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3 reasons why long-term disability claims for fibromyalgia are denied

On Behalf of | Jul 1, 2022 | Long Term Disability Claim Denial

If you suffer from fibromyalgia, you know: This is a serious, debilitating condition. Widespread pain, loss of sleep, fatigue and serious emotional stress are all common symptoms and side-effects of fibromyalgia, as noted by the CDC.

Although fibromyalgia is serious, and should qualify as a disability in anyone’s book, long-term disability claims for fibromyalgia in employee-provided insurance plans are all too often denied. Although it is unfortunate, it is important to understand some of the most common causes for fibromyalgia claim denials, so you can avoid them and get the benefits you need.

Why are fibromyalgia claims denied?

A few of the reasons for denied fibromyalgia claims include:

  1. Some policies explicitly exclude fibromyalgia: Because of the subjective nature of the symptoms and difficulties with accurate diagnoses, many group policy providers intentionally and explicitly exclude fibromyalgia from their coverage policies. If an illness is specifically excluded from a plan, it is highly unlikely that the carrier will cover it.
  2. Difficult symptoms to diagnose: The reason carriers often exclude fibromyalgia from their policies, and one reason why long-term disability claims for fibromyalgia are so often denied, is the difficulty in diagnosing the disease. The symptoms of fibromyalgia are all self-reported and subjective, involving pain sensitivity and loss of sleep, all symptoms that could be easily faked.  Insurance companies will use the subjective nature of the data as a cause for claim denials.
  3. Errors in filing: Long-term disability claims for fibromyalgia, like any other type of long-term disability claims, involve a very exacting process with many essential details. It is very common for people to have their claims denied due to an inaccurate detail, lack of adequate medical verification, late filings or other administrative errors.

Fibromyalgia is a serious, debilitating condition that can render its victims unable to work. But obtaining long-term disability benefits for this disease is a particularly difficult task. If you are seeking long-term disability benefits for fibromyalgia, or if you have already had a claim denied, it is important to discuss your case with an experienced attorney who can walk you through the process and help you get the benefits you need.