Is Fibromyalgia A Long Term Disability

Disability Tax Credit Guide For Canadians Suffering From Fibromyalgia

The Disability Tax Credit or DTC is a fairness measure enacted in 1988 as a way to ease the tax burden of Canadas disabled citizens. The idea behind the Disability Tax Credit is that a reduced tax burden will allow the disabled to more effectively deal with the extraordinary healthcare costs associated with their particular disability. Since its enactment the Disability Tax Credit has been hailed as a groundbreaking piece of legislation and an invaluable tool in the struggle of the disabled to regain control of their lives and reclaim a productive position in society.

Gather Evidence And Write The Appeal

At CCK, our skilled attorneys know what evidence to collect in order to build the best evidence record possible for you. Common forms of evidence we gather are:

• Medical records
• Expert opinions
• Witness statements from you, your family, friends, co-workers, etc.

Preparing an exhaustive evidence record to file with your appeal is critical for winning your case. Gathering all necessary documentation is especially important with ERISA-governed policies because the administrative appeal stage is often the final opportunity you have to submit substantive evidence into the record. We make sure that the evidence we gather is submitted thoroughly and on time for our clients. Our evidence-supported arguments will work to prove that you meet your policys definition of disabled.

Can I Get Disability For Fibromyalgia In Canada

You may be able to qualify for disability benefits in Canada based on your fibromyalgia diagnosis.

Disability insurance carriers do include fibromyalgia in the list of disabilities they cover for both short- and long-term disability. So, yes, you may be able to get disability for fibromyalgia in Canada. According to the Arthritis Society, fibromyalgia affects about two percent of people in Canada.

However, your medical records need to prove the severity of your condition and show that it prevents you from working to be awarded disability benefits. If you received a denial on your fibromyalgia-related disability claim, you may be able to challenge the denial through an internal or external appeal.

What Other Proof Must I Provide For Disability

Describing your fibromyalgia symptoms alone will not qualify you for Social Security disability. You have to be specific about signs and physical findings related to fibromyalgia and pain and how that impacts your ability to work. The Social Security staff will consider all your symptoms, including pain.

All of this information considered together must lead to a conclusion that you are disabled before you will be granted disability with benefits. If more detailed information is needed, you may have to be examined by a doctor approved by the Social Security Administration.

Iv How Do We Evaluate A Person’s Statements About His Orher Symptoms And Functional Limitations

Generally, we follow a two-step process:

Request For Doctor Clarification

You may feel you have a legitimate claim and have supplied adequate verification of your fibromyalgia diagnosis to be approved for the Disability Tax Credit. However, the Canada Revenue Agency has stated that diagnosis alone whether for fibromyalgia or any other condition is not sufficient to qualify for DTC benefits. As a result the doctor or qualified medical practitioner must provide clarifying details relative to your impairment and how it affects your ability to perform at least 1 of the basic activities necessary for daily living.

Disability Tax Credit Benefits Amounts

For fiscal year 2016 the Disability Tax Credit limit is $40,000. This is the maximum benefit you may receive. The actual Disability Tax Credit amount you ultimately receive will depend on your taxable income as well as other factors. This does not mean however, that $40,000 is a lifetime cap on total benefits you may receive via the Disability Tax Credit, since once approved for the DTC you may be able to claim retroactive benefits for up to 10 years as well.

Improve Your Chances For A Successful Long

Primary care physicians regularly diagnose a patient with fibromyalgia when they are unable to pinpoint the cause of a patients discomfort. As a result, it is vital that you regularly consult with your family doctor and a rheumatologist, who will utilize a number of techniques to diagnose and treat your condition..

Because fibromyalgia is a conglomeration of maladies, some of which can affect a patients mental health, it is important to keep a journal of all of your symptoms. In doing so, your physician will be able to not only give you a more accurate diagnosis, but possibly help prove to your insurance provider that your condition is genuine.

