Chronic Pain/Fibromyalgia

We need to feel a certain degree of pain in order to survive. As distressing as it is to feel these sensations, they are an essential evolutionary development that alerts our bodies to avoid harmful elements around us, or serves as a warning that we’ve sustained an injury that must be treated or protected as it heals.

But for people with chronic pain (fibromyalgia), some of the sensations they feel offer no benefit. In fact, this pain can become so debilitating that they are unable to work or enjoy life as they should.

For many years, people suffering from fibromyalgia and other Central Sensitivity Syndromes (CCS), encountered dismissive medical practitioners and were frequently told the discomfort they felt was not a physical, but rather a symptom of mental illness. Thankfully, as researchers develop a greater understanding of the central nervous system, including the effects of chronic hypersensitivity, doctors are now able to recommend some promising new treatments.

However, when it comes time for insurers to pay disability benefits to people suffering from chronic pain, the invisibility of the condition and the subjectivity of how individuals experience pain leads some deserving claims to be denied.

If you or a loved one is experiencing significant chronic pain that prevents you from working, you may be eligible for compensation, including income replacement. Successfully applying for disability benefits is often contingent on comprehensive and persuasive medical records and expert medical opinions.

Howie, Sacks & Henry has helped many people just like you access compensation they need and deserve. At a moment when you are distressed to learn your claim has been denied, our team of disability benefits lawyers can help you understand your legal rights, options, and paths forward. At HSH LLP, Hope Starts Here.

What Is Fibromyalgia?

Fibromyalgia, or chronic pain syndrome, is a long-term central nervous system disorder that results in otherwise unexplainable pain and/or tenderness throughout the body. Previously thought to be a musculoskeletal condition, experts now believe fibromyalgia falls under the CCS umbrella – conditions caused by chronic hypersensitivity of the central nervous system.

Habitually overactive or sensitized neurons in the brain and spinal cord may begin to send abnormal signals associated with pain. Over time, the signals sent by these neurons may be amplified, leading to worsening pain.

Conditions such as fibromyalgia can weaken a person’s immune system, cause inflammation that damages mitochondria (a cell’s energy source), and lead to persistent fatigue. Other CCS conditions include: Chronic Fatigue Syndrome (CFS)/myalgic encephalomyelitis, Multiple Chemical Sensitivities (MCS), chronic lyme disease, Irritable Bowel Syndrome (IBS), and chronic migraines.

Beyond chronic muscle pain, abnormal sensitivity to stimuli, and fatigue, fibromyalgia is commonly associated with several other symptoms, including:

insomnia
headaches or migraines
face and jaw pain
digestive problems
loss of bladder control or interstitial cystitis (pain while urinating)
postural tachycardia syndrome (fast heart rate, dizziness and fatigue when standing after lying down or sitting)
altered moods such as increased anxiety or depression
memory problems (also referred to as “fibro fog” or “brain fog”

A flare up of fibromyalgia may not lead to the same symptoms or the same sequence of symptoms every time.

What Causes Fibromyalgia and Chronic Pain Flare Ups?

The processes that lead to hypersensitivity are not fully understood, but some people are believed to have a genetic predisposition to CCS. Researchers are currently exploring the theory that genetic mutations in neurotransmitters lead to the condition. The initial onset of chronic pain symptoms is thought to be triggered by physical injuries, infections, or psychological trauma or intense and prolonged stress.

Certain factors increase a person’s risk of developing chronic pain. These include:

family history – having one or more family members with the condition
age – being over 40 years of age
sex – women are diagnosed with the condition twice as often as men
comorbid chronic illnesses

Fibromyalgia symptoms tend to flare up and wax and wane over time. Individuals who have lived with the condition for some time may recognize particular triggers linked to flare ups, including:

changes in diet/poor diet
medication changes
hormonal changes
weather or temperature changes
poor sleep or unusual sleep patterns
emotional stress
illness
changes in routine which tax your body

How is Fibromyalgia diagnosed and treated?

Fibromyalgia is a differential disease. This means there are no diagnostic tests which will indicate that a person has the condition. Rather, doctors must rule out other conditions that may cause the same or similar combinations of symptoms.

To be diagnosed, a person must have widespread pain throughout the body for at least three months, including pain in at least four of five regions: upper left/right (shoulders, jaw, arm), lower left/right (leg, hip, buttock), and axial (neck, back, chest/stomach).

Doctors will also take a symptom history from the patient and use specific scales to produce a rating, including: a score of seven or more on the Widespread Pain Index (WPI), a score of five or more on the Symptom Severity Scale (SSS), or an alternative scoring if a person’s WPI is lower, but their symptoms are more severe.

Chronic pain impacts each individual differently. Therefore, the particular treatments that work for one patient may not help another. Discovering what types of treatment and preventative care for flare ups will help you may take time.

Common treatments include:

over-the-counter pain relievers
muscle relaxant medications
antidepressant medications
anti-seizure medications
therapies (stress management, cognitive behavioural therapy, sleep therapy, physical therapy, Transcutaneous Electrical Nerve Stimulation (TENS) therapy)
regular exercise

When Chronic Pain Requires Time Off Work

Depending on the severity and duration of your fibromyalgia symptoms, you may find that there are periods when sick days alone won’t provide sufficient time to recover. Fortunately, many people with health insurance through their employer or other private group disability insurance may be able to take short-term or long-term disability leave.

Disability benefits serve as an income replacement while a person seeks treatment and recovers from a debilitating condition. Although short-term disability (for periods of 15 weeks up to one year) usually only requires regular reports from your treating medical practitioner, insurance companies are frequently more strict and demanding when a person seeks long-term disability. Insurers can require applicants to be seen by their own doctors and use surveillance to determine if an applicant is being dishonest about the extent of their disability.

Sadly, when a person has an invisible disability, there may be few outward signs of the debilitating symptoms they are

experiencing. Moreover, when treatment for certain symptoms includes exercise or socializing to combat depression, an insurer’s interpretation of surveillance may be used to undermine an applicant’s claim.

If you or your loved one has been denied disability benefits, you don’t have to accept their “no” as a final answer. But rather than pursuing the internal appeals process, it may be in your interest to speak with a knowledgeable, experienced and skilled disability benefits lawyer who can advocate on your behalf.