What’s Changing in Fibromyalgia Disability Insurance Claims?
Unfortunately, there are thousands of people that are disabled and unable to work as a result of suffering from fibromyalgia. Long term disability companies are notorious for challenging the claims of people suffering from fibromyalgia. Hopefully some new medical research will help doctors solidify a diagnosis of fibromyalgia.
The 19 point pain index, a new way to diagnose fibromyalgia
Diagnosing fibromyalgia has long been a problem in the medical community. However, the American College of Rheumatology (ACR) has proposed a new set of diagnostic criteria for fibromyalgia that is inclusive of common symptoms such as fatigue, sleep disturbances, and cognitive problems, as well as pain. The new criteria were published in the May 2010 issue of the ACR journal Arthritis Care & Research.
These new criteria recognize that fibromyalgia is more than just body pain,” said Robert S. Katz, one of the authors of the new criteria and a rheumatologist at Rush University Medical Center. “This is a big deal for patients who suffer symptoms but have had no diagnosis. A definite diagnosis can lead to more focused and successful treatment and reducing the stress of the unknown.”
A diagnosis of fibromyalgia had previously been made by a tender point test, a physical exam that was developed in 1990 by the ACR and focused on 18 points throughout the body. Patients must have had widespread pain in all four quadrants of their body for a minimal duration of three months and experienced moderate pain and tenderness at a minimum of 11 of the 18 specified tender points.
However, the tender point test did not account for fluctuation of pain, which can affect the number of tender points, and the tender point test did not adequately measure symptom severity, including common symptoms such as fatigue, sleep disturbances, and cognitive problems.
The authors of the new criteria also noted that most primary care doctors don’t bother to check tender points or they aren’t checking them correctly. Consequently, fibromyalgia diagnosis in practice has often been a symptom-based diagnosis.
The resulting confusion of diagnosing fibromyalgia has not been lost on disability insurers, who often deny claims from people suffering with fibromyalgia, particularly when claimants cannot get a definitive diagnosis of their condition.
The new criteria seek to standardize a symptom-based diagnosis so that all doctors are using the same process. The tender point test is being replaced with a widespread pain index and a symptom severity scale. The widespread pain index score is determined by counting the number of areas on the body where the patient has felt pain in the last week. The checklist includes 19 specified areas.
The symptom severity score is determined by rating on a scale of zero to three, three being the most pervasive, the severity of three common symptoms: fatigue, waking un-refreshed and cognitive symptoms. An additional three points can be added to account for the extent of additional symptoms such as numbness, dizziness, nausea, irritable bowel syndrome or depression. The final score is assessed between 0 and 12.
To meet the criteria for a diagnosis of fibromyalgia a patient would have seven or more pain areas and a symptom severity score of five or more; or three to six pain areas and a symptom severity score of nine or more, the symptoms still must have been present for at least three months, and the patient must not have a disorder that would otherwise explain the pain.
Getting a solid fibromyalgia diagnosis is still a fairly new concept, as much of the medical community had once dismissed the disorder as merely a figment of the patient’s imagination. The new diagnostic criteria should legitimatize fibromyalgia and help those who suffer from the disease receive the help they need.
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Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
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When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.