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Adrienne Dellwo

Honda Must Pay Long-Term Disability Benefits for Chronic Fatigue Syndrome

By March 10, 2011

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NEWSBRIEF: After a long legal battle, the 9th Circuit Court of Appeals has ruled that Honda must pay long-term disability benefits to a former employee who developed what several doctors called the most severe case of chronic fatigue syndrome they'd ever seen.

One of the judges wrote this about Honda:

"Its decision was illogical, implausible, and without support in inferences that could reasonably be drawn from facts in the record, because: (1) every doctor who personally examined Salomaa concluded that he was disabled; (2) the plan administrator demanded objective tests to establish the existence of a condition for which there are no objective tests; (3) the administrator failed to consider the Social Security disability award." -Judge Andrew Kleinfeld

This ruling is important to people with chronic fatigue syndrome and similar "diagnoses of exclusion" by clearly establishing that it's not legal to demand objective tests to prove someone is ill, when in fact no such tests exist for the illness. It also establishes that companies need to consider whether the Social Security Administration has determined the person to be disabled, which it had in this case.

Have you faced similar battles over benefits you believed you should receive? Did you ever get the benefits? Leave your comments below!

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Comments
March 10, 2011 at 1:54 pm
(1) Carly says:

There are no objective tests for any of the mental illnesses, yet they approve those all the time.

March 11, 2011 at 4:09 pm
(2) Pat says:

I applied for “catastrophic leave” several months before I was approved for Social Security disability. I had not yet applied for Social Security when I applied for the catastrophic leave, which would have provided me with income and benefits for six months or more. I was denied for catastrophic leave. I did not appeal it after being approved for SS disability. So I never received those benefits. I lived on credit cards for about 6 months and then had to file for bankruptcy after my disability benefits began.

March 11, 2011 at 4:25 pm
(3) Nathalie says:

Thank you for this, Adrienne.

It reminds me of the case: Kevin Keays vs Honda Canada.
Mr. Keays got $500,000.00 which was later reduced to $100,000.00.

http://www.macleoddixon.com/documents/MACLEOD_DIXON_ALERT_-_Honda_Canada_Inc__v__Kevin_Keays.pdf

March 11, 2011 at 7:40 pm
(4) NancyOK says:

I was diagnoised with fms and was on sick leave from my job while all those test that proved nothing were run. Thankfully I recieved sick pay but once SS concluded that I was disabled and awarded my disability the company dr, who did not see me, supposedly looked at all my medical files and said I could work at a sit down job. This was in a factory that did not have sit down jobs. I was denied my pension from the company. This was in 2001 and I have to wait until 2012 before I can get my pension. As with anyone with fms knows you just don’t have the energy to fight. Plus my husband was and continues to be very ill so I have my hands full. I hope and pray that the ones that do have the energy to fight this prejudice can and one day some of you will get our rightful pensions etc. as well as our illness is recongnised for the debilitating disease it is.

March 11, 2011 at 9:21 pm
(5) Iris says:

If this was a woman she would have lost the case.

March 11, 2011 at 10:58 pm
(6) Maggie says:

Right on, sister!

March 12, 2011 at 8:28 am
(7) Karen Davidson says:

I worked at Liberty Mutual for 28 years. During this time, I came down with Mono. The worst case according to the mono test results. I was on on short term for over a month. I went back to work, starting with half days, feeling pressured by management, started working full time,then back to the 50-60 hours a week,that I was working prior to the mono. Being a salaried employee, they expected this type of work, yet I was not compensated for it.

During the next few years, I stay out more due to colds, viruses, and exhaustion. But would work from home. The illnesses and exhaustion, caused me back to short term. My short term time ended, and I went to long term illness salary, which I paid via my own wages to Liberty.

A Case Manager would contact me on a weekly basis, and ask me how I was, and would get updates from my my primary care, and immune specialist.

Liberty, because I was on long term, started and paid for procedures for me to collect Social Security Disability Benefits. Just before I was to run out of Long Term benefits (after 18 months), Liberty told me I had to return to work. My doctors wrote them, and said I could not. Liberty gave me three options, return to work, appeal their decision, or be terminated.

