Chronic Pain and Fibromyalgia: Can I Claim Long Term Disability Benefits?

Chronic pain and fibromyalgia are recognized medical conditions accepted by the Courts in Canada when determining if someone is disabled from working.
You can make a long term disability claim for chronic pain and fibromyalgia so long as chronic pain and chronic pain from fibromyalgia is not an excluded medical condition under your long term disability benefits policy. Most long term disability policies in Ontario will cover disability arising from chronic pain syndrome and fibromyalgia.

What is Chronic Pain?

Chronic pain is pain that persists beyond the usual healing time following an injury. This is a condition that must be diagnosed by a medical doctor after extensive investigation and treatment to rule out an organic cause for the pain.

When diagnosing chronic pain syndrome (CPS), physicians often typically on the following six criteria for chronic pain as described by the American Medical Association Guidelines:

1. Use of prescription drugs beyond the recommended duration and/or abuse of or dependence on prescription drugs or other substances.
2. Excessive dependence on health care providers, spouse, or family.
3. Secondary physical deconditioning due to disuse and or fear-avoidance of physical activity due to pain.
4. Withdrawal from the social milieu, including work, recreation, or other social contracts.
5. Failure to restore pre-injury function after a period of disability, such that the physical capacity is insufficient to pursue work, family, or recreational needs.
6. Development of psychosocial sequelae after the initial incident, including anxiety, fear-avoidance, depression, or nonorganic illness behaviors.

What is Fibromyalgia?

Fibromyalgia is a variant of chronic pain and is characterized by chronic diffuse pain of unknown origin attributable to undetected organic conditions or psychogenic sources. It is characterized by the presence of “tender points” in predictable, and usually symmetrical, locations, and fatigue and sleep disorder.

Successful Chronic Pain Syndrome and Fibromyalgia Disability Claims

To have a successful long-term disability claim for CPS and fibromyalgia you have to seek treatment and undergo medical investigations to rule out causes other than chronic pain syndrome or fibromyalgia for your pain. You will need extensive medical records and treatment records supporting your CPS and fibromyalgia long term disability claim.

If your insurance company denies your claim for disability from chronic pain syndrome or fibromyalgia, our experienced disability lawyers will help you obtain the necessary expert medical opinion to confirm that you cannot work because of chronic pain or fibromyalgia chronic pain.

If your case goes to trial, we would also need to get evidence from you about the impact of chronic pain and fibromyalgia on your day-to-day functioning, such as taking care of your self, your family and your home, your ability to participate in leisure and social activities, and your inability to work. Corroborative evidence from friends, family, your treating medical professionals, and your employers or co-workers is also important for winning fibromyalgia or chronic pain disability case.

Finally, and most importantly, because there is no objective cause for your persistent and debilitating pain, we have to trust what you say; therefore, credibility is really important in chronic pain and fibromyalgia disability claims.