Readers' Forum
Correspondence with the Chronicle editor

The diagnosis dilemma
I thought Scott M. Riemer's article, "What to Do if You Become Disabled," (The CFIDS Chronicle, Winter 2001), covered an important topic.

I want to add that there's a Catch-22 for working people who come down with CFIDS.  By definition, a diagnosis cannot be given until six months after the onset of symptoms.  Some patients go much longer before receiving a definitive diagnosis.  This wait can end up costing you benefits.

It happened to me.  One year after developing symptoms, I still had no diagnosis.  My company told me that without one they owed me no benefits.  I couldn't use sick leave because without a diagnosis I wasn't sick.  I eventually went on leave without pay.  I did not receive federal Family and Medical Leave Act (FMLA) benefits during this period.

I was never able to return to full-time work.  Since I still did not have a formal diagnosis, I was told I wasn't covered by the Americans with Disabilities Act (ADA).  My employers said they did not have to make accommodations for my condition.  I was forced to resign.

Is there any advice for PWCs going through this problem?
A PWC in Florida

Attorney Scott M. Riemer responds:
This dilemma is very common, but it's not necessarily fatal to a claim under FMLA, ADA or long-term disability (LTD).  It's vital to have your doctor(s) thoroughly document your symptoms through clinical exame.  This can be used to support your claim until a definitive diagnosis is made.

Many clients come to my office int his position when applying for LTD benefits.  Most LTD policies require that proof be submitted within a defined time frame (usually 90 days after the elimination period of 180 days).  If a diagnosis is unavailable by that deadline, I advise my clients to submit medical documentation supporting their symptoms--including a written opinion from their treating physician(s) stating that they suffer from "debilitating chronic fatigue of unknown origin."  Included with the proof should also be a letter explaining that their doctor(s) are presently investigating the cause of their symptoms, and that additional proof will be submitted when available.

LTD policies require that you be unable to work.  What renders you disabled are your symptoms, not your diagnosis.  A missing diagnosis is not fatal to your claim.  Your employer telling you so is just wrong.

Scott M. Riemer is an attorney specializing in long-term disability litigation. He may be reached at 212-297-0700.