Regardless of whether you have an employer provided insurance plan or an individual long-term disability policy, collecting money from an insurance company is going to be a complex process that is packed with limitations, exclusions, and exceptions. A skilled disability lawyer can help you navigate the complex claim process for a fibromyalgia disability. He or she will be able to help ensure you meet claim deadlines and pursue any appeals if necessary.

How Is Fibromyalgia Diagnosed

The American College of Rheumatology has issued criteria to determine whether an applicant has fibromyalgia. There are two alternatives in ACR criteria that can be used in determining whether you have fibromyalgia. The ACR requires the following for a diagnosis of fibromyalgia:

• Evidence of chronic widespread pain, including pain in the back, neck, or chest;
• Evidence that shows your doctor ruled out other diseases that could cause the same symptoms , such as lab tests and examination notes, and
• One of the following:
• Tender point sites in at least 11 of 18 tender point areas of the body, with tender points occurring on both sides of the body and both above and below the waist. A list of the tender points can be viewed in the SSAs recent ruling on fibromyalgia. In testing tender points, your doctor should apply the approximate amount of pressure needed to blanch his or her own thumbnail; or
• Repeated manifestations of six or more fibromyalgia symptoms, signs, or conditions that often occur with FM, particularly fatigue, non-restorative sleep, cognitive or memory problems , depression, anxiety, or irritable bowel syndrome . Other possible symptoms include headache, muscle weakness, abdominal pain, Raynauds phenomenon, seizures, and dizziness.

How To Support Your Diagnosis And Strengthen Your Claim

Record everything.Pain may be subjective, but keeping a daily pain journal to record the frequency, severity, and intensity of symptoms can strengthen your claim for benefits. Note all of your symptoms, no matter how big or small, in detailed entries that include dates, times, and what activity increased or decreased the pain.

A detailed record of your symptoms may support the information in your medical records and fill in any gaps. If your treating physician includes a review of your entries in their patient evaluation, your journal may be considered objective evidence. Since insurance companies seek often objective evidence of your diagnosis, this may be crucial to strengthening your disability claim.

Make sure your doctor is familiar with fibromyalgia. Your regular treating doctor should understand fibromyalgia and how it affects your ability to function and how disabled you are. If the doctor is not experienced in diagnosing and treating the condition, as well as filling out monthly attending physician statements certifying disability, find a specialist who is.

A doctor who can properly identify and describe the restrictions and limitations caused by fibromyalgia is crucial to supporting your disability claim.

Gather supporting documentation.

You already have a pain journal, medical records from all treating providers and the results of your 18-point tender point test do you really need more documentation?

Other Documentation Of A Fibromyalgia Claim

In addition to using your treating doctors medical records, the LTD insurance adjuster may request records from psychologists and physical therapists you have seen. The adjuster may also send you for an independent medical examination. At the exam, you will be seen by a doctor who is paid by the insurance company and who will report on whether he or she thinks you have fibromyalgia, its severity, its duration, and the ways it functionally limits you.

Employment And Disability Rights For Fibromyalgia

Many people worry about losing their jobs because of fibromyalgia. As a general rule, employers can fire anyone as long as they give proper notice and dont do it for a discriminatory reason.

However, most employers wont fire employees who need sick leaves. Under Canadas human rights laws, employers have a duty to help employees with medical conditions that affect their work. Allowing sick leave is a reasonable accommodation that employers should give.

To take a sick leave, youll need to provide a doctors note. It should confirm that you cant work and need the leave. Youll need to bring these notes often every three to six months to confirm that you still cant work.

If your application gets denied, you can stay on sick leave while you appeal. Most employers wont mind, as long as you have a doctors note.

If your employer attempts to fire you while youre on sick leave, then you may have legal rights to severance pay. You might even be able to get the termination overturned if it was done because of your condition. However, these situations are complicated. You should always get legal advice.

To learn more, read our page on disability and employment rights.

Were Long Term Disability Benefits For Fibromyalgia Denied By Your Insurance Company

Insurers often deny disability claims based on fibromyalgia and other chronic pain diagnoses. Most insurers will look for weakness in a claim that gives them a way to avoid paying benefits. Unfortunately, the subjective nature of this disease creates further incentives to deny. 

