At Mulqueen Disability Law, we know that chronic pain is a very real and debilitating medical condition. We also know that long term disability claims for pain conditions are at high risk of being denied by insurance companies. 

Chronic Pain is an Invisible Disability 

Once you have been diagnosed with chronic pain, judging the severity of your condition presents another hurdle with this invisible disability. You know how your pain affects your day to day functioning, but your insurance company considers pain to be a “subjective” symptom because it relies on your self-report. They are looking for “objective” evidence when assessing your claim, something that does not really apply to chronic pain claims. Unfortunately, because the insurance companies tend to take this approach, chronic pain claims are often denied on the basis that there is no objective evidence to support the claim. 

At Mulqueen Disability Law, we have seen this happen time and time again. In fact, the insurance company will often use the fact that there are some activities that you can still perform, such as doing the dishes, getting groceries, or spending time with family and friends, to say that your condition cannot be considered severe and totally disabling. They do not consider the variable nature of your condition and the fact that you may sometimes have a “good day” where you can accomplish some tasks, often paying for it later with several “bad days” in a row. It seems like, to the insurance company, it’s “all or nothing”. If you can do anything, then you can do everything, including work. 

Challenges with Treatment

Treatment of chronic pain conditions presents another challenge. There is no medical formula that helps all patients all the time. There is an element of trial and error when it comes to managing chronic pain, and treatment needs to be tailored to each individual, which is something you and your doctor will work through. Insurance companies, however, will often impose their own ideas of what your treatment should look like. They may support their denial of your claim on the basis that you are not taking a certain medication, or are not seeing a particular type of specialist such as a rheumatologist, without taking into account the reality of your situation and your specific needs. 

Long Term Disability claims for chronic pain are often complicated by the presence of other medical conditions like chronic fatigue and mental illness, which are also invisible conditions that are difficult to prove to the insurance company. The very real interaction between pain, fatigue and mental illness, is often downplayed or completely ignored by the insurance company in its assessment of disability claims. 

The Benefit of the Doubt 

We know that no one would choose to spend all of their time going to medical appointments and fighting with their insurance company instead of going to work. People are not likely to choose to live on a reduced income, or no income at all. We know that if you were able to work, you would do so. 

However, insurance companies do not tend to give people the benefit of the doubt. In fact, they will go so far as to deny our clients’ Long Term Disability claims on the basis that our clients are “self-limiting” their activities. In other words, they are choosing to be less active or to not work. The insurer will say that working is not “contraindicated”, meaning work would not cause our client’s conditions to worsen, and that activity is the appropriate treatment and, therefore, our client can and should work. This position totally ignores the reality of being limited by pain, fatigue, anxiety and depression which, taken together, make it impossible for our clients to work. 

We feel strongly that you should never be made to feel like you are lying, exaggerating or malingering by the insurance company. 

Holding the Insurance Company Accountable 

Proving a Long Term Disability claim for a pain condition is not only challenging, it can be extraordinarily stressful and aggravate our client’s symptoms and set them back in their recovery. Our clients often tell us that, had the insurance company paid their Long Term Disability benefits and supported them through their recovery, then they might have been able to return to work. Instead, by denying their benefits and treating them as if their pain was “all in their heads”, their condition has worsened. In many cases, the very idea of returning to work now may seem entirely out of reach. 

In helping our clients dispute their Long Term Disability claims we often argue that the insurance company has not fulfilled their duty of good faith to our clients. They have mischaracterized and “cherry-picked” medical and disregarded self-reported evidence, and have ignored other relevant evidence such as the opinions of treatment providers in the assessment of the Long Term Disability claim. We provide evidence to support our position that their reliance on irrelevant information and disregard of supportive information in their decision to deny our clients’ claims has caused our clients serious emotional and financial distress. 

Trauma-Informed Long Term Disability Legal Services 

Living with constant pain is exhausting, both physically and emotionally. It takes a huge toll on a person and their family. The entire process of applying for Long Term Disability benefits, being denied, and appealing the decision can cause serious emotional distress. When a Long Term Disability claim for chronic pain is denied, the financial stressors that result will only further aggravate a person’s condition. It can often be a traumatic experience with serious consequences.

Contact Mulqueen Disability Law in Markham for Trusted Guidance on Appealing a Long-Term Disability Claim Denial

If you’re facing a Long Term Disability claim denial and feel overwhelmed, our team at Mulqueen Disability Law is here to help you navigate this challenging situation and fight for your rights. With nearly 25 years experience dedicated to disability insurance litigation Courtney Mulqueen and her specialized legal team are focused on providing highly skilled, trauma-Informed legal representation to clients whose Long Term Disability claims have been denied or terminated.

Mulqueen Disability Law specializes in hard-to-prove long-term disability claims for “Invisible Conditions” such as mental illness (depression, anxiety, PTSD) and chronic conditions (pain, neurological, immunological, concussion, post-COVID)  Contact us for a free confidential consultation.

The preceding is not intended to be legal advice. This blog is made available for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog, you understand that there is no solicitor client relationship between you and the blog publisher. The blog should not be used as a substitute for competent legal advice from a licensed lawyer in your jurisdiction. If your disability claim has been denied and you require legal advice, contact a lawyer specializing in disability law.