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Spate of Disability & Job Discrimination Wins for ME/CFS and Fibromyalgia Patients

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www.ProHealth.com • June 6, 2012


The past month has brought news of several significant disability and job discrimination suit wins for ME/CFS and fibromyalgia patients. For example:

Children’s Hospital of Colorado Ordered to Pay $95K in FM Job Discrimination Suit

May 31: Children’s Hospital of Colorado withdrew a job offer they had made to an applicant after a medical screen revealed she had fibromyalgia. The EEOC suit won $95,000 on behalf of applicant Cecilia McMurray for a violation of the Americans with Disabilities Act.

EEOC reportedly had first attempted but failed to reach a ‘pre-lawsuit’ settlement through its conciliation process. In connection with the lawsuit, Children’s Hospital of Colorado has also agreed that it will henceforth train its employees in ADA requirements and will report to the EEOC any time it bases a decision not to hire a person on this type of medical screen.

Employers need to be very careful when they use such screens, says EEOC Regional Attorney Mary Jo O'Neill, because the obligations in this respect are “particularly complex.”

“It is important that employers give applicants with disabilities a fair shake and make employment decisions based on facts and not myths, fears or steorotypes,” adds EEOC Denver Field Office Director Nancy Sienko.

Legal Victory for CFS Patient in Wrongful Termination of Disability Benefits Suit vs AT&T

April 4: In reaching a decision in favor of disabled CFS patient Judi Peterson vs AT&T Umbrella Benefit Plan No. 1, administered by third-party administrator Sedgwick CMS, the US District Court for the Northern District of California noted that the insurer and the medical professionals hired to review the patient's records had "abused its discretion in five specific ways." See news release here.

For example, after initially finding that Ms. Peterson suffered from disabling CFS in 2006, and although the evidence showed her condition had remained unchanged, they terminated her benefits in 2009.

"This decision illustrates that policymakers cannot always rely on an 'unbiased' third-party administrator to make logical and fact-based benefits decisions," says the lead attorney who represented Ms. Peterson. "Denials must be carefully scrutinized, and if the conclusions appear unfair, incorrect, or ridiculous, they probably are."

Oregon Court Finds for CFS Patient in Wrongful Termination of LTD Benefits Suit

April 19: Life Insurance Co. of North America (LINA, a CIGNA subsidiary and ERISA-regulated health benefits plan) initially approved disability insurance payments for former attorney Keith Ayers, based on a diagnosis of total disability owing to chronic fatigue syndrome. Then 5 years later LINA terminated payments on the grounds that his true diagnosis was depression, not CFS.

When Ayers filed a claim for his long-term disability benefits owed from Oct 2007 through Sep 2011 (when he reached age 65 and was no longer eligible for benefits under the plan), contending "LINA sabotaged his application for SSDI benefits." LINA filed a counter claim stating Ayers owed them nearly $100,000 in “overpaid benefits.”

The US District Court of Oregon ruled for Ayers, concluding he indeed suffered from total disability owing to CFS, based on documentation proving he had been unable to work due to fatigue and other symptoms. Based on testimony of medical experts, the court noted that Ayers had been suffering from depression but it was unrelated to the CFS impairments, and that “even severe depression could not result in his severe cognitive impairments.”

Further, the Court raised the issue of whether LINA had “made fraudulent statements and commissioned false medical reports to facilitate termination of Ayers’ long term disability payments.” For the step-by-step case and medical record, click here.



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