Fibromyalgia & Long-Term Disability Benefits


BY MATT LALANDE in Long-Term Disability 

Fibromyalgia is a difficult disorder to diagnose, which can be incredibly frustrating for individuals who are living in pain, cannot work and who need to apply for long-term disability benefits. It’s often called the “invisible disease” and for doctors, it’s often referred to as a condition that is very difficult to diagnose.

Living with fibromyalgia is not easy and can be very limiting for individuals who suffer from this condition.  According to scientific researchers, fibromyalgia is more commonly diagnosed in women than men (up to 80-90%), and on average impacts approximately 2 to 3% of people in Canada and the United States. Individuals with fibromyalgia are often forced to maintain a “balancing act” with trying to maintain work, or often times, has detrimental effects on their ability to work.

What is Fibromyalgia?

Fibromyalgia is a medical disorder that is a very commonly known as a “chronic widespread pain condition” in rheumatology.  In the US, Fibromyalgia is considered an “arthritis condition” which, according to the National Institute of Health, means it’s a medical condition that impairs the joints and soft tissues and causes chronic widespread pain.  It turns out to be much more than that, however, due to the multitude of symptoms that surround this condition.

Fibromyalgia is not a “unique” condition which always exhibits the same symptoms among those suffering. Each person’s fibromyalgia manifests somewhat differently, making it extremely difficult for doctors to treat. And though the symptoms are so varied, they intertwine to “make up” the syndrome, with pain and fatigue the common denominator.

Individuals with fibromyalgia experience hypersensitivity to pain. Certain physical and/or emotional stressors can aggravate or trigger the pain (more below) such as physical trauma, stress, infections, or psychological distress. However, in some cases, there is no specific cause for the pain and it may simply occur without explanation.

There is no specific cause that has been identified for the development of fibromyalgia. It is possible to develop this condition after a traumatic event such as a car accident or if you have another medical condition such as lupus or rheumatoid arthritis. Other risk factors include age (likelihood increases at middle age), obesity, repetitive injuries such as degenerative joint pain, or a viral infection.

What are Symptoms of Fibromyalgia?

As mentioned, pain is a predominant symptom that almost always underlies fibromyalgia.  For a person with fibromyalgia, pain flare-ups are often severe, sharp and long-lasting and are generally brought on by some instigating factor, or aggravator, which amplifies the pain and/or other symptoms to acute levels. When the flare-up subsides, a person will almost always still have pain —it almost never goes away because fibromyalgia is a chronic condition.

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Despite pain being the most common symptom of fibromyalgia, it is only part of a constellation of symptoms that a person with the condition will suffer. Often times, people with fibromyalgia will suffer all consuming fatigue, numbness and tingling sensations throughout their extremities, IBS, restless leg syndrome, dizziness, allergic reaction type symptoms like runny nose and burning eyes, nausea, dizziness, headaches etc.

A more detailed outlook of fibromyalgia symptoms are as follows:

Knotted or Tightened Muscles: many people with fibromyalgia experience the feeling of knotted or tight muscles. Muscles often hurt to the touch and pain radiates to other body areas when pushed on certain muscles. This increased sensitivity is often known as “trigger points” –  which doctors use to diagnose a fibromyalgia condition by pushing on certain areas of the body and noting how many of the trigger points are painful to the person. Often times people with fibromyalgia will turn to massage therapy to assist with the feeling of knotted or tight muscles, cramping and weakness.

Digestive Disorders: people with fibromyalgia often experience digestive disorders such as heartburn, constipation, diarrhea and indigestion. Other symptoms include abdominal cramping is triggered by certain foods.

Widespread body pain: this is the core symptom of fibromyalgia that often prevents people from working. Typically, the pain with fibromyalgia is a dull, aching pain sensation in the muscles and/or joints that lasts for at least three months or more. In order to meet the criteria for widespread pain, the individual must experience pain in at least four out of these five areas: left upper body, right upper body, left lower body, right lower body, and/or the axial region (neck, chest, or back). People with fibromyalgia have often described widespread body pain as feeling like one has the flu, which is exacerbated by any kind of movement.

Fatigue: fatigue is a common symptom for all people with fibromyalgia is a total lack of deep, restful, restorative, stage four sleep. This is the period of sleep where the body repairs and replenishes and heals itself.  Persons with fibromyalgia often suffer from severely interrupted sleep and often wake exhausted – with fatigue persisting through the day.

Brain fog and Cognitive Issues: this symptom is sometimes referred to as “fibro fog” and impacts the patient’s focus, memory, attention span, and concentration. People fibromyalgia often complained that they cannot focus, concentrate and have word finding difficulties. Tasks that require quick or frequent changes in thought may also be more difficult. Memory difficulties and confusion are very prevalent in people that suffer from fibromyalgia.

Morning Stiffness: it’s often been written by experts that the pain and stiffness that a person with fibromyalgia sufferers is often much worse in the morning when they first get out.

Headaches, Migraines and Balance Difficulties: headaches and migraines can be a daily occurrence for someone suffering from fibromyalgia. Pain medication might not be strong enough, thus needing prescription pain relievers. Balance difficulties are often common, often due to brain fog, headaches, and muscle wastage. It’s not uncommon for someone for someone with fibromyalgia to have difficulties riding a bike or walking long distances.

What can aggravate fibromyalgia?

Because fibromyalgia has no cure, it is important to know which symptoms can exacerbate your condition.  Some aggravating factors have noted to be:

Suffering from overexertion: exercises that you might have been able to previously do may now be much more difficult and may exacerbate your fibromyalgia symptoms. If whatever exercise or activity you are doing makes your symptoms worse, it may be a good idea to lessen your physical activity.  There’s no doubt that people with fibromyalgia need to move their bodies and exercise – but it should be within their ability and should not worsen or aggravate their symptoms. Overexertion is known to cause an increase in muscle spasms – which in turn can increase pain levels.  