To meet the insurance companys threshold of evidence for FM, it is essential to prepare your LTD claim with the same level and strength of medical and vocational evidence used to win Social Security disability benefits for fibromyalgia. If denial occurs, you will have a well-developed case that will hold up in court.

How The Symptoms Of Fibromyalgia Can Affect You

Fibromyalgia isnt progressive and generally doesnt lead to other conditions or diseases. It can, however, lead to pain, depression and lack of sleep. These problems can then interfere with your ability to function at home or on the job, or maintain close family or personal relationships. The frustration of dealing with an often-misunderstood condition also can be a complication of the condition.

The pain associated with fibromyalgia is described as a constant dull ache, typically arising from muscles. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.

The American College of Rheumatology has established two criteria for the diagnosis of fibromyalgia: widespread pain lasting at least 3 months and a person must have 11 positive tender points out of 18.

People with fibromyalgia often suffer from sleep disturbances and are rarely able to reach a deep restorative stage of sleep. Sleep disorders that have been linked to fibromyalgia include restless leg syndrome and sleep apnea.

Many people who have fibromyalgia also suffer from co-existing conditions such as; chronic fatigue syndrome, depression, endometriosis, headaches, irritable bowel syndrome , lupus, osteoarthritis, post-traumatic stress disorder and rheumatoid arthritis.

What Causes Fibromyalgia

The causes of fibromyalgia are unknown. There may be a number of factors involved. fibromyalgia has been linked to:

• Stressful or traumatic events, such as car accidents;
• Repetitive injuries;
• Illness; and
• Certain diseases.

Fibromyalgia can also occur on its own. Some scientists think that a gene or genes might be involved in fibromyalgia. The genes could make a person react strongly to things that other people would not find painful.

Can You Get Long

When you have been diagnosed with fibromyalgia or another chronic pain disorder it can feel like no-one believes you. These are serious conditions that can severely limit your ability to work and live a normal life. But insurance companies often deny long-term disability benefits for fibromyalgia or chronic pain. Find out how to fight back and get the coverage you need when you can no longer work due to the pain.

This blog post will discuss why it can be difficult to get long-term disability benefits for fibromyalgia and other types of chronic pain. It will address the problems proving pain and occupational limitations, and insurance companies tendency to discount patient reports of symptoms. It will also address how having an experienced attorney can help improve your chances to receive benefits.

Fibromyalgia Is Now A Long

With the help of three-year efforts of patient and client council in Northern Ireland, the fibromyalgia has been declared as a long-term disability.

Now, the dedicated services can establish the trusts and centers for managing the fibromyalgia as a long-term condition.

Patients can get medical advice and interventions from the medical care professionals.

Also, it is hard to decide which alternative therapy will best suit you to manage the fibromyalgia; so, you can also get the information regarding the therapies.

As pain is the major complaint of most of the fibromyalgia patients, most of the medications would be given to treat the pain perception; however, other symptoms are less noticed.

Increased awareness about the condition could help the earlier detection of this disease.

Also, if people around you, like friends and family members, are well-aware about the fluctuations of the symptoms and behavioral issues, then, they may provide you the higher level of comfort and can participate in doing household chores. Fibromyalgia awareness could make the life of the persons easier.

It is also suggested that the relationships of the person with fibromyalgia might not be healthy with his colleagues, friends, and family. It happens because the people around you have little knowledge about this disease.

People with fibromyalgia often feel isolated and alone. Their social isolation could be a barrier to getting the treatment.

What Are The Signs And Symptoms Of Fibromyalgia

The most common symptoms of fibromyalgia are

• Pain and stiffness all over the body
• Fatigue and tiredness
• Problems with thinking, memory, and concentration
• Headaches, including migraines

Other symptoms may include:

• Tingling or numbness in hands and feet
• Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome
• Digestive problems, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome

Pain Throughout The Body

The physical pain associated with fibromyalgia is widespread and long-lasting. Before diagnosis, the sufferer will generally experience what is often classified as a dull aching sensation for at least three months. In addition, the pain will not be isolated to one area of the body it will be felt on both sides, above and below the waist.

