Science Reporter with Chronic Fatigue Syndrome Wins Lawsuit in New Jersey Against Prudential
A science reporter with Chronic Fatigue Syndrome wins his lawsuit in New Jersey against Prudential Insurance Company. Mr. Vastag was an accomplished reporter for the Washington Post when he found himself suddenly ill with flu-like symptoms. After many tests and visits to specialists, he was diagnosed with Chronic Fatigue Syndrome (“CFS”).
He filed a short-term (“STD”) and long-term disability (“LTD”) benefits claim with Prudential. Prudential denied both claims. He then filed a lawsuit. The Court found the abundance of medical evidence supported his disability and inability to work due to CFS.
Can I get disability benefits with CFS?
Yes, of course. The difficulty with CFS is that the testing and recognition of this condition is fairly new. It affects nearly 1 million people, but many doctors do not understand it.
There are specialists around the country that do special testing to diagnose CFS. They test patients to determine things like fatigue, exertion, cognition, cardiovascular output, recovery time, and so on. The more someone with CFS exerts themselves, the harder and longer it takes to recover.
The testing and evidence used to establish a disability with CFS can include:
Cardiopulmonary Exercise Testing (“CPET”)
Quantitative Electroencephalogram (“qEEG”)
Insurance companies are still slow to recognize and accept CFS as real and disabling. But cases like Mr. Vastag’s help to shine a light on this very debilitating condition. Significantly, Mr. Vastag underwent every test possible and saw specialists who confirmed his symptoms and CFS diagnosis. He provided all the records to Prudential.
Based on his testing his doctors confirmed that he cannot function normally, let alone work. Fro example, the CPET results showed it took him over seven days to recover from physical activity. Rightfully, the Court found he is disabled from working as a reporter.
How do insurance companies review a CFS disability claim?
In reviewing a CFS case, Prudential, like other companies, use their run-of-the-mill doctors to review the medical records. These doctors do not know anything about CFS. They are not CFS experts. In many instances they do not even believe CFS is a real condition.
In CFS cases, insurance companies also allege the symptoms are self reported and not verifiable. This goes back to not understanding CFS. The tests that are conducted, like CPET, are objective tests. They provide objective evidence of a disability, just like an MRI or an X-ray would.
The Court found Prudential's doctors ignored, or just didn’t understand, CFS and the supporting medical evidence. The reporter proved his disability through well-documented and thorough medical records and test results. He was awarded the STD and LTD benefits he deserved.
In proving your CFS case, it is important to see your doctor, particularly specialists in CFS. Have as many tests done as possible. The more you can show, the better your chances.
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