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Chronic fatigue syndrome (CFS) is a complex disorder characterized by extreme fatigue that has no underlying medical explanation. People who live with this condition may experience worsening symptoms as their mental or physical activities increase, but rest does not bring them relief. Other names for this condition include myalgic encephalomyelitis (ME) and systemic exertion intolerance disease (SEID).
If you live with ME/CFS, you know just how debilitating and life-altering the condition can be. You may be unable to work because of it, enjoy the activities you once loved, or participate in your life at all. If this is the case, you may have filed an insurance claim to help you cover the cost of medical expenses associated with therapy, treatment, and damages—and chances are, your claim was denied. Unfortunately, insurance companies do not take chronic fatigue syndrome seriously and often deny claims for it. Our attorneys at Kantor & Kantor LLP can help you explore your options post denial and work to recover the benefits to which you are entitled.
There are several obstacles to recovering benefits for CFS, each of which our attorneys have encountered on several occasions. For one, there is no known cause of chronic fatigue syndrome. Though there are several theories regarding what causes it—ranging from psychological stress to viral infections—research has yet to yield a concrete cause.
Additionally, there is no tangible way to confirm a diagnosis of chronic fatigue syndrome. Though there is evidence that cardiopulmonary exercise testing does provide sufficient enough evidence to confirm a diagnosis, getting insurers to recognize the validity of the testing has been a slow and difficult process.
Another issue with CFS is that the science behind it is cutting edge and creates more questions than it answers. That said, medical science does prove that the condition is real and that it affects thousands of people across the U.S.
Finally, insurers often claim that the evidence used in CFS claims is subjective. This is true even if a patient submits what any other person or medical professional would consider objective evidence, such as bloodwork and doctor’s accounts.
The first thing you should do if your insurance company denies your claim for chronic fatigue syndrome is to check your insurance policy for objective evidence requirements. Often times insurance companies will deny claims on lack of objective evidence even if the policy does not contain language regarding what type of evidence the company will and will not accept. In your case, subjective evidence may be enough.
However, if it is not, reach out to Kantor & Kantor LLP to speak with one of our claims denial attorneys today. Our team can help you build a strong case that includes expert testimony and undeniable evidence so you can recover the benefits you need to get your life back on track. To speak with a member of our team today, contact our firm online or by phone.
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