Stress – stress has been known to trigger a worsening of fibromyalgia symptoms. Stress, which can be emotional or physical, can no doubt cause anxiety and tension that could catalyze or exacerbate muscle pain, headaches, anxiety attacks and muscle 

Weather: believe it or not, persons with fibromyalgia who spend an extra-ordinary amount of time in the sun may unfortunately feel an increase in burning and itching of their skin.  Rapid changes in the weather, as well as cold weather can really be hard on the person with fibromyalgia. Symptoms of depression, muscle aches and headaches often get worse with rapid changes in weather or when the weather is snowy or rainy.

How is Fibromyalgia Treated? 

As there is no cure for fibromyalgia, most patients with this condition are often in treatment to maintain control of their symptoms throughout their lives.

In more severe cases, patients may benefit from neurological therapies such as electrical nerve stimulation or transcranial stimulation, but these are typically only used when the above treatment options are not effective.

Alternative or holistic therapies such as tai chi, yoga, hydrotherapy, or acupuncture are sometimes reported as helpful for fibromyalgia patients, but there is limited evidence on these methods. However, they may be helpful in alleviating some of the particular symptoms and promoting some aspects of therapy such as stress management and sleep promotion.

Can Fibromyalgia affect a person’s ability to work?

While fibromyalgia is not a life-threatening condition, the chronic widespread pain caused by the disorder can absolutely have negative pervasive influences on one’s quality of life and so, not surprisingly, can have detrimental effects on a person’s ability to work.

Individuals who suffer from fibromyalgia are generally required to avoid stressful triggers as part of their ongoing treatment. When these stressors exist in an individual’s workplace, it is difficult to perform the duties of the job without experiencing chronic musculoskeletal pain that compromises safety and well-being.

Physically, it is often difficult to avoid triggers that cause pain aggravation when the individual works in an environment that requires manual labour or physical activity. Additionally, the “fibro fog” impacts an individual’s ability to concentrate or focus on and pay attention to their work.

In December of 2020, a comprehensive study concerning patients with fibromyalgia and how it effects their ability to work was published in the “Canadian Journal of Pain.” The authors noted that:

Studies have consistently shown that a significant proportion of patients with fibromyalgia have difficulties remaining employed. For example, questionnaire-based studies have found that between 35% and 50% of patients with fibromyalgia were not working. A survey of patients being followed at tertiary-level Rheumatology clinics found that though 50% of patients with fibromyalgia were employed, only 15% had full-time employment. Of those employed, 80% planned on continuing to work but 34% of those who were unemployed could not imagine themselves working.Can J Pain. 2020; 4(1): 268–286.

Further, living with constant chronic pain and the symptoms that come along with it can severely impact one’s mood and outlook. Major depression can severely limit workplace function and reduce an individual’s motivation to enjoy or perform the activities or tasks they once did before they began developing symptoms.

Can I qualify for Long-Term Disability if I suffer from Fibromyalgia? 

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Fibromyalgia can cause a significant amount of pain that limits an individual’s ability to work. However, many insurance carriers are notorious for being difficult when it comes to approving disability benefits for chronic pain conditions such as fibromyalgia – largely due to the fact that it is an invisible injury, difficult to diagnose and not commonly understood.

For decades, there have been many myths and misconceptions about fibromyalgia, including the question of whether it is a real disease at all. However, fibromyalgia is an officially recognized disease by the World Health Organization (WHO), the Canadian Rheumatology Association, the Canadian Pain Society, and the American College of Rheumatology.

Whether or not you qualify for long-term disability benefits comes down to whether or not you are able to prove that you satisfy the definition of “Total Disability” within your own particular individual or group disability insurance policy. Although disability policies are all different, most, if not all disability policies define a person being “Total Disabled” if he or she is unable to complete the substantial duties of his or her own job.

The onus is on you, as the claimant, to satisfy that you are totally disabled by providing consent to your disability insurance company, as well as providing medical records and medical support to prove your total disability.  Many persons who suffer from fibromyalgia often face both employment difficulties and have difficulties remaining employed due to their constellation of symptoms – all of which are unfortunately, unpredictable.

What should I do if my disability insurance company has denied or cut-off my long-term disability benefits?

If your long-term disability benefits were denied but you are in too much pain to work, you still have options. You can appeal a denied disability claim internally. Many, if not most disability insurance companies allow and invite claimants to submit additional medical documentation to support the fact that they are totally disabled. These appeals, however, rarely succeed.

You also have the right to hire a disability lawyer to help fight to get your monthly benefits back on track. At our firm, we have represented countless claimants who suffer from fibromyalgia and wrongfully denied their long-term disability benefits. We have successfully filed claims against long-term disability carriers such as Manulife, Sunlife, Great-West Life, Canada Life, SSQ, Empire Life, RBC and many more disability carriers who, without enough valid reason, cut off their claimants disability benefits after happily accepting years of payments of premiums.

If you suffer from Fibromyalgia and have been denied your Long-Term Disability Benefits, call our Hamilton Long-Term Disability Lawyers Today

Lalande Personal Injury Lawyers have been specializing in disability law since 2003, and has litigated against many of the major insurance carriers in Canada. We have helped recover millions of dollars in lost disability benefit payments for individuals who have been wronged and unfairly treated by their insurance carriers across Ontario. 

If you are suffering from fibromyalgia and have been unreasonably denied disability benefits, book a free consultation with us to go over your options and get your benefits back on track. All consultations are free, and we work on a contingency basis, which means we do not charge anything until you win your case. If you don’t win, we don’t charge.

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