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Independent Examiner Struck Down!

    Michael graduated Rensselaer Polytechnic Institute in  Troy, NY in
1974, went on to get a Masters Degree in Mechanical Engineering and took
graduate courses at MIT (Massachusetts Institute of Technology) and the
University of Lowell.  In 1989, he was hired by Raytheon as a senior
engineer and helped develop and test missile systems.  

    Michael was diagnosed with mononucleosis in July of 1992 but the
symptoms never abated.  He was absent from work a lot although he tried to
resume full time work.  In July of 1994, Michael was diagnosed with
"Chronic Fatigue Immunodeficiency Syndrome" (CFIDS).  He previously
had been diagnosed with bipolar which was under control by the time he got
"mono."  MetLife approved his claim  but continued to evaluate his claim.
His physician suggested he try working three half days a week but the
company rejected this saying "he has a diminished mental capacity..a
psychiatric problem...cognitive problems."
    In 1996, MetLife terminated Michael"s disability. Most long term
disability companies have a two year limit on "mental" illnesses and they
often try to put ME/CFIDS into this category to discontinue benefits. On the
advice of his attorney, Bernard A. Kansky, Michael underwent vocational
assessment by Paul Blatchford, Ed. M. who found that he could no longer
work as a "lead engineer."  A neurological evaluation found he met "the
diagnostic criteria by the Centers for Disease Control for the diagnosis of
Chronic Fatigue Syndrome."   Despite this, a physician hired by MetLife,
Dr. Robert Petrie, found "the medical records provided do not support the
diagnosis of chronic fatigue syndrome,"  even though he never examined
Michael in person.  Companies often hire and pay consultants to review
only records.  Dr. Dedra Buchwald, the co-chair of the NIH's Workshop on
CFS in June did this under contract to MetLife and found one patient not
disabled because she could carry a grocery bag! Most of the Independent
Medical Examiners (IME) never see the patient but their job is to give
unfavorable reports of the patient as that is what the companies are paying
them for. Dr. Petrie said Michael could not have CFS because he was
bipolar and "CFS cannot co-exist with other debilitating conditions" and
that he had "no demonstrated physical impairment."  MetLife also had
Michael undergo their own vocational assessment but he flunked that one as
well as the one administered by vocational expert Paul Blatchford, Ed. M.!

"Evidence of cardiovagal dysfunction" was found during an autonomic
function test and blood work was consistent with CFS, yet still MetLife
terminated his benefits saying they had not received all this medical data,
even though it was sent to by certified return request and signed for.  In
1997, the Federal Social Security Administration (SSA) found Michael fully
disabled, awarding him benefits retroactive to 1995.  However, Dr. Petrie
again found all this information "insufficient" since both bipolar and CFS
"do not prevent employment."  MetLife demanded thousands back which
the SSA had awarded Michael under duplication of payments and refused to
reevaluate his claim. Left with no alternative, Michael filed suit in 2000.
   An order was entered in 2003 and Michael was found totally disabled by
CFS (CFIDS).  The judge ordered that his long term disability benefits be
retroactive to May 1996 and said that the non-examining independent
medical examiner may have been less than impartial.  For those still fighting
for their disability cases, this order from the United States District Court of
Massachusetts, Civil Action no. 00-12071-NG could be very helpful.
(Michael Houle, Plaintiff v. Raytheon Company, et al, Defendants, April 28,

    The May 12th issue of the Massachusetts Lawyers Weekly noted this
case under "Important Decisions" on the front page of their newsletter
which we thought was most appropriate for "Awareness Day."

The National CFIDS Foundation * 103 Aletha Rd, Needham Ma 02492 * (781) 449-3535 Fax (781) 449-8606