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T&P Disability claim rejected on clinical examination by a Neurologist.

Discussion in 'General ME/CFS Discussion' started by Goodness to M.E., Feb 16, 2014.

  1. Goodness to M.E.

    Goodness to M.E.

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    Adelaide
    Hi Folks, for those who have Myalgic Encephalomyelitis (M.E.) the basis for my TPD claim, might find my experience very interesting.
    My Super fund insisted I be assessed by 'Any' Neurologist as M.E. is a neurologic disease (their words).
    (As there are no Specialists in M.E. in my state and confirmed by Super Medical Advisor and Government Health Department)

    2 separate doctors treating me collectively for 10 years provided 2 separate reports and it appears, given no consideration. Nor the update report from my treating doctor 3 months prior to their Neurologist report.

    Quote from his report: 'From solely a physical point of view I can find no condition that would prevent employment of 40% of more..(Neurological condition)

    'I'm unable to make a diagnosis of M.E. or that of inflammatory diseases of the nervous system because I do not have the confidence or expertise however, one has to deduce there are other factors regarding the complex symptoms being experienced.

    Suggestions folks? I have insisted on a further internal review of all the facts not just what appeals to them and will continue if further rejected.

    This brings to mind a very old story.
    An inebriated, tipsy man was crawling on hands and knees under a bright street light.
    He was searching for his lost keys.

    “Where did you drop your keys?” asked the passer-by.
    
“Oh, about half way down the block.”
    
“So why are you looking for it here?”
    
“Because the light is so much better.”
    Last edited: Feb 16, 2014
    golden, maryb and Nielk like this.
  2. SickOfSickness

    SickOfSickness Senior Member

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    Did that neuro see your 2 doctors' reports? You may need to get some expensive testing done (SPECT scan is one example) or the difficult 1 day or 2 day CPET if anyone in your area would do one. Perhaps low blood volume testing and other abnormalities would make the neuro think again, or let them consider you a non-neurological case.
  3. Goodness to M.E.

    Goodness to M.E.

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    Adelaide
    All were provided, MRI, heart ultrasound for low circulating blood volume etc. blood, saliva and urine test results and (the 2 doctors used the ICC for diagnosing and treating M.E. 2012) and years of medical history from both doctors. The neurologist was also provided with the 'Primer' but chose not to use it.
    golden likes this.
  4. Kati

    Kati Patient in training

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    You need to provide solid evidence of disability, and the Workwell Foundation would do this for you. Go see a ME expert that is very knowledgeable in disability dispute. Get a lawyer. Do not give up.

    Edit: (Sorry I didn't see you were in Australia).
  5. AndyPandy

    AndyPandy Making the most of it

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    Australia
    Hi Goodness. Sorry to hear about your bad experience.

    The Victorian ME/CFS Society has a fact sheet about superannuation and insurance claims put together by the law firm Maurice Blackburn Lawyers. The Society website also indicates that Maurice Blackburn Lawyers can assist with claims related to ME/CFS. See www.mecfs-vic.org.au/legal-issues-and-mecfs under "Legal issues and ME/CFS".

    I rang Maurice Blackburn Lawyers before I put a disability insurance claim in and had a "no fee" conversation. My claim was successful, but if it wasn't then I would have contacted them again for some further assistance with the review and appeal process. If you decide to contact them, I would suggest that you insist on speaking with someone experienced in ME/CFS claims.

    Good luck with this.
    golden and Kati like this.
  6. Goodness to M.E.

    Goodness to M.E.

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    Adelaide
    I dont have CFS and have limitations placed on some fixed unit purchased after CFS was dubiously diagnosed in 2009 where that doctor failed to carry out any diagnostic tests to rule out other possible causes of intermittent loss of endurance and stamina following a common and periodical infection. In 2011 I was diagnosed with Addison's disease, hormone deficiencies, pyloria, Vitamin D deficiency, liver and gut problems that then ruled out a diagnosis of CFS as per Fukuda 1994.
    I experienced flu to 2012 and had a workplace flu injection in May 2012 and by July 2012 I was bedridden and unable to function in any capacity. My treating doctor using the ICC Primer for M.E. then diagnosed me with M.E. (not CFS) due to POTS, low circulating blood volume, PEME, all physical and terrible cognitive issues. I was approved for a Disability Pension and I have a 'live-in' family member who receives the 'Carers Allowance' due to the erratic and never-ending symptoms that are unpredictable and range in severity. I have now made contact with Maurice Blackburn. There are no M.E. specialists in my state however, my treating doctor has 14 years of 'special interest and 'sole treatment' of the range of conditions diagnosed by her and associated with M.E.
    Thanks folks, I appreciate your help and advice.
    golden likes this.
  7. AndyPandy

    AndyPandy Making the most of it

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    Australia
    Not sure if this will help you. In the lead up to my claim, I was diagnosed by a Rheumatologist and had a favourable report from him and also had a useless report from a Neurologist who didn't believe in ME/CFS, but ultimately I was assessed by an occupational physician nominated by the super fund (and also by a psychiatrist - they insist on this with ME/CFS claims!).

    Occupational physicians assess your capacity for work/the extent of your disability. The one I saw was familiar with ME/CFS and had no difficulties in assessing me as 10/10 TPD. Perhaps you could discuss the option of such an assessment with Maurice Blackburn.

    I can provide you with more information about who I saw and the kind of information I included in my claim via PM. Let me know if you are interested.

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