Elevated Burden Of Proof

The Canada Revenue Agency has adopted a more stringent burden of proof in recent years with regard to Disability Tax Credit claims. As a result it is not uncommon for the CRA to request ever more detailed medical records relevant to a claimants condition. In many cases approval will not be granted without a second, corroborating medical opinion as well. As this is all part of the CRAs attempt to stamp out fraud it should be a welcome development and any requests the CRA makes should be met in full and without delay.

Also, due to the more rigorous level of scrutiny the CRA is applying it is more important than ever that any applicant make sure form T2201 is completed in full and that all information contained within is completely accurate and verifiable.

The Courts Have Confirmed That Fibromyalgia Is Ground For Declaring A Permanent Disability

Social Chamber of the TSJ of Catalonia has measured in a modern judgment, S 1403/2015, of February 24, chronic fatigue syndrome and fibromyalgia are grounds for proclaiming the permanent disability. The declaration talk about a situation of a woman, operaria chemical manufacturing, which suffered a picture of recurring most important depression without psychotic symptoms severe nature, neck pain and degenerative procedure without root contribution, CFS and fibromyalgia. Supreme Court of Catalonia give emphasis to settled jurisprudence on setting the LGSS ago on disability, which says that the valuation of permanent disability need to be done in response mainly derived functional restrictions of the sufferings of member.

According to Chamber, the debility need to be be understood as the loss of ability for severe functional or anatomical reductions that diminish or nullify the labor ability, and without that would prevent the rating the opportunity of retrieval of working ability when it is exist as undefined or for very long. Specifically, not only essential not only be acknowledged when it lacks any physical likelihood for any specialized work, but similarly when even keeping expertise to execute some activity, dont have to do it with negligible efficiency, as the awareness of any job, no matter how simple, needs a schedule desires, interaction and movement, along with attention and diligence.

Proving Your Fibromyalgia Disability

There are, however, accepted clinical tests to support a fibromyalgia diagnosis. Courts have supported the use of 18-point tender point tests and functional capacity evaluations to measure the effect of fibromyalgia on your ability to live and work. By working with a doctor familiar with the condition and its treatment, you can get the objective evidence the insurance company is looking for and improve your chances of receiving long-term disability benefits for fibromyalgia.  In the Social Security context, the Social Security Administration has recognized various criteria to establish a FM diagnosis.  While not binding on insurance companies, this detailed policy guidance can be instructive in applying a set of medically accepted criteria to your case.

There are also several things you can do yourself to improve your long-term disability claim:

• Be specific about your condition and the things you can and cant do .
• Document your good and bad days, listing what you could do and what was difficult for you at work .
• Follow all your doctors medical recommendations and discuss any alternative or holistic medicine options you are trying with him or her to receive their recommendations.  Not receiving adequate treatment is another boilerplate reason insurance companies use to deny claims.
• Gather evidence of your condition including witness statements, letters from doctors, and your own day-to-day journals.
• Apply for Social Security Disability Insurance to establish your disability.

Fibromyalgia And Long Term Disability Insurance

Fibromyalgia, also known as fibromyositis, is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Millions of American men and women suffer from this debilitating medical condition. Patients with fibromyalgia may be unable to work because of their disease and its related complications.

Patients who find themselves unable to work because of their fibromyalgia may qualify for long term disability benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.

How A Disability Case Is Evaluated

Not all workers with a fibromyalgia diagnosis may qualify for disability benefits. The insurance provider may examine the claimants medical records and other documentation to determine if they meet the standards set in their policy. They may consider:

• The severity of symptoms

• Rheumatoid arthritis
• Lupus

In some cases, it may be easier to prove your claim based on one of these diagnoses than it is to document your fibromyalgia symptoms.

