Claim Denied for Client with Fibromyalgia

Claim Denied for Client with Fibromyalgia

People suffering from Fibromyalgia experience debilitating pain that prevents them from performing even the simplest task. Since every day life becomes a constant struggle, victims will often rely on insurance benefits as they learn to manage life with a chronic illness; however, "claim denied" is not what they expect to hear from their insurance company.

Stacey's Story

Stacey, a 45-year-old teacher, led a physically demanding life throughout her career. She trained and practiced as a nurse for years before making the transition into teaching. Becoming a highschool teacher was a rewarding moment for Stacey. Harboring an unparalleled love for education and working with adolescents, she believed teaching to be her true calling.

However, Stacey suffered from chronic pain her whole life, and her symptoms included intense muscle strain. As she aged, she began to experience migraines and severe fatigue more frequently. When she got a second opinion from a new doctor, she was diagnosed with Fibromyalgia.

In 2014, Stacey’s pain became so intense that it began to interfere too heavily with work, so she decided to take a leave. Her years of fulfilling her passion for teaching came to an abrupt end.


Change of Definition

Stacey received excellent benefits through her teachers union. She was approved by the insurance company to collect disability as she managed her Fibromyalgia. After paying benefits to Stacy for two years, the insurance company argued that there is a change of definition. They were going to cut her off because they believed that she could work in a different career.

Stacey knew this wasn’t true - between her migraines and muscle pain, it was exhausting for her to get through the day or perform any type of work. To prove her diagnosis, she went back to her doctors for additional tests and medical examinations. Every doctor she saw concluded that she could no longer work as a teacher or in any other field.


Claim Denied

Stacey appealed the insurance company’s decision using the new medical information from her doctors. Yet again, the insurance company denied her claim.

Stacey called her union, requesting they help her get her benefits back. After six months had passed, nothing had changed and no attempts were made to assist her. She didn’t know what to do and it seemed like nobody wanted to help.

One afternoon, Stacey saw a Share Lawyers commercial on TV. Even though she was feeling doubtful, she decided to call the office and give it a shot.


Successful Settlement

To her surprise, Share Lawyers successfully took over her case from the union. They worked in tandem with her medical professionals to develop a strong case, which they successfully settled.

Thanks to Share Lawyers, Stacey received a favourable settlement and now can focus on managing her Fibromyalgia. She is extremely grateful that she can spend her time on what matters most in her life, rather than wasting energy and finances fighting an insurance company.

*All names and identifying details have been changed to protect the confidentiality of all involved.

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