Several decades ago, physicians were still prescribing morphine drips for insureds diagnosed with Fibromyalgia. Other physicians recommended their patients to “just get up on the treadmill and exercise, and you’ll be fine”. The disease abbreviated, FMS, was eventually defined as a “syndrome”, which is a series of undefined symptoms, not identifiable, credibly originating in a person’s head and frequently said to be a mental disorder.
Over time, FMS was officially named a “two pronged disease” having both physical and mental components. Changes to the DSM (Diagnostic, Statistical Manual) supported the idea that FMS had significant mental components that required treatment; and, of course, insurers required both physical and mental counseling as “appropriate treatment.”
Today, Rheumatologists are reluctant to sign off on permanent disability for FMS since they don’t really believe FMS as a physical disease really exists. Over the years, insureds have become programmed into thinking they do have FMS, and that it never goes away. Insistent insureds often convince their physicians “they have what they say they have” and treatment is given, including pain medications.
Fifteen years ago the CDC outlined specific criteria that must be met before a diagnosis of FMS can be made. (Look these up on the CDC website.) Exercise and remaining active is still part of the treatment for FMS, but to be honest the “fad” of having FMS has significantly diminished over the years. Nevertheless, FMS is still a sticking point for disability insurers and claims are frequently translated into mental and nervous limitations of 24 months, or self-reported classifications, also limited to 24 months of payments.
Lyme disease claims have also significantly decreased in number due to the new positions taken by insurers to limit benefits. In the past, Lyme disease was largely diagnosed by clinical examination of the red ring produced by the tick bite. Again, many insureds were so certain they had Lyme that physicians, too often then should have been, went along with their patients’ diagnoses and engaged in some of the most outlandish harmful treatments.
Two of these treatments actually caused harm, including IV antibiotics that were administered without end. This type of treatment destroyed the patients’ livers, and the bariatric oxygen chambers were freakish to say the least. Physicians taking the cautionary route prescribed herbal alternatives that alleviated some symptoms, but never got rid of the bacteria.
Finally, the medical community including state licensing departments had enough and threatened to take away the medical licenses of those physicians still prescribing the above treatments for their patients. In fact, they did remove a few medical licenses of the most prominent and well-known Lyme physicians. Since then, there has been a substantial decrease in the number of diagnosed Lyme cases.
Today, it is generally recognized that unless a patient has a positive CD-57 or Western Blot within 30 days of diagnosis, he/she does not have the disease. Even with positive Ig testing, the patient is given a 6 week trial of antibiotics, after which it is concluded the person no longer has Lyme. Late-stage Lyme is no longer accepted as a major cause of long-term disability.
There are still insureds out there insisting they have FMS, Lyme, and, I’ll throw in Chronic Fatigue here as well. Physicians are at times confused as to how to treat these people. Absent specific diagnostic data, physicians usually throw in “well, it must be multiple sclerosis”, and brain MRIs are ordered, and an occasional spinal tap is performed, still with no evidence of lesions or MS. Disability insurers, all too often, opt for the DMS-5’s definitions of somaticized disease (all in your head), and will limit benefits to 24 months, if they pay at all.
These diseases have evolved a long way from “morphine drips” and IV antibiotics. FMS and Lyme Disease are often misdiagnosed, and the real cause of impairment is overlooked. In any event, FMS and Lyme disease are no longer considered cause for long-term disability.
Now, someone out there is going to write me to say that they’ve had FMS or Lyme Disease and have been on claim for 10 years. Yes, I know there are always exceptions, but in general, disability insurers are still identifying FMS and Lyme as potential somaticized complaints.
