Bartolic Law helped many clients with Fibromyalgia get long-term disability claims approved, or denials overturned. In one case, a client came to us after exhausting pre-litigation appeals. We discovered that the insurer performed multiple vocational reviews and consistently noted it needed the client to have at least light physical exertion capacity to terminate disability benefits. After sending the client to an IME, who originally stated the client had only sedentary capacity, the IME changed her opinion days later elevating the limitations to medium exertion capacity.
After we sued under ERISA § 502(a) and confronted the insurer’s counsel about this, the insurer quickly put our client back on claim. In another client’s case, we successfully persuaded the insurer our client’s Fibromyalgia precluded even sedentary work after a benefit denial. Shortly thereafter, the insurer attempted to raise a contractual basis to deny benefits, which we overcame after filing a lawsuit. We know our clients would rather be working and earning a living than be disabled, and their claims are real. That is why Bartolic Law never gives up.
Fibromyalgia is another chronic pain disorder that can include widespread and persistent musculoskeletal pain, as well as mood issues, memory problems, sleep disorders, and fatigue. This condition can be triggered by physical or psychological trauma or stress, infection, or other health issues. In other cases, there is no discernible cause for fibromyalgia starting. Victims of fibromyalgia can experience debilitating pain that does not quit, and there is no cure. Medications might be necessary for pain and psychological symptoms, such as anxiety or depression.
The most common reason insurers give to deny Fibromyalgia-related long-term disability claims is that the severity of symptoms is subjective and self-reported. When challenging a denial, the best strategy is to create as much corroborating evidence as possible and create objective measures of your limits. Insurers sometimes hire doctors to review Fibromyalgia-related long-term disability claims who write that Fibromyalgia does not cause disability. When this happens, it is a good indicator the doctor cannot deny good evidence in your records. The best response to this is to pull out all the examination findings and records of your symptoms and highlight them.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)
If you have been diagnosed with fibromyalgia, it can make it difficult to work or even engage in regular activities. It can be necessary to seek benefits by filing a long-term disability claim, and Bartolic Law can advise you of the best course of action. To learn how we can help, complete the questionnaire below, and one of our representatives will contact you.