Chronic Fatigue Disability Lawyer Calgary
The fatigue is invisible. The inability to work is not.
- Living with chronic fatigue syndrome that prevents you from returning to work?
- Submitted a long-term disability claim and received a denial letter?
- Benefits were approved, then terminated once the insurer re-evaluated your file?
Chronic fatigue syndrome lacks definitive diagnostic tests, a fact insurers often use to deny claims. Symptoms like overwhelming exhaustion and cognitive issues are frequently dismissed as unverifiable. We understand this challenge because we have navigated it from both sides.
Same-day response on business day inquiries.
Chronic fatigue claims stall when symptoms aren’t translated into functional limits.
Insurers prioritize sustained capacity over reported exhaustion. With James’s 30 years in plaintiff-side litigation and Mark’s 20 years as Senior Counsel for a major insurer, we offer a unique perspective on chronic fatigue claim evaluations and how to address insurer shortcomings to strengthen your case.
Claim Files
*Past results are not indicative of future results. The outcome of each case depends on its unique facts and circumstances.
Denied and Cut-Off Claims
Denied at the Point
of Application
Your long-term disability claim was denied. Insurers often deny chronic fatigue syndrome claims because the diagnosis is clinical, not test-based. Reasons include symptoms not being severe enough, inconsistent treatment, or functional limitations not meeting policy thresholds. Insurers may use assessments from doctors without chronic fatigue syndrome experience to justify the denial.
Our review begins with the denial letter. The language used tells us precisely where the insurer’s process may have failed and where errors can be challenged in litigation.
Terminated at the Two-Year Definition Change
At two years, many policies shift the focus from your own occupation to any occupation. Insurers conduct new assessments, often via independent medical exams and vocational reports, to terminate benefits. For chronic fatigue syndrome claimants, these assessments frequently overlook post-exertional malaise and symptom fluctuation. This accounts for about 80% of our cases and is where insurer errors are most consistent.
Same-day response on business days.
Chronic Fatigue Disability in Canada
Chronic fatigue syndrome is recognized as a disabling condition under most Canadian group and private disability insurance policies. The challenge is not recognition. It is proof. Insurers prioritize objective findings, and chronic fatigue syndrome produces subjective symptoms. That gap is where claims fail.
Insurers deny these claims on predictable grounds: no objective diagnostic test, treatment gaps, assessments from physicians with no background in chronic fatigue syndrome, and arguments that alternate work is available. Each of these grounds can be challenged in litigation, and the basis for denial frequently contains procedural errors around which medical professionals the insurer selected and whether those selections aligned with policy terms and best practices in claims handling.
Chronic Fatigue
Syndrome Symptoms Relevant
to a Disability Claim
- Extreme fatigue
- Post-exertional malaise
- Non-restorative sleep
- Cognitive difficulties
- Widespread body pain
- Difficulty concentrating
The Documentation Gap
A chronic fatigue syndrome diagnosis supports a claim. What determines whether the file holds is the documentation connecting each symptom to a specific functional limitation and demonstrating why that limitation prevents sustained employment under the policy terms.
From Denial Letter to Resolution
01
Initial Consultation
Your denial letter, policy, and medical history are reviewed to determine whether there is a viable case worth pursuing. We respond the same business day.
02
Document Collection
Your complete claim file is requested from the insurer, including internal decision records and the medical assessments they relied on.
03
File Review
We identify errors and improper assessments in how the insurer handled your claim. Insurers make mistakes: relying on assessments from non-physicians, misapplying policy provisions, disregarding your treating doctor’s findings. These errors can mean additional damages beyond reinstated benefits.
04
Statement of Claim
If the case proceeds, a lawsuit is filed to recover benefits and pursue additional damages for improper claims handling.
05
Discovery
Both sides exchange documents and conduct questioning. Independent medical examinations that contradict your treating physician are challenged at this stage.
06
Mediation
Most cases settle here. Approximately 80 percent resolve within 18 to 24 months. Settlement amounts depend on policy terms, benefit calculations, and insurer conduct.
07
Trial
If settlement is not reached, the case proceeds to trial. Outcomes depend on the specific facts, medical evidence, and policy language in your case.
We know how they think.
A chronic fatigue diagnosis starts, but doesn’t secure, a disability claim. Success depends on two factors we review immediately; linking symptoms to specific functional limits, and ensuring the insurer followed proper procedures.
The Insider Advantage
We understand the specific benchmarks insurers use to deny chronic fatigue claims. Our team uses this insight to build a file that is difficult for them to dispute.
Dedicated Client Care
You deal directly with our senior counsel. We take the time to understand your physical limitations so we can represent your daily challenges accurately.
Maximum Recovery Focus
We refuse to let insurers undervalue your fatigue. We push for a comprehensive settlement or court award that accounts for your ongoing needs.
FAQs
Is chronic fatigue syndrome a disability in Canada?
Yes. Chronic fatigue syndrome is recognized under most Canadian disability insurance policies when it prevents a person from performing their job duties. Demonstrating the degree of functional impairment to an insurer that prefers objective findings is where these claims require careful construction.
Does chronic fatigue qualify for disability benefits?
It can, provided the medical evidence demonstrates that chronic fatigue syndrome prevents you from working and the file connects that impairment to the policy definition of disability. Claims are frequently denied initially despite valid symptoms and treating physician support. That denial is a position, not a final determination.
Why do insurers deny chronic fatigue claims?
The most consistent reasons are the absence of objective diagnostic tests, treatment gaps, assessments from physicians without relevant background in chronic fatigue syndrome, and arguments that the claimant can perform alternate work. Each of these grounds can be challenged, and the basis for denial often contains procedural errors that become central to the case.
What happens at the two-year mark for chronic fatigue claims?
Many policies change from own occupation to any occupation disability after 24 months. Insurers use this definition change to terminate benefits, arguing the claimant can work in a different capacity. For chronic fatigue syndrome claimants, these assessments frequently fail to account for how symptoms fluctuate and the impact of post-exertional malaise on sustained employment.
How long does chronic fatigue disability litigation take?
Most cases settle within 18 to 24 months through mediation. Complex cases or those requiring trial take longer. Reinstatement of ongoing benefits typically requires trial preparation rather than a negotiated lump sum.
What do I do when the insurer denies my chronic fatigue disability claim?
Call Ludwar Law at 403-670-0055. We will review your denial letter, your policy, and the basis for the insurer’s decision. We serve clients in Calgary, across Alberta, and in Saskatchewan. We respond the same business day.
A denied claim is not a closed one. We will review your file and tell you clearly what your options are.
Calgary-based Serving Alberta and Saskatchewan
Same-day response on business days
Past results are not indicative of future results. The outcome of each case depends on its unique facts and circumstances. This page is for informational purposes only and does not constitute legal advice.