If you live in Chicago, and have made a long term disability claim based on Chronic Migraine, or other chronic pain conditions, you undoubtedly heard the insurer say there was not enough “objective” evidence of your claim. The insurer probably even cited that your laboratory tests, MRIs, and other tests were negative or normal, and denied your claim for that reason. But those negative and normal tests do not mean there is no disability. Those tests help doctors rule out other potential causes of your symptoms. But long term disability insurers struggle to grasp disabilities when medical records lack any such hard, objective evidence. These denials also highlight the difference between what the medical community calls “objective” evidence, and what the legal system considers objective evidence.
In a recent case, Hamid v. Metropolitan Life Insurance Co., No. 20-cv-1601, 2021 WL 405225, (N.D. Cal. Feb. 5, 2021), Mr. Hamid suffered from Chronic Migraine, and the persistent pain in his head and face made him unable to work. He worked for Bank of America as a Manager of Retail Mortgage Lending, responsible for eight locations, and approximately a dozen employees who reported to him. MetLife denied his long term disability claim, citing the lack of objective evidence of the degree of pain he suffered from his Chronic Migraine. He sought treatment for the pain for nearly two decades, tried numerous medications like opioids and ketamine, tried Botox injections (now FDA approved to treat Chronic Migraine under certain circumstances), and had multiple statements from family and co-workers attesting to his symptoms.
After MetLife denied his claim, he sued under ERISA § 502(a). While an insurer saw nothing “objective” in the evidence, a court did. While the evidence is not “objective” in the sense of a positive test result, or in the way doctors think about objective evidence, there was ample corroborating evidence, which boosts credibility of self-reported symptoms in the legal system. So the court granted judgment for Hamid. In cases we have handled, we go a step further and work with clients to create as much documentation a possible of symptoms, such as a daily symptom journal. These boost credibility even more.
If you suffer from Chronic Migraine and have a long term disability insurance claim, talk to a skillful long term disability lawyer about how to get your claim paid.