“Objective” Evidence of Disability

Frequently disability insurance companies and benefit plans will deny a claim for benefits on the ground that the claimant hasn’t provided “objective evidence” of disability. “Objective evidence” typically means medical testing of some kind, such as x-rays, MRIs, or electrocardiograms. On the other hand, “subjective evidence” typically refers to your perception of your condition, such as reports of pain or fatigue.

On the surface, this may make sense. After all, it is the claimant’s burden to prove that he or she is entitled to the disability benefit. Shouldn’t claimants have to provide some kind of objective evidence that they are disabled? If not, wouldn’t insurance companies just have to “take everyone’s word for it” and pay every claim, regardless of its merit?

Certainly, claimants should have to provide sufficient evidence of their disability. If your disability is due to a broken arm, it makes sense that an insurer would want to see an x-ray of your arm.

However, most insurance policies and benefit plans don’t require that claimants provide “objective evidence.” And there are many seriously disabling diseases that cannot be diagnosed or assessed solely through objective testing. For example, fibromyalgia and chronic fatigue syndrome are very real diseases for which there are no definitive tests. Instead, these diseases are determined through clinical symptoms, interpreted by the claimant’s physician. Similarly, back pain and cognitive problems are often difficult to measure objectively.

If you have a disabling disease like fibromyalgia or chronic fatigue syndrome, or another condition in which your disabling symptoms are not susceptible to “objective testing,” you must be careful when applying for disability benefits. Try to document your symptoms as much as possible. Report all your symptoms to your physician, and provide him or her with diaries if necessary.

If there is any objective testing that might assist in your diagnosis or treatment, such as fatigue testing or a neuropsychological examination, you and your physician may want to consider doing that. It won’t guarantee that your claim will be approved, but it may help you avoid one of the most common insurer traps. If you are having difficulty with your insurer, contact us on 888-569-6013 for a free consultation.

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