Man Seeks Permanent Disability Due to Fibromyalgia, But His Claim Is Denied

Fibromyalgia, a chronic and often invisible ailment, faces a wall in the courts when it comes to granting permanent incapacity benefits.

The fibromyalgia diagnosis. A word that for many evokes chronic pain, extreme fatigue, and countless symptoms that tremendously complicate daily life. However, when claiming permanent incapacity, the reality in court is often much more elusive. The case of a travel agent whose claim for incapacity was denied, despite suffering from this ailment and others associated with it, is unfortunately not a surprise.

## The Medical Report, Key to the Decision

The heart of these judicial resolutions lies, in large part, in medical reports. In this particular case, the High Court of Justice of Balearic Islands upheld the initial decision, basing it fundamentally on the report of a forensic medical expert. This report, according to the judgment, was "conclusive" in stating that the claimant's clinical picture did not reach the severity necessary to justify permanent incapacity. The forensic expert determined that the worker presented no significant limitations regarding concentration or memory, and therefore could perform the tasks of his profession, which involve administrative management and customer service. It was even noted that during periods of temporary incapacity leave, there is no need for symptom continuity, as this situation exists for study, diagnosis, and treatment.

## Treatment and Fluctuating Nature of the Illness

Another crucial point that seemed to weigh against granting the incapacity is the nature of the illness. While the chronicity of fibromyalgia is acknowledged, tribunals often focus on its "fluctuating" character. This means that while there are periods of pain exacerbation and other symptoms, there are also periods of improvement. The regulations regarding permanent incapacity require a decrease or cancellation of work capacity that is "continuous," not intermittent. The treatments received by the claimant, described as symptomatic and palliative, including medication such as anti-inflammatories or corticosteroids, were not deemed sufficient to prove a permanent and irreversible decrease in his work capacity.

## The Legal Labyrinth of Incapacity

The process for obtaining permanent incapacity is inherently complex. Having a diagnosis is not enough. One must demonstrate, with solid medical evidence and expert assessments, that the functional limitations derived from the pathology substantially and continuously prevent the performance of one's habitual profession, or indeed any other work activity. In this case, the worker alleged a clinical picture including fibromyalgia, polymyalgia, polyarthralgias, and other ailments. He provided various medical reports, including a private expert report, in an attempt to modify the proven facts and detail his symptomatology. However, the tribunal found that these documents did not demonstrate a "gross" error in the initial assessment and that, in reality, it was an alternative interpretation of the evidence, overlooking the forensic report.

The law is clear: permanent incapacity is granted in cases of "severe anatomical or functional reductions that are objectively determinable and predictably definite." Fibromyalgia, by its very nature, often presents challenges to this "objective determination" sought by the courts. The fact that the existence of the pathology is not denied is one step, but it does not guarantee the benefit. The key appears to be demonstrating that the illness, in its concrete manifestation in the individual, generates a constant limitation of such magnitude that it prevents the development of any professional activity.

It is important to remember that every case is unique, and judicial decisions are based on the specific evaluation of the evidence presented and current legislation. Fibromyalgia is a real and debilitating illness, and those who suffer from it deserve proper recognition of their limitations.