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6 DISABILITY CLAIMS COMMONLY DENIED

Even in circumstances where the insurance company permits you to appeal the decision, it is still important to seek legal advice from a disability claim lawyer for the following reason:

YOU ONLY HAVE A LIMITED TIME WITHIN WHICH TO TAKE LEGAL ACTION. THIS IS CALLED A LIMITATION PERIOD. WHEN THE TIME LIMIT BEGINS TO RUN WILL DEPEND ON THE FACTS OF YOUR CASE.

Time limits are not the same for every policy and every circumstance and that is why it is essential to get legal advice to know what time limits apply in your particular circumstance.

1. CHRONIC FATIGUE SYNDROME (CFS)

Chronic fatigue syndrome (CFS) is the common name for a group of debilitating medical conditions characterized by persistent fatigue and other specific symptoms that lasts for a minimum of six months. The fatigue is not due to exertion and is not significantly relieved by rest.

Symptoms of CFS include feelings of tiredness after exertion; sleep disturbance, widespread muscle and joint pain, headaches and cognitive difficulties.

Although there is agreement that CFS poses genuine threats to health, happiness and productivity, the diagnostic criteria, causes and treatments are all controversial.

Disability claim cases are often denied for “lack of medical evidence”. Our disability claim lawyers have successfully resolved denied claims by bringing forth the medical evidence required to prove the disability as defined under the policy.

2. DEPRESSION

Depression is often much more than feeling sad or despondent. Symptoms often include loss of self-esteem, feelings of uselessness, hopelessness, excessive guilt, slowed thinking, forgetfulness, difficulty concentrating, difficulty making decisions, loss of interest in work, fatigue, mood swings, oversleeping or insomnia, thoughts of death, dying or suicide.

Depression is a medical condition that affects one’s thoughts, feelings, physical health and behaviours. For diagnostic purposes, a depressive episode must be experienced at a certain level of severity for a minimum duration of two weeks.

Factors that increase the risk of developing or triggering depression include:

  • Having relatives with depression
  • Having traumatic experiences
  • Experiencing stressful life events
  • Having few friends or other personal relationships
  • Abusing alcohol or drugs

Disability claim cases are often denied for “lack of medical evidence”. Our disability claim lawyers have successfully resolved denied claims by bringing forth the medical evidence required to prove the disability as defined under the policy.

Read More About Depression Disability Claim Denials.

3. ANXIETY

Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying. These disorders affect how we feel and behave, and they can manifest real physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can be extremely debilitating, having a serious impact on daily life.

People often experience a general state of worry or fear before confronting something challenging such as a test, examination, recital, or interview. These feelings are easily justified and considered normal. Anxiety is considered a problem when symptoms interfere with a person’s ability to sleep or otherwise function. Generally speaking, anxiety occurs when a reaction is out of proportion with what might be normally expected in a situation.

Disability claim cases are often denied for “lack of medical evidence”. Our disability claim lawyers have successfully resolved denied claims by bringing forth the medical evidence required to prove the disability as defined under the policy.

4. FIBROMYALGIA

Fibromyalgia (FM) is a condition where one experiences chronic widespread pain and a heightened and painful response to pressure. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Other symptoms include decreased cognitive functioning, sometimes referred to as “fibrofog”.

Its exact cause is unknown but is believed to involve psychological, genetic, neurobiological and environmental factors. Fibromyalgia is frequently seen with psychiatric conditions such as depression, anxiety and posttraumatic stress disorder.

The cause of fibromyalgia is unknown. However, several hypotheses have been developed including “central sensitization”. This theory proposes that fibromyalgia patients have a lower threshold for pain because of increased reactivity of pain-sensitive nerve cells in the spinal cord or brain.

Disability claim cases are often denied for “lack of medical evidence”. Our disability claim lawyers have successfully resolved denied claims by bringing forth the medical evidence required to prove the disability as defined under the policy.

If an insurer has wrongfully denied you benefits, you may have no alternative but to take legal action.

5. CHRONIC PAIN SYNDROME (CPS)

Chronic Pain Syndrome (CPS) is usually diagnosed in cases where pain, including discomfort, soreness, tightness, stiffness, shooting, burning, aching pains, persists for more than six months without a clear physiological explanation. Chronic pain can range from mild to severe; can be occasional or continuous; and in some cases completely disabling.

People with CPS also often suffer from stress, depression, and fatigue. Such negative feelings may aggravate sensations of pain.

Because this condition is an “invisible” illness/injury, disability claim cases are often denied for “lack of medical evidence”. Our disability claim lawyers have successfully resolved denied claims by bringing forth the medical evidence required to prove the disability as defined under the policy.

While these claims are generally based on subjective complaints from those suffering, our disability claim lawyers have successfully resolved denied claims by marshalling the medical evidence required to prove the disability as defined under the policy.

If an insurer has wrongfully denied you benefits, you may have no alternative but to take legal action.

6. CHRONIC HEADACHES/MIGRAINES

Most people have experienced headaches in their lives and while they can be painful, they usually do not affect your ability to go about your normal activities and are more annoying than anything and controlled with common over-the-counter medication. However, some people experience severe headaches that can affect their ability to function in a work place. These types of headaches include “cluster” headaches, migraine and non-migraine headaches.

A Cluster headache manifests itself by a pounding/stabbing sensation in one area (usually around the eye) that can cause eye watering and trouble breathing. Someone suffering from cluster headaches can experience repeated attacks of very painful head pain. They can be sporadic and in severe cases, the pain never lets up.

People who experience either chronic headaches or migraines typically feel a throbbing head pain that can last hours or days. Severe headaches affect vision, balance and mental function. While most sufferers find effective medical treatment that result in only minor time off from work, there are people who suffer to the degree that renders them disabled from work.

Because this condition is often considered an “invisible” illness, disability claim cases are often denied for “lack of medical evidence”. Most people suffering from disabling headaches will have normal CT scans and MRIs.

While these claims are generally based on subjective complaints from those suffering, our disability claim lawyers have successfully resolved denied claims by marshalling the medical evidence required to prove the disability as defined under the policy.

If an insurer has wrongfully denied you benefits, you may have no alternative but to take legal action.

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