People diagnosed with fibromyalgia or who know someone with this debilitating medical condition understand how serious its symptoms might be. Fibromyalgia can affect everything from someone’s ability to focus to the quality of their sleep at night. Chronic pain, especially when uncontrolled, can leave someone unable to continue working or force them into a less-demanding profession.
Unfortunately, those requesting long-term disability benefits for fibromyalgia may receive some pushback from the insurance provider. Thankfully, the Employee Retirement Income Security Act (ERISA) gives these workers who need benefits the right to appeal and prove their needs.
Is it possible to conclusively prove the impact of your condition after a diagnosis with fibromyalgia?
Fibromyalgia is a diagnosis of exclusion
There are certain conditions that doctors can test for and determine conclusively that someone has. Imaging tests and biopsies can identify different kinds of cancer, possibly down to the genetic level. Tests can affirm that someone has multiple sclerosis or pinpoint the location of spinal cord injuries, but there is no test that can conclusively show that you have fibromyalgia.
Instead, doctors diagnose you with this condition when you have intractable pain, among other symptoms, and they have ruled out other known causes for your symptoms. People typically need to have intractable pain throughout much of their body for three months or longer to meet the diagnostic criteria, which have changed in recent years.
Rather than focusing on validating the condition itself, a better approach for those trying to demonstrate a debilitating medical condition for ERISA long-term disability benefits may be to focus on the symptoms and how they impact their lives. The symptoms caused by fibromyalgia can leave someone completely unable to work.
Exploring the medical limitations that fibromyalgia causes may help someone applying for ERISA long-term disability benefits.