look sick.
If they only knew the knots ....tight ones.....all over my body.
Then they could understand. People dont understand what they cannot see.
Don't be a victim. Don't choose defeat. Persevere.
Stay well. Don't get this flu going around. I bet that isn't good at all.
I hope what I've said helps. That's my only intention....that it helps.
Nothing personal....except to say I have read about what Ian wrote on diagnostic testing.
Its all so complicated!!! I like the attitude......No worries. Be Happy.
Peace.
Jennifer
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The problem is I also know somone who got Disability due to Fibromyalgia and doesn't really have it. She knows the symptoms well and has lied to the Doctors about her condition. She works. She plays softball and was even the softball manager for the Time Out Tavern softball team. Goes bowling, rides in mechanical bull contests and is out in bars 6 nights a week playing pool and singing karaoke, drinking and stripping naked in public. It is people like this who make it hard for people who "really do" have Fibromyalgia and other autoimmune disorders to be taking seriously by the Social Security Administration and other agencies.
Hopefully someday, they will come up with a blood test that will confirm diagnosis, so people who are really truly ill can be diagnosed earlier.
Saul Register
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Bonita
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Bonita
Judy Bush
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Sherry Vaught
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Everytime I try to go back to work I have to quit because the pain is crippling, over and of again since as long as I can remember. I have bone sitting on top of bone in my lumbar spine, and cervical spine. They(disability board) says my husband makes too much money so I can't get it as long as I am married to him. I don't want to be married to him, but I have nowhere to go, no insurance, no home. I am 45 years old with a 17 year old son, my son who he adopted because his dad walked away. Why can't I qualify under the statute of reg SS since my parents filed for me as a child. I did not know I should have filed before a certain age. I have filed at least 4 times. Can you help me?
Ian Hodgson PhD
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If you take anyone with FM or ME/CFS and test for upregulation of immunological markers you will always find that the patient must be suffering. The markers are not definitive for FM or ME/CFS but they still tell you "this person has a disease". For example, you will see:
consistently increased IFN-alpha and gamma
low natural killer cell function
increased titers of RNase-L
various other cytokine abnormalities
brain abnormalities.
Oxygen uptake dysfunction.
Taken together they spell a disease.
Insurers take advantage of the unwillingness to test the patient to this degree because it is expensive to do so.
eleen a backman
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Wayne Robbins
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Cathy Boyes
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Lori Devine
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Marianne Stanton
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SO many people have been wrongfully denied Social Security Disability Income benefits.
The purpose of my blog is to assist people obtaining their benefits and what to do and where to go when they've been denied.
Martina Donnelly
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