Insurance Lawyers for Fibromyalgia Insurance Claim Denials

Living with fibromyalgia is hard enough without an insurer questioning your symptoms or denying your benefits. If your fibromyalgia insurance claim was denied, or you’re appealing denied insurance claims for fibromyalgia, the insurance lawyers at Taylor & Blair LLP can help you challenge the decision and pursue the benefits you’re entitled to under your policy.

Fibromyalgia is a disorder which is characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. There is evidence that Fibromyalgia affects the way your brain actually processes pain signals, which causes pain sensations to be amplified significantly.

The exact causes of fibromyalgia are not known, however it is believed there is a psychological and neurological overlap. Fibromyalgia often can be found in individuals with psychological conditions such as depression or Post Traumatic Stress Disorder (PTSD) and is more common in women than men.

Symptoms of Fibromyalgia

  • Musculoskeletal pain
  • Heightened pain responses
  • General fatigue
  • Sleep disturbance
  • Joint stiffness
  • Decreased cognitive functioning
  • Irritable Bowel Syndrome (IBS)
  • Anxiety
  • Depression

Due to the unknown nature of the exact causes of fibromyalgia, insurers often deny disability claims caused by fibromyalgia.  Denials like this are common for long-term disability claims where the symptoms are subjective in nature.  Insurance companies will often say that if there are no objective symptoms then the disability cannot be supported.  This is not true.  If you have doctors on your side confirming your disability, then you should be getting the benefits you are entitled to.   

Why Fibromyalgia Claims Get Denied

There is any number of reasons a fibromyalgia insurance claim can be denied, but examples of common reasons insurance companies often reject fibromyalgia claims are:

  • Lack of objective evidence – Fibromyalgia is diagnosed clinically, and insurers sometimes discount pain, fatigue, and cognitive symptoms (“fibro fog”) when they don’t see definitive test results.
  • Paperwork & timing issues – Late notice, incomplete attending physician statements, or missing function-based restrictions can trigger a denial.
  • Change of definition at 24 months – Many long-term disability policies switch from “own occupation” to “any occupation,” and insurers claim you can do “some” job despite your limitations.
  • Surveillance & inconsistent records – Brief activity on a good day or gaps in treatment can be misused to argue you’re not disabled.
  • Pre-existing or exclusions – Some policies rely on look-back periods or exclusion clauses to refuse coverage.

If you’ve had your fibromyalgia insurance claim denied, the insurance lawyers at Taylor & Blair LLP can help.

Insurance Lawyers for Fibromyalgia Claims

Dealing with an insurance denial can be a stressful and complicated process.  It involves complex contractual issues as well as an understanding of the medical information required to prove your claim.  Having an insurance lawyer who specializes in insurance denial on your side will help to reduce your stress and ensure you get the insurance benefits you are entitled to. 

If your fibromyalgia insurance claim was denied, or you’re appealing a denied insurance claim for fibromyalgia, we’re ready to help. Contact Taylor & Blair LLP today for a free consultation. We’ll review your policy, your denial letter, and your medical evidence—and map out the fastest path to getting you paid.