Fibromyalgia Long Term Disability Case Study
Lynda Morton - Fibromyalgia Claim Denied
At age 48, Lynda Morton thought that life was unfolding as it should. She had a happy marriage and two grown children. Her work as an assistant manager in a retail store was rewarding enough that she had stayed with the company for fifteen years. In a few years, she could look forward to retirement. Then illness overtook her.
Lynda knew what it was like to work with the pain. Years earlier, she had begun to develop irritable bowel syndrome, neck and lower back pain, and incontinence. These symptoms combined with sleep disorder, chronic myofascial pain, chronic headaches and migraines, asthma, and episodic vertigo; Lynda was diagnosed with fibromyalgia in 1992. Despite these conditions, she soldiered on for another eleven years.
In 2003, despite medication and various therapies, Lynda's symptoms got much worse. She could not continue working. She made a claim for Long Term Disability benefits under her group disability plan from work. Her claim was denied on insufficient medical evidence. Her insurance company argued that Lynda had worked for many years, but with no explanation from the doctors who had been treating her, as to why she could no longer work. The doctors agreed that there had been a severe worsening in her symptoms, but they could not pinpoint a cause.
Help At Last
With no income but debts accumulating, Lynda felt desperate. She was running out of options. Then she called Share Lawyers. When she learned that there would be no charge unless we were successful, she was happy to find someone who could help without putting her further into debt.
On Lynda's behalf, we sued the insurance company for all benefits owing and for future benefits. Rather than take the case to court, they agreed to an early mediation. Meanwhile, they had Lynda go to their doctors for psychiatric and physical assessment.
Honest and Credible
Lynda didn't want to go to their doctors. She felt that it was pointless, except perhaps to make her feel like a criminal. Still, she attended the assessments. Though the results were in favour of the insurance company, the specialists noted that Lynda was honest and forthright. This credibility helped in mediation.
Payment and Validation
When her case was heard at mediation, a lump-sum settlement was negotiated in Lynda's favour: $120,000.00. Lynda was very happy with the amount. She felt that it validated her claim and strengthened her ability to get on with her life.
Her priorities now are to control her symptoms, pay her debts, and possibly to work part-time from home when feeling well enough.
*Names have been fictionalized to protect the privacy of our clients.