LTD TRENDS: GOOD NEWS & BAD NEWS

Recent conversations with the staff of two national CFS specialists revealed some extremely interesting trends in private long-term disability (as opposed to Social Security Disability.) Please keep in mind that this information came informally from highly reliable sources, but has not yet officially appeared in print anywhere.

A lawyer in Maryland provided enough evidence to convince a judge that the IME (Independent Medical Exam) his client was required to undergo was in fact not "independent", but was biased. Since the company used the results of this IME to deny benefits, the lawyer requested a "denoveau review" of the case. (I think it that's the term. It might be something else.) The judge granted it. The big news came when the guidelines of ERISA were set aside, making it possible for the patient to sue for punitive damages, not just the disability benefits that were due.

Another conversation with a different doctor's office revealed that a patient, who has been on disability for years, was informed her disability carrier had canceled her scheduled IME! (One wonders if IMEs will soon be a thing of the past now.) Instead she was given a new form to fill out asking her to describe in much greater detail her symptoms and activities. She then received a letter stating that all disability benefits were being terminated immediately, since she had a "subjective, self-reported illness". This specialist's office has recently received many calls from CFIDS patients whose disability carriers are discontinuing benefits for the reason given above. This means that objective evidence of our illness is more crucial than ever. Nuclear SPECT scans (available in Dallas), QEEG brainmappping (available in Houston), and the bicycle stress test with expired gas analysis (North Carolina, maybe Dallas) are very strong ways to make your case, in addition to the documentation provided by a good primary care provider. (Contact Carol Sieverling if you would like more information on the tests mentioned above.)

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