Can You Get a Long Term Disability for Fibromyalgia in Canada?

Can You Get a Long Term Disability for Fibromyalgia in Canada?

More than 2-8% of Canada’s population suffer from fibromyalgia, a chronic condition that limits an individual’s ability to function daily due to symptoms such as body pain, tenderness, and fatigue. Since victims may experience disruption in their ability to work, fibromyalgia is now a long-term disability in Canada. This means that you may qualify for long-term disability benefits if you have fibromyalgia.

Common Symptoms of Fibromyalgia

According to research, fibromyalgia affects the central nervous system and makes the nerve endings more sensitive. This disorder is said to change the way the brain and spinal cord process pain signals. That’s why sufferers experience amplified pain sensations throughout their bodies.

Widespread pain: Sufferers of fibromyalgia report a persistent dull ache that continues for not less than three months or longer. This pain often occurs below and above the waist. The pain can be accompanied by tingling or sensitivity to pressure on the skin.

Fatigue: Another common symptom of fibromyalgia is prolonged tiredness. This is often a result of lack of sleep since the constant pain disrupts sleeping patterns. In fact, many patients have reported sleep disorders like sleep apnea and restless legs syndrome.

Cognitive difficulties: Fibromyalgia can also result in cognitive symptoms such as memory loss, lack of concentration, and mental health issues such as anxiety, depression, and chronic fatigue syndrome.

When Do Fibromyalgia Symptoms Begin

Many people report fibromyalgia symptoms after a traumatic event such as a physical injury, surgery, or significant psychological distress. There are also cases where there is no triggering event, and the symptoms only develop and worsen over time. Researchers also believe that fibromyalgia affects more women than men. While there is no cure for this disorder, there are medications as well as exercises and relaxation measures that can help manage the symptoms.

Can I Get a Disability for Fibromyalgia in Canada?

The first thing you’ll need to do to determine if you qualify for benefits is check your policy document. Insurance policies specifically exclude fibromyalgia as a condition that qualifies for long-term disability benefits. Others will limit the benefits to be awarded for a maximum of two years.

Applying for fibromyalgia long term disability benefits: How to improve your chances of approval

  1. Get tested to confirm your diagnoses: First things first. You need to undergo a medical test to confirm that you are suffering from fibromyalgia. This disorder is somewhat invisible because it’s hard to prove with objective medical testing. However, there are some blood tests that your doctor can recommend to rule out similar conditions and narrow down the diagnosis to fibromyalgia.
  2. Obtain all medical records to confirm your illness and treatment: If you have undergone different medical tests to diagnose fibromyalgia, the records will be crucial when filing your disability claim. A record of all these tests run by your doctor needs to be included in your filing. If you have been referred to a specialist from time to time, keep all the appointments and records on medical visits as supporting documentation when filing for benefits. Additionally, if you’ve suffered from other conditions such as mental health issues and gotten treatment for them, document them as they will also help support your disability claim.
  3. Continue seeking treatment: If you fail to follow the treatment as advised by medical experts, this could hinder the success of your claim. Follow the instructions given by your doctor, psychologist, physiotherapist, or any other specialist you’re seeing. Following this treatment plan to the letter will add credibility to you and your claim. Do this even if you don’t agree with the doctor’s recommendations on some treatment options. However, if you have genuine concerns regarding the treatments or medication given, address them with your doctor to seek other alternatives.
  4. Document changes in your day-to-day life and wellbeing: Fibromyalgia is a disorder that may manifest in many ways. Have a journal where you document all your symptoms as a way to articulate to your doctor how the condition is progressing over time. This can also help support your claim as it shows that your physical symptoms are real. Your journal should cover every change that you experience. This includes changes in mood, sleep patterns, or deficiencies. If you have any side effects with some drugs you’re taking, document them in your journal too.
  5. Demonstrate that you made an effort to continue working: Another step you can take to boost your credibility is to show that you’ve made some effort to continue working. For instance, you can ask your employer for accommodations at work and explain in your application why those accommodations were requested. You may also ask your co-workers or employer to provide a statement of how they’ve observed your attempts to continue working. These statements will help support your claim for disability.

Different Types of Disability Benefits for Fibromyalgia

If you have been diagnosed with fibromyalgia, you have several options when it comes to disability benefits that you may be eligible for. You can apply for disability benefits given by the government, your insurer, or your employer.

Let’s look at the most common options for fibromyalgia disability benefits in Canada:

  • Employment Insurance (EI) sickness benefits: These are temporary benefits paid by the federal government and typically cover up to 55% of your salary within a period of 15 weeks. You must have joined the EI program and paid regularly through your paycheque.
  • Short-term disability insurance: These are also temporary benefits that pay 50-67% of your salary for 15 to 17 weeks. You must have a plan through your workplace to qualify.
  • Long-term disability insurance: These benefits last for a longer period, typically 2, 5, or 10 years or up to a certain age. They cover 50-67% of your monthly salary. LTD benefits often come from group plans (offered by the company, e.g., as part of your medical plan) or private policies (for the self-employed & underinsured).
  • CPP disability: This also covers permanent disability as they can be paid until age 65. To qualify, you must have paid into the program and have the right number of credits. You can qualify for both CPP and LTD at the same time.
  • Workers’ compensation: If injured on the job, you may qualify for short- or long-term benefits through worker’s compensation. To qualify, you must prove that the condition was caused or worsened by a workplace injury. Since the payments for worker’s compensation may overlap with CPP and LTD payments, you need the help of a lawyer to see how you can keep some or all your benefits.
  • Veterans Affairs Canada: The Canadian Forces also offers its members short- and long-term disability benefits. However, to qualify, you must prove that the injury is ‘service-related.’ That is, the fibromyalgia must have been caused or worsened by your service.

Why is Your Fibromyalgia Long-term Disability Claim Denied?

Even if there are no explicit exclusions in your coverage, accessing disability benefits for a condition like fibromyalgia may be difficult. Below are a few reasons why:

  • It’s hard to measure the severity of the condition, let alone confirm your diagnosis: Unlike most medical conditions that can be quickly diagnosed through objective medical testing, fibromyalgia can only be detected by testing for low levels of cytokines. However, this testing cannot tell the severity of the disorder. This makes it even harder to prove the disability. Lack of proper medical evidence and documentation can quickly lead to your disability claim for fibromyalgia being denied.
  • You failed to seek appropriate treatment: A very common reason most disability claims are denied is that the applicant did not seek proper medical attention or lacks the relevant documentation to confirm their diagnoses. Even though the medical tests to prove disability can be unreliable, you can work with a long-term disability lawyer to help you gather enough medical evidence & documentation for a successful claim.

What to Do if Your Fibromyalgia Long-term Disability Claim is Denied

The process of filing for long-term disability benefits in Canada can be complicated. Many applicants feel overwhelmed, especially since they are still in the process of managing the disability. If you suffer from fibromyalgia and haven’t been able to return to work, or you’ve been denied long-term disability benefits, you can get help.

Is fibromyalgia a long-term disability? Fibromyalgia is considered a disability in Canada. When you’ve been cut off from your long-term disability benefits, you can take steps to get a positive outcome and begin getting your life back on track. The insurance company wants you to walk away from your rights simply. With the help of disability lawyers who understand how the process works, you can appeal the denial. Keep in mind that you have a limited time to file a claim for full compensation. An experienced lawyer will review the facts of your specific situation and let you know if you have a case. Get legal help to fight the insurance company denying you benefits so you can get the financial support owed to you in your time of need.

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