Fibromyalgia is a chronic condition that affects many Canadians, particularly women. Characterized by widespread pain, fatigue, sleep disturbances, and cognitive difficulties (often referred to as ‘fibro fog’), fibromyalgia can significantly hinder a person’s ability to maintain employment and carry out daily activities. As a disability lawyer with extensive experience representing clients suffering from this debilitating condition, I’m often asked, ‘Is fibromyalgia considered a disability in Canada?’ I’ve seen firsthand the challenges they face when seeking short-term (STD) and long-term (LTD) disability benefits. Understanding your rights and the nuances of fibromyalgia claims is crucial.
Fibromyalgia is a recognized disability
Yes, fibromyalgia is considered a disability in Canada. Our country’s Human Rights Act protects individuals from discrimination based on disabilities, including chronic conditions like fibromyalgia. Employers must provide reasonable accommodations to help those with fibromyalgia carry out their jobs effectively. These accommodations can range from modified work schedules to adjustments in physical tasks.
However, when it comes to STD and LTD benefits, a diagnosis of fibromyalgia alone isn’t enough to guarantee approval. Disability benefits programs typically look at how serious the condition is and how it affects your ability to work. To qualify for benefits, you must show that your fibromyalgia causes a level of impairment that meets the specific criteria noted in your disability benefits plan.
READ MORE: 5 things every employee should know about long-term disability and how to get benefits
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The challenges of proving fibromyalgia in disability claims
Proving fibromyalgia as a disabling condition in the context of a disability claim can be challenging. Insurance companies are often skeptical of fibromyalgia because its symptoms are subjective and not easily measured through medical tests. This skepticism leads to many claim denials.
To successfully claim disability benefits for fibromyalgia, comprehensive medical documentation is crucial. This includes a diagnosis from a qualified healthcare provider such as a rheumatologist, pain specialist, or neurologist -who can confirm that fibromyalgia significantly impairs your ability to work. Additionally, documentation should detail the specific ways in which fibromyalgia affects your job performance and overall functioning, including the unpredictability of flare-ups and the impact of chronic pain and fatigue on daily life.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
Common pitfalls in fibromyalgia disability claims
A common issue in fibromyalgia-related disability claims is the misconception that since the condition is not visibly apparent, it isn’t severe enough to be disabling. Insurers might argue that since fibromyalgia doesn’t show up on standard medical tests, it isn’t “real” or “debilitating.” However, anyone who lives with fibromyalgia knows that its effects can be profound and life-altering.
Another pitfall is the variability of symptoms. Fibromyalgia can present differently from day to day, with some days being more manageable than others. Insurers may use these “good” days to argue you can work, but it’s crucial to demonstrate that the overall impact of fibromyalgia remains debilitating despite occasional improvements.
What to do if your claim is denied
If your claim for STD or LTD benefits due to fibromyalgia has been denied, don’t lose hope. Many denials result from incomplete information or misconceptions about the condition. This is where legal assistance can make a significant difference, leveling the playing field in your favour.
READ MORE: Denied long-term disability for fibromyalgia? 3 things you must do
At Samfiru Tumarkin LLP, we’ve helped numerous clients successfully appeal denied claims for fibromyalgia and other chronic conditions. We understand the strategies that insurance companies use to deny claims and how to effectively counter them. For instance, I once represented a client whose benefits were denied because the insurer claimed her fibromyalgia symptoms were “inconsistent” and didn’t justify time off work. We countered by providing detailed reports from her pain specialist, along with a journal she kept, documenting her daily battles with pain and fatigue. This evidence clearly demonstrated how unpredictable and debilitating her condition was, leading to a successful appeal and securing the benefits she deserved.
Discover your rights and take action
If you’ve been denied disability benefits for fibromyalgia or have any questions about how your insurer is handling your claim, don’t navigate this challenging situation alone. Contact my team to understand your rights, gather the necessary evidence, and get the financial support you are owed.
READ MORE: 3 reasons you shouldn’t appeal a denied long-term disability claim
Our firm specializes in assisting individuals across Canada who have been denied short-term and long-term disability benefits. We frequently resolve these claims efficiently and successfully, helping many clients, like Sandra Bullock and Julie Austin, get the support they need.
At Samfiru Tumarkin LLP, we offer free consultations to help you find the best path forward. Your health and well-being are too important to leave to chance.
Concerns about how the insurance company is handling your disability benefits for fibromyalgia? STD or LTD claim denied?
Contact the firm or call 1-855-821-5900 for a FREE consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin is a disability lawyer a co-founding partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in long-term disability and employment law claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.