I decided to find legal representation. I hired a lawyer who had just won a case against a large insurer in Maine, who had been denying the continuation of long term benefits to employees, especially those with CFS and Fibro.

After paying $7,000, I lost against Liberty. Liberty has “outside” doctors, which are paid by Liberty to review cases. This doctor came up with excuses for every fact my doctors gave. This decision came down about 2-3 weeks, before notification came that I was going to receive Social Security Benefits.
I now wonder if I should find another attorney and bring this back to court. I was terminated with 9 months full pay, and I retired early, to help me out financially.

March 12, 2011 at 11:16 am
(8) karen says:

I am having terrible problems with an insurance company, i am at present trying to make a claim on a policy i hold’ that was taken out when i purchased my home it covers us for death and critical illness which also covers disability.
Twelve months after being diagnosed with fm by a specialist i submitted a claim and after various letters and an examination by an independant doctor they decided that at that present moment in time they could not pay out.
After a further twelve months on the sick i decided to contact them again with an update and asked for them to re-look at my claim as there was now a strong possibility that i had cfs i am still waiting for a decission to be made (and i must state that i am still meeting montly payments and have never fallen behind) they clutch at straws when having been told by my own gp that i won’t work again they still think to go over his head and find ways to not have to pay out, the policy asks if i will return to employment in the role i was employed in before my sickness/disability started, well after been unable to work for 5yrs due to all this fms and cfs i would more than likely have to re-train as a accounts assistant to be able to return to this type of employment.
It is just one big headache and very stressful when trying to deal with them and also remembering why do they not understand or believe at the the end of the day you just can not make up this type of illness and when you have worked all of your life to be suddenly knocked off your feet its a big hit for us to have to take in and a big life changing situation for all of us who sufer these invisible illnesses.
Gentle hugs to all xxx

March 14, 2011 at 11:45 am
(9) Cindy says:

I worked as a Psychotherapist with people living with AIDS and in hospice. I saw people dieing and I saw what they had to go threw to get Social Security. They were so sick they could barley lift a finger, yet they had to do all the paper work. When I got sick I got turned down twice, then I got a lawyer, that helped a lot. The whole thing is you are so sick, to sick to be making phone calls getting records together… all that you have to do to go to court. There has to be a better way.

March 15, 2011 at 7:23 am
(10) weeroo says:

I was too tired to fight after being turned down 3 times for short term disability through my work. Had Fibro and then was diagnosed with CFIDS by doc because I couldn’t keep up the full time job anymore. Reduced hours to 30, kept insurance thank goodness, but short term disability insurance refused to pay the lost wages. What did I buy for all those years? Could have easily gone from short to long to ss, but now business is closing and losing this job that understood my flex needs and facing jobless/homeless status. How could this have happened? Only 12 years ago my “future was so bright I had to wear shades!”

March 23, 2011 at 12:52 pm
(11) poodleloverdlj says:

I am not allowed to leave any details due to a court order yet I want to comment. I did sue & won but I must warn that fighting against companies that have huge attorney funding proved that one could win & lose at the same time. These suits are not contingency based. Attorney fees cost me everything, my home, my life, my friends. But it did give me the support & encouragement to establish that I was not crazy. The compliation of data insured SSD. However, I was forced into bankruptcy, then moved alone to a far distant but cheaper state. Later I fought the IRS too for withdrawing money from my IRA in order to keep my head above water.

In the end, only the attorneys ‘made money’ or were even reimbursed for their expenses. I was told I had the tightest case ever seen in my previous home state. I had union backup yet not financially. Understand that in the end the laws are what stand. If an employer is governed under ERISA, you are not entitled to compensation from the begining nor for all your expenses. Your pockets will have to be deep to prove your point.

I don’t know of anybody who has CFS/FMS & had to deal with the string of medications & co-payments for the years it takes to get a DX that has that much reserve funds. There are a few that benefited from suing. Consider your case from many many angles to determine if winning will actually benefit you, physically, mentally & financially. It didn’t benefit me at all.

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