Many insurance companies insist that a person suffering from fibromyalgia must provide “objective evidence” of disability in order to qualify for disability benefits. A number of federal decisions, however, make very clear that a person seeking disability benefits for fibromyalgia need not establish “objective evidence” of disability.
In Hawkins v. First Union Corp. Long-Term Disability Plan, 326 F.3d 914 (7th Cir. 2003), the Court of Appeal characterized as the “gravest problem” with the position of the ERISA insurer’s medical consultant that “subjective” symptoms accepted as true by the treating physician can never establish disability. In reversing the District Court’s upholding of the denial, the Court of Appeals stated, “Pain often and in the case of fibromyalgia cannot be detected by laboratory tests. The disease itself can be diagnosed more or less objectively… but the amount of pain and fatigue that a particular case of it produces cannot be.” Id. at 919.
In Jordan v. Northrop Grumman Corp. Welfare Benefit Plan, 370 F.3d 869, 877 (9th Cir. 2004), the 9th Circuit Court of Appeals stated as to fibromyalgia, “Objective physical signs, laboratory results, and x-ray results are generally negative, and “because the majority of patients appear tense and anxious and have no recognizable objective basis for symptoms, the syndrome is often considered psychogenic.” Id. at 872-873. In Eisner v. Prudential Ins. Co. of Am., 10 F. Supp. 3d 1104, 1117 (N.D. Cal. 2014), the Court stated, “… disability claims based on fibromyalgia and chronic fatigue syndrome may be premised on subjective evidence and the reports of treating physicians.”
Accordingly, when a disability insurer informs a person suffering from fibromyalgia that he or she must provide “objective evidence” of disability to prove the claim, there is abundant legal authority to the contrary.
-Posted on July 24, 2017, by Bennett M. Cohen