One of the most common things we hear from clients with chronic fatigue syndrome is this:

“I don’t know how to explain it properly.”

Sometimes they add:

“It just sounds like I’m tired.”

And that’s the problem.

Because what they are dealing with is not tiredness in the way most people understand it. It is something much more limiting. Something that affects not just energy, but the ability to function consistently over time.

By the time someone reaches out to us about a long-term disability claim, they have usually already tried to push through it. They have adjusted their schedule. They have taken time off when they can. They have done everything they can to keep working.

Eventually, they reach a point where continuing is no longer possible.

They apply for LTD benefits.

And then the claim is denied.

If that has happened to you, you are not alone. And just as importantly:

A denial in a chronic fatigue claim does not mean your case is weak.

In many cases, it means the condition has been assessed in a way that does not reflect how it actually affects your ability to work.

Chronic Fatigue Syndrome Does Not Fit How Disability Is Measured

Chronic fatigue syndrome—also referred to as ME/CFS—is not a condition that shows up clearly on a test.

It is diagnosed based on symptoms, medical history, and clinical assessment.

Those symptoms often include:

persistent fatigue that is not relieved by rest, cognitive impairment, disrupted sleep, and what is known as post-exertional malaise—a worsening of symptoms after even minor activity.

CDC overview:
https://www.cdc.gov/me-cfs/about/index.html

Government of Canada overview:
https://www.canada.ca/en/public-health/services/diseases/chronic-fatigue-syndrome.html

From a medical perspective, this is well understood.

From an insurance perspective, it creates a problem.

Because insurance companies are structured to look for clear, measurable findings. When those are not present in a traditional sense, they often focus on what is missing.

That is how many claims end up being denied.

The Reality of Living With Chronic Fatigue

Most people with chronic fatigue do not stop working right away.

They adapt.

They reduce hours. They work through exhaustion. They rest when they can. They try to maintain some level of normal routine.

For a time, that works.

Until it doesn’t.

Over time, the fatigue becomes more persistent. Recovery takes longer. Concentration becomes more difficult. Even small tasks require significant effort.

Eventually, the ability to function in a consistent, predictable way breaks down.

That is the point at which many people apply for disability benefits.

Learn more about LTD claims:
https://mulqueendisabilitylaw.com/long-term-disability/

Why These Claims Are Often Denied

When insurers assess these claims, they are not always looking at the condition in the same way.

They often focus on:

• normal test results
• limited objective findings
• isolated moments of functioning

For example, they may note that:

• you were able to attend an appointment
• you were able to complete certain tasks
• there are no abnormal lab results

From their perspective, this suggests capacity.

From your perspective, it may not reflect reality at all.

A Scenario We See Frequently

A client has been working for years while managing increasing fatigue.

They take time off when they can. They adjust their workload. They push through because they have no choice.

Eventually, they stop working.

Their doctor supports the claim. The symptoms are documented.

But the insurer focuses on what appears to be “normal”:

• normal test results
• brief observations
• the absence of measurable findings

And the claim is denied.

What is missing from that analysis is the central issue:

Whether the person can function consistently and reliably in a work setting.

The Legal Test Is About Reliability—Not Occasional Functioning

This is one of the most important points in these cases.

Insurance policies do not ask whether you can function occasionally.

They ask whether you can work on a consistent, reliable basis.

For someone with chronic fatigue syndrome, that is often where the problem lies.

You may be able to function for short periods.

You may have better days.

But if you cannot sustain that level of activity over time, you are not able to work in the way the policy requires.

Why Many Claims Fall Short the First Time

In many cases, the issue is not the condition.

It is how the condition has been translated into evidence.

Medical records may describe fatigue, but not clearly explain:

• how long you can sustain activity
• how often symptoms flare
• how long recovery takes
• why work cannot be maintained consistently

That gap is often the reason for denial.

Learn more about denied claims:
https://mulqueendisabilitylaw.com/long-term-disability-denied/

What Happens After a Denial

After receiving a denial, many people begin to question themselves.

They read the insurer’s explanation. It sounds structured. It references reports and findings.

They start to think:

“Maybe I should be able to do more.”

“Maybe I just need more evidence.”

That reaction is very common.

It is also often based on a misunderstanding of how these claims are assessed.

A Different Way to Approach Chronic Fatigue Claims

At Mulqueen Disability Law, we approach these claims by focusing on how chronic fatigue actually affects your ability to function in a work setting.

Not in theory.

In practice.

We look at:

• whether activity can be sustained over time
• how fatigue impacts concentration and decision-making
• how long recovery takes after exertion
• whether work can be performed consistently

Then we make sure the evidence reflects that clearly.

Why a Trauma-Informed Approach Matters

Many clients with chronic fatigue are already dealing with significant limitations before they contact us.

The process itself can feel like too much.

Repeated requests for information. Deadlines. The need to explain symptoms again and again.

That can make things worse.

Our entire team is trauma-informed trained.

That means:

You do not need to over-explain your experience or go beyond what is necessary.

We focus on what is legally required. We take over communication with the insurer wherever possible. And we structure the process so it is manageable.

You Do Not Need “Perfect” Evidence

Another common concern is that there is not enough proof.

That is understandable.

Chronic fatigue syndrome is not diagnosed through a single definitive test.

But that does not mean it cannot support a disability claim.

The question is whether the evidence, taken as a whole, supports that you are unable to work.

In many cases, it does.

When Should You Get Advice?

You do not need to wait until everything is clear.

In fact, many people reach out at the point where things feel uncertain.

You should consider speaking with a lawyer if:

• your LTD claim has been denied
• the insurer says there is not enough evidence
• you feel like your condition is not being taken seriously
• the process is becoming overwhelming

Moving Forward

A denial is not the end of your claim.

It is the insurer’s interpretation of the evidence.

That interpretation can be challenged.

And in many chronic fatigue cases, it should be.

Speak With Mulqueen Disability Law

At Mulqueen Disability Law, we assist clients across Ontario with LTD claims involving chronic fatigue syndrome and other invisible disabilities.

We understand how these claims are assessed—and where they often go wrong.

We combine strong legal advocacy with an approach that recognizes how difficult this process can be.

Further Information

• CDC ME/CFS overview:
  https://www.cdc.gov/me-cfs/about/index.html
• Government of Canada ME/CFS:
  https://cihr-irsc.gc.ca/e/52474.html 
• LTD claims:
  https://mulqueendisabilitylaw.com/faqs/ 
• Denied LTD claims:
  https://mulqueendisabilitylaw.com/contact/your-initial-consultation/ 

Frequently Asked Questions

Is chronic fatigue syndrome a valid disability claim in Ontario?
Yes. It is a recognized condition that can support LTD benefits.

Why do insurers say there is no objective evidence?
Because the condition is diagnosed clinically rather than through a single test.

What matters most in these claims?
Whether you can function consistently and reliably in a work setting.

Can I still qualify if I have good days?
Yes. The issue is whether you can sustain work over time—not whether you can function occasionally.

Can a denied claim be challenged?
Yes. Many chronic fatigue claims are successfully challenged when properly presented.

Do I need to explain everything in detail?
No. We focus on what is necessary and avoid unnecessary repetition.

Disclaimer

This article is intended for general guidance and does not constitute legal advice. Because every long-term disability claim is unique and hinges on the specific language of your policy, this information may not apply to your personal situation. We encourage you to reach out for a consultation to discuss the realities of your claim with a legal professional.