Chronic Fatigue Syndrome Leading to Long-Term Disability
In general, in order to receive a diagnosis of chronic fatigue syndrome, you must have both of the following two criteria:
1. You must have severe chronic fatigue for at least six months with other known possible medical conditions excluded by clinical diagnosis.
2. You must have concurrently four or more of the following symptoms:
- substantial impairment in short-term memory or concentration
- sore throat
- tender lymph nodes
- muscle pain
- multi-joint pain without swelling or redness
- headaches of a new type, pattern or severity
- unrefreshing sleep
- post-exertional malaise lasting more than 24 hours
The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.
Why seek legal advice and legal representation for Chronic Fatigue Syndrome?
If your Chronic Fatigue Syndrome is preventing you from working and if you have long term disability coverage, you are eligible for long term disability benefits.
However, many insurance companies deny long term disability applications from Chronic Fatigue Syndrome patients. If your application is denied, you should hire a lawyer and sue your insurance company.
Long Term Disability Lawyer Tim Louis has been acting for individuals with Chronic Fatigue Syndrome for over three decades.
Do not waste your time appealing your long term disability benefits denial. Your appeal will be dealt with by an employee of your insurance company. There is little likelihood that your appeal will be successful. What the appeal will do is delay the point in time when you start your lawsuit.
Your lawyer will typically hire experts to provide reports supporting your claim for long term disability Benefits. This is important as if your lawsuit goes to trial the judge will need to hear from experts and not just from yourself.
Chronic Fatigue Syndrome Example Case
I acted for an individual suffering from Chronic Fatigue Syndrome. His insurance company had denied his long term disability application.
Like many others, his symptoms would wax and wain from day to day. Many days he would be bedridden for the entire day. Sometimes he would have a great day – a gift from heaven. It was always very difficult for him to resist the temptation to do all the activities he wanted to do on a great day.
Eventually, he learned to never do more than half of what he felt he was capable of doing on a great day. If he did more, there would be a devastating rebound effect the following day.
One day, there was a knock on his front door. He opened the door and a woman explained that her car had stalled in front of his home blocking traffic. She asked if he could help by pushing her car out of the way. He was a very kind man, and did so. Unbeknownst to my client, she was an actor. The insurance company had hired a private investigator to film him pushing her car. The insurance company knew that the video might be devastating to my client’s case at trial.
Fortunately, my client’s landlord was a retired RCMP officer. He lived above my client. He confirmed that my client spent many days every week bedridden.
I provided the landlord’s written statement to the insurance company letting them know that he was a retired RCMP officer. Days later, the insurance company came to the table re-settled, and we settled for over $300,000.
Long term Disability Law and Chronic Fatigue Syndrome
Long term disability law can be quite complex. First of all, it is not sufficient that only you give evidence at trial. In fact, it is not sufficient that only you and a number of other lay witnesses give evidence at trial.
Most judges will want at least one expert witness. Typically, your family doctor will be one of your expert witnesses. If you are being cared for by a specialist, in addition to your family doctor, your lawyer will probably want to have this specialist also be one of your expert witnesses. In addition to your caregivers, your lawyer may decide to retain a vocational expert. This individual will be able to provide the judge with expert evidence as to whether or not you are employable.
Don’t forget that in most long term disability policies, you are not considered disabled after the first two years of being on claim even if you are still unable to do your own occupation unless you are also unable to do any occupation.
This means that if your insurance company can find a different type of job for you that you are able to do, then you will lose your case. However, the different type of job must pay at least 2/3 of what your job paid.
If, before you became ill and unable to work, you were paying your long term disability premiums, then your benefits are entirely non-taxable.
If on the other hand your employer was paying your long term disability premiums, then your benefits are taxable. Most people will choose to pay their own premiums.
In British Columbia, there is a 2 year limitation period for starting a lawsuit against your insurance company. If you wait until the end of this 2 year limitation period before filing your lawsuit, it is too late. Your lawsuit will be barred by the 2 year limitation period.
Many individuals believe that the 2 year limitation period does not begin to run until after their long term disability application has been denied. This is not the case. Your 2 year limitation period begins running as soon as you have submitted your long term disability application. This is before your application has been denied.
Denied Compensation? How Tim Louis & Co can help
If you have been denied long term disability benefits, I will not waste time appealing your insurance company’s decision.
Typically, this is a waste of time and only moves us closer to missing the two year limitation period. It also delays the date by which we can reserve your trial date.
Instead, I will almost always immediately file a lawsuit. My goal is always to give you trial dollars without having to go to trial. This means I aim to get your insurance company to put an offer on the table that makes it unnecessary to go to trial.
I have been acting for individuals denied their long term disability benefits since 1984.
Suffering from Chronic Fatigue Syndrome?
Long Term Disability Lawyer Tim Louis can help!
Call me now for a free consultation. I welcome calls on my cell 778-855-3494.
Also, don’t hesitate to take a look at my online reviews. With a 4.9/5 rating, my clients are a testament to the fact that I do not eat cornflakes for breakfast – I eat insurance companies.
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