Fibromyalgia: Disability Application Cases Archive

In the past several years the courts have accepted fibromyalgia as a disabling condition. Disability insurance companies often challenge fibromyalgia as a disabling condition because of the lack of objective tests available for the diagnosis. There is no objective test such as blood work, x-ray, ultrasound or an MRI to confirm the diagnosis. A person disabled by fibromyalgia must be able to prove how their pain prevents them from being able to work with reasonable continuity.

Disability Attorneys Talk About the Need for Medical Documentation to Support a Claim for Disability Benefits

Watch our video to learn about the importance of medical documentation to support any disability insurance claim. Disability attorneys Gregory Dell and Alex Palamara discuss how Mr. Palamara won long term disability benefits for his client on administrative appeal to Mutual of Omaha. The case demonstrates the importance of having comprehensive medical documentation of how the diagnosis affects the claimant’s ability to work.
This client suffered from lupus, COPD, fibromyalgia, spinal stenosis, and emphysema. Even so, his claim for disability benefits was denied after his medical records were reviewed by a nurse.
Read more »

Court Orders Unum Life to pay Plaintiff Disability Benefits

The case of Chris Bunger v. Unum Life Insurance Company of America, is an example of how hard an insurer will fight in order to avoid paying a claim for short term and long term disability benefits. This was the second district court opinion on this case out of Seattle, but it will not be the last one.
Read more »

Appellate Court Rules Sun Life Owes Plaintiff Disability Benefits

Diahann L. Gross v. Sun Life Assurance Company of Canada is a decision from the U.S. Court of Appeals for the First Circuit. It is the second appeal for a case that began in August 2006 when the Plaintiff, an optician and office manager, became too sick to work. She suffered from chronic and severe debilitating pain which was substantiated by numerous medical reports.

Sun Life rejected her claim for disability benefits on the grounds that surveillance video conducted over a nine-day period of time showed three instances when the Plaintiff acted in apparent conflict with the medical reports. After exhausting her administrative remedies, Gross filed an ERISA lawsuit in the District Court of Massachusetts, which held she was entitled to disability benefits and Sun Life appealed.
Read more »

MetLife Cannot Require Objective Proof of Chronic Fatigue Syndrome

In Bosley v. Metropolitan Life Insurance Company (MetLife), Robert Bosley, a nurse at Kaiser Permanente, had his claim for long-term disability benefits granted in 2009 based on the diagnosis of chronic fatigue syndrome. Subsequently, he returned to work in a position that caused him less stress. That lasted until 2011 when MetLife again granted him long-term disability benefits based on his “laundry list of health problems.”
Read more »

Anthem Denies Disability Benefits for Plaintiff’s Pre-Existing Condition

This case was not handled by our office, but claimants may find it instructive on the topic of treatment for pre-existing conditions during a waiting period for benefits established by an insurer as well as on the topic of being disabled from a claimant’s own occupation.
Read more »