chronic fatigue and your rights to long-term disability benefits

like depression or fibromyalgia, chronic fatigue syndrome is an invisible illness, due to the difficulty of measuring its symptoms objectively.

by nainesh kotak

published aug 15, 2024

3 minute read

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3 minute read

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unfortunately, no single objective test exists for identifying chronic fatigue syndrome and the condition is typically diagnosed after other health problems have been ruled out. getty images

it is estimated that more than 580,000 canadians live with myalgic encephalomyelitis (me), formerly known as chronic fatigue syndrome, or me/cfs. this evaluation was noted in a federal government health research news release in 2019, which also stated “this poorly understood, multi-system disease is debilitating and can strike individuals of all backgrounds and at any age.”

patients experience symptoms including:

unrelenting exhaustion following mild physical and cognitive activity that is not relieved by rest
muscle and joint pain
headaches
inability to remain standing due to sudden drops in blood pressure
poor sleep quality

the cause is not fully understood, there are no diagnostic tests available, and there is currently no cure.

it is not difficult to imagine that a disorder that currently cannot be identified by a single medical test and for which there is no specific treatment or cure, presents a challenge when making a long-term disability claim.

like depression or fibromyalgia, chronic fatigue syndrome is an invisible illness, due to the difficulty of measuring its symptoms objectively. many members of the public, the medical community, and particularly, insurance companies, have yet to catch up with respect to acknowledging and accepting cfs as a genuine condition with debilitating effects.

persons suffering from chronic fatigue syndrome (cfs) have typically been struggling with their symptoms for a long time before being diagnosed. in fact, a recent study from the u.s. centers for disease control and prevention shows more than nine in 10 people with me/cfs have not been diagnosed by a doctor. to make matters worse, people with chronic fatigue syndrome are sometimes stigmatized or told that they are exaggerating their condition and don’t have a “real illness”.

the cause of cfs is generally unknown, but medical experts believe it may result from a number of underlying conditions or a combination of triggers, including stress, viral infections, immune system problems and hormonal imbalances.

unfortunately, no single objective test exists for identifying chronic fatigue syndrome and the condition is typically diagnosed after other health problems have been ruled out. the difficulty in diagnosing cfs, in addition to the skepticism by some in the medical community, has meant that symptoms are often dismissed or misdiagnosed.

american researchers concluded that cfs “can severely impair patients’ ability to conduct their normal lives” and many sufferers are home-bound or bed-ridden at some point while struggling with this condition. in an in-depth 2015 report, the american institute of medicine urged physicians to diagnose myalgic encephalomyelitis or cfs if the patient’s symptoms meet diagnostic criteria and after an appropriate physical examination, medical tests and history.

anyone who is unable to complete the essential aspects of their job due to their cfs symptoms is entitled to claim long-term disability benefits under their benefits plan. the most important first step for sufferers is to obtain a proper diagnosis from their physician. don’t hesitate to seek out a second or even a third opinion until you find a doctor who understands the nature and effects of this disorder on your life and your ability to function at work.

although a diagnosis would be very helpful, you are still able to proceed with a disability claim without one. you generally need to have been experiencing several persistent and serious symptoms, including fatigue, for at least six months before receiving a diagnosis of cfs. in addition, you may have a stronger case if you exhibit cognitive impairment (sometimes referred to as ‘brain fog’).

once diagnosed, another important step is to follow your doctor’s advice for any suggested treatment, which may include limiting exercise, forced rest periods and taking steps to reduce stress.

if your claim is denied, an experienced disability lawyer can help by focusing on the symptoms suffered. because, in the end, it shouldn’t matter whether a diagnosis is suspected or confirmed when the consequence is a debilitating effect on your ability to function in your daily life and in your work.

nainesh kotak, is the founder of kotak personal injury law, a firm focusing on protecting their client’s rights to justice and obtaining the compensation their clients deserve. he also serves as the chair of the long-term disability section of the ontario trial lawyers’ association.