What Happens If Your Fibromyalgia Is Found To Be An Mdi

If the SSA determines that you do have a medically determinable impairment, fibromyalgia, Social Security’s evaluation is not over; in fact, it has just begun. The SSA will develop a “residual functional capacity” assessment for you to determine if there is any work you can do, including your past work. An RFC assessment is an evaluation of your ability to perform various exertional levels of work; for example, if you can’t lift more than 10 pounds, you will be given a sedentary RFC. The SSA bases your RFC on your medical records, opinions from doctors and specialists, and statements from you and possibly your family members. In preparing your RFC, the SSA will rely on your doctor’s opinion as to your abilities, such as how long you can stand, sit, and walk, how much you can lift, and how well you can focus and remember instructions. Functional limitations in these areas are the key to showing the SSA why you can’t work.

After creating your RFC, the SSA will compare it to your previous job and the types of jobs available for someone with your RFC level and limitations. If your RFC rules out all jobs, even sedentary work, you will be found disabled. For more information, see our articles on how Social Security uses your RFC and tips on winning disability with fibromyalgia.

Filing For Long Term Disability With Fibromyalgia

Traditionally, when an LTD claims examiner received a case in which the only disability alleged in the claim was fibromyalgia, the outlook for an initial approval was poor. Disability insurance examiners generally gave little weight to a claim of fibromyalgia unless another severe medical condition was involved, such as arthritis or degenerative disc disease.

For example, if a claimant made a disability claim and the chief impairments were fibromyalgia and rheumatoid arthritis, or fibromyalgia and degenerative disc disease, the fibromyalgia allegation automatically carried more weight when seen in combination with another impairment as opposed to fibromyalgia being evaluated on its own. This may be because fibromyalgia is seen as a logical and plausible extension to what is generally considered as more proven impairments.

As a result, unless a fibromyalgia diagnosis was made in conjunction with another medical diagnosis, especially one of a musculoskeletal nature, a disability claimant with fibromyalgia had little chance of being approved for LTD benefits.

What allows a claims handler to consider subjective complaints to be taken as medical signs in the case of fibromyalgia? When a symptom is an abnormality that can be documented by clinical diagnostic techniques that have been accepted by the medical profession, such as found in the definition established by the ACR, the claims handler may view this as sufficient evidence.

Denial Letters In Fibromyalgia Claims

In short, it is very common for an initial long term disability claim to be denied when the application is based on a fibromyalgia diagnosis. That does not, however, mean that you will be unable to successfully appeal the denial of your claim. Many claimants who have been denied at the initial application stage based on a diagnosis of fibromyalgia go on to appeal the decision and win benefits.

If your long term disability claim is based on fibromyalgia along with another medical diagnosis, it will be easier to have your claim approved than it would be if you are filing a claim based on fibromyalgia alone.

How your condition was diagnosed will also play a role in the success of your long term disability claim. If you have had your condition diagnosed by a family doctor or primary care physician, it will not carry as much weight as a diagnosis that has been made by a Rheumatologist or Orthopedist. If you have not yet seen a specialist to verify your fibromyalgia diagnosis, you may want to do so before filing a claim for long term disability benefits.

Can I Get Long Term Disability Benefits If I Have Fibromyalgia

June 16, 2020

Fibromyalgia is a disorder that causes widespread musculoskeletal pain and tenderness. If you suffer from this disorder, then you will likely have trouble sleeping and experience memory and mood issues. However, doctors have not yet determined what causes the pain associated with Fibromyalgia. This may mean that you will have trouble proving definitively that you suffer from this disorder. An insurance company may choose to deny your Fibromyalgia long term disability claim.

Are you currently suffering from Fibromyalgia? If so, then consult with an ERISA attorney at Tucker Law Group. Our nationally recognized law firm has won hundreds of fibromyalgia disability claims and can analyze your disability policy during a free case evaluation. We know that insurance companies look for ways to deny Fibromyalgia long term disability claims. We can help you and your treating physicians present the most persuasive evidence of your disorder.