Whether you have filed a disability insurance claim and been denied, or are preparing to file a claim and want to be sure you have everything in order, how you handle your claim from the beginning will make a big difference in whether or not your benefits are approved.
The following information will assist you in preparing your claim properly to avoid problems. By putting together the necessary documentation before you file your claim, you may well avoid having to take legal action against your insurer in order to obtain your benefits.
The main components of a fibromyalgia (or any) disability case are: (1) establishing that you have a medical impairment and (2) establishing that the degree of your impairment precludes you from working in the “usual and customary manner and with reasonable continuity.”
In an “own occupation” policy you must be unable to perform the substantial and material duties of your own occupation (surgeon, court reporter, computer programmer, dentist). In an “any occupation” policy you must be unable to perform the substantial and material duties of any occupation for which you are qualified by reason of your education, training or experience.
To qualify for “total” disability benefits you do not have to be unable to do anything. You simply have to be unable to work normally for the number of hours you had been working at the time you became disabled.
Fibromyalgia is usually diagnosed by a rheumatologist and is evidenced by a physical examination and specialized testing which reveals pain in all four quadrants of the body. The condition is usually permanent and is accompanied by debilitating pain. Many individuals with fibromyalgia also suffer from related physical or psychiatric conditions including sleep disturbance, clinical depression and chemical dependence. A host of medications are used to address these conditions. Unfortunately, the medications, themselves, often cause disabling side effects.