Kleine-Levin Syndrome and Long-Term Disability Claims

Kleine-Levin Syndrome is a rare and complex neurological condition that can be disabling. Patients have recurring episodes of excessive sleep, cognitive disturbances, and behavioral changes. These symptoms can interfere with daily functioning and the ability to maintain employment. Securing long-term disability benefits is critical, but these claims can be challenging.

What Is Kleine-Levin Syndrome?

Kleine-Levin Syndrome is a rare sleep disorder. It involves recurring episodes of hypersomnia where the patient may sleep up to 20 hours a day. Episodes can last days, weeks, or even longer, with periods of normal behavior between. The cause is unknown, but experts think dysfunction in certain regions of the brain is a factor.

Common symptoms include:

• Extreme sleepiness (hypersomnia)
• Cognitive impairment (confusion, memory issues, slowed thinking)
• Derealization or feeling disconnected from reality
• Behavioral changes (e.g., irritability, apathy, hyperphagia)
• Disinhibited behaviors (e.g., hypersexuality)

This condition often begins in adolescence, but it can continue into adulthood. The unpredictability and severity of episodes can disrupt your personal and professional life.

Functional Limitations and Work Impact

The primary impact of KLS is the unpredictability and duration of episodes. During active episodes, a person may be completely unable to perform any job duties. Between episodes, cognitive and emotional changes can affect concentration, memory, and interpersonal interactions.

For example:

• An office worker may miss work due to hypersomnia and be unable to meet deadlines.
• A teacher may struggle through lessons due to fogginess or disinhibited behavior.
• A manual laborer may struggle with fatigue, poor coordination, and impaired decision-making.

Medical Evidence to Support Your Claim

Because KLS lacks a definitive diagnostic test, strong supporting documentation is essential. Medical records should include:

• Diagnosis by a neurologist or sleep specialist
• Sleep studies and EEG results (if performed)
• Detailed clinical notes describing frequency, duration, and severity of episodes
• Neuropsychological evaluations
• Statements from caregivers or family documenting observed behavior

Consistent treatment shows that you are managing symptoms to the best of your ability. This is important even if there is no cure for your condition.

Challenges in Getting Approved for LTD Benefits

Insurance companies often deny KLS claims due to the rarity of the condition and lack of evidence. Common challenges include:

• Claim reviewers downplaying the severity of episodes
• Surveillance during asymptomatic periods
• Biased medical reviewers unfamiliar with KLS
• Mischaracterization of the condition as a psychiatric issue rather than a neurological disorder

A Hypothetical Case Example

Consider “Alex,” a 29-year-old software developer diagnosed with KLS at 19. Alex experiences episodes every 4 to 6 weeks, each lasting up to 10 days. During these episodes, Alex is nonfunctional. She sleeps 18+ hours per day and is unable to communicate.

Alex filed a claim for LTD benefits, but the insurer denied it. The denial letter stated that the denial was due to “insufficient objective evidence.” She then hired an attorney to help her appeal the decision. The appeal included medical records and affidavits from family and a former supervisor. The insurer approved the claim upon review of the appeal.

How a Long-Term Disability Attorney Can Help

If your insurance company has denied you KLS LTD claim, you don’t have to appeal alone. An experienced attorney can be instrumental in navigating the appeals process. A long-term disability attorney can:

• Help gather persuasive medical and vocational evidence
• Identify and address claim file deficiencies
• Challenge unfair reviews by insurance doctors
• Represent you in ERISA appeals or litigation, if necessary

We understand the nuances of complex neurological conditions like KLS. We also have a proven track record of success in LTD appeals. We can put that experience to work fighting for your benefits.

Take the Next Step Toward Protecting Your Rights

If your insurer has denied your long-term disability claim, don’t give up. We offer nationwide representation and personalized legal support. Call us today at (888) 321-8131 to take the first step toward securing your financial future. We have the experience needed to recover the benefits you deserve.