Ontario LTD Lawyers Advising on Claims Based on Immunological Conditions, Chronic Fatigue Syndrome & Lyme Disease

Symptoms of immunological conditions and other conditions like Lyme Disease, Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, and undiagnosed conditions are often severe – but also subjective. These disabilities make for some of the hardest-to-prove long-term disability (LTD) claims, and are most often denied. Proving these claims when you lack the physical and mental energy for the task makes it seem impossible. But it’s not.

Weakness, pain, and fatigue are the three big reasons our clients are unable to work.

At Mulqueen Disability Law, we are passionate about representing claimants who suffer from invisible conditions and illnesses that are challenging to prove, diagnose, and treat, including mental health and chronic conditions. With over 20 years of experience advocating for disabled clients, we provide top-quality, trauma-informed legal services to LTD claimants across Ontario.

Common immunological conditions causing long-term disability

Immunological conditions may take time to diagnose, delaying LTD decisions or resulting in denials before a diagnosis has been confirmed. It is important that your insurance company assess ALL of your conditions as well as the interplay between them. Insurance companies tend to separate out various conditions to deny claims on the basis that none of your conditions, taken separately, is severe.

There are several immunological diseases that can cause long-term disability, and which our clients have struggled to prove without our assistance.

MS is a chronic autoimmune disease in which the immune system attacks the myelin sheath covering the nerves in the brain and spinal cord, leading to nerve damage and disability.

RA is a chronic inflammatory disease that affects the joints, causing pain, stiffness, and swelling. Over time, it can damage the joints and cause disability.

SLE is an autoimmune disease that can affect many parts of the body, including the skin, joints, and organs. It can cause a range of symptoms, including joint pain, fatigue, and kidney damage.

GBS is a rare autoimmune disorder in which the immune system attacks the nerves outside of the brain and spinal cord, causing temporary paralysis and sometimes long-term disability.

MG is a neuromuscular disorder in which the immune system attacks the receptors on the muscles, leading to muscle weakness and fatigue. It can cause difficulty with breathing, swallowing, and speaking, and in some cases, can be severe enough to cause disability.

Other conditions: Chronic Fatigue Syndrome (CFS) & Lyme Disease

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating disorder characterized by extreme fatigue that cannot be explained by an underlying medical condition and is not significantly relieved by rest.

Symptoms of Chronic Fatigue Syndrome

In addition to extreme fatigue, other common symptoms of Chronic Fatigue Syndrome include:

  • Cognitive impairment;
  • Sleep disturbances;
  • Headaches;
  • Joint pain; and 
  • Muscle weakness.

These symptoms can severely impact a person’s ability to perform daily activities and can lead to significant disability. 

Proving exhaustion is exhausting: establishing disability due to CFS

Proving disability due to CFS can be challenging, as there is no specific test or diagnostic criteria for the disorder. However, a diagnosis of CFS can be made by a qualified healthcare professional based on a thorough medical history, physical examination, and exclusion of other possible causes of the symptoms.

To prove disability due to CFS, it is important to provide detailed medical documentation of the symptoms and their impact on daily activities, as well as any treatments and their effectiveness. This may include medical records, doctor’s notes, and statements from family members or caregivers.

If fatigue is one of the main reasons you are unable to work and the reason for your fatigue is not yet determined or if you have been diagnosed with CFS, you may also suffer from other conditions such as chronic pain, Fibromyalgia, depression, and anxiety.

LTD claims for Lyme Disease

Lyme Disease is another condition for which LTD claims are often denied. Proving disability due to Lyme Disease can be challenging as the symptoms can vary from person to person and may not always be easily identifiable or measurable.

Here are some key steps to proving disability due to Lyme Disease:

It is important to get a comprehensive evaluation from a Lyme Disease specialist or a healthcare provider familiar with the condition. The evaluation should include a review of your medical history, a physical exam, and diagnostic tests to confirm the presence and severity of the condition.

Keep a detailed journal of your symptoms, including when they occur, how severe they are, and how they impact your ability to perform daily activities and work

Obtain copies of all medical records and documentation related to your Lyme Disease diagnosis and treatment, including laboratory test results, imaging studies, and treatment plans.

Mulqueen Disability Law can help you navigate the claims process, gather and organize documentation, and present a strong case for disability benefits on appeal or in litigation.

Gather supporting evidence, such as statements from your treating physicians, employers, and coworkers, and any other relevant documentation that can help demonstrate the extent of your disability.

The appeals process for disability claims can be lengthy and complex. Be prepared to invest time and effort in building a strong case, and don’t hesitate to seek legal guidance and support throughout the process. You can also choose to skip the appeal process and retain us to litigate the denial for you, allowing you the time and energy to focus on your health and recover.

Proving disability due to Lyme Disease can be challenging, but with the right medical documentation, legal support, and perseverance, it is possible to obtain the benefits you deserve.

Grounds for denial of LTD claims based on immunological conditions, Chronic Fatigue Syndrome & Lyme Disease

Long-term disability claims for immunological conditions, Chronic Fatigue Syndrome, Lyme Disease and other invisible and undiagnosed conditions are denied for various reasons, including:

Insurance companies often require objective medical evidence to support disability claims. In the case of immunological conditions, this can include laboratory test results or other diagnostic tests to support the diagnosis.

If an individual has not sought medical treatment or has not followed through with prescribed treatment, insurance companies may argue that the disability is not severe enough to prevent work.

To establish a disability claim, it is important to provide comprehensive medical documentation that establishes the extent of the disability and its impact on daily activities and work. Insufficient documentation may lead to a claim being denied.

If there are conflicting medical opinions or a lack of agreement among healthcare providers, it can be difficult to establish a clear diagnosis and demonstrate the extent of the disability.

If an individual has a pre-existing immunological condition, insurance companies may argue that the disability is related to the pre-existing condition and not a new disability.

Insurance companies may deny claims if they suspect that an individual is exaggerating their symptoms or is not truthful about their condition.

Mulqueen Disability Law: providing skilled representation in LTD disputes involving immunological & other conditions in Markham, Toronto & York Region

Mulqueen Disability Law has over 20 years of experience representing clients in complex long-term disability litigation, involving cases where LTD for immunological conditions have been denied. We are dedicated to representing claimants who suffer from invisible disabilities that are challenging to prove, diagnose, and treat, including Chronic Fatigue Syndrome, Lyme Disease, and undiagnosed conditions.

With locations in Markham and Toronto, Mulqueen Disability Law advocates for disabled clients throughout Ontario. For clients who have difficulty meeting us in person, we are able to provide our services virtually. To discuss your LTD matter with a member of our disability law team, please contact us online or by phone at 416-900-0368 (or toll-free at 833-363-3LAW [3529]).