Patients with multiple myeloma may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their multiple myeloma may qualify for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
What Is Multiple Myeloma?
When cancer forms in white blood cell types called plasma cells, it’s known as multiple myeloma. These blood cells are in charge of making antibodies to fight infection by recognizing and attacking germs. Multiple myeloma reduces these healthy blood cells by accumulating in the bone marrow and crowding out the plasma cells. Instead of producing helpful antibodies, these cancer cells create abnormal proteins which lead to multiple complications including the following:
- Anemia (low red blood cell count) – Because myeloma grows and crowds out normal blood cells, it can cause blood problems like anemia;
- Reduced kidney function – Multiple myeloma can cause kidney problems, including kidney failure. It causes higher calcium levels in the blood due to eroding bones and this calcium can interfere with your kidney’s blood waste filtering ability. Myeloma cells also create abnormal proteins which can lead to similar problems;
- Bone issues – Your bones can also be affected by multiple myeloma, which can cause broken or thinning bones or bone pain; and
- Frequent infections – As myeloma cells crowd out healthy blood cells, they inhibit your body’s ability to fight off infection, so you may find you get infections more easily.
Disability Evaluation of Multiple Myeloma
Long term disability insurance companies usually refer to the CDC (Center for Disease Control) to evaluate multiple myeloma. The CDC defines myeloma as a cancer of the plasma cells. The cells grow too much and form a tumor or mass in the bone marrow. The most common form of myeloma is multiple myeloma.
When you turn in your application, the LTD company assigns an adjudicator and potentially other medical professionals, such as a disability examiner, physician, or psychologist, to review your claim. You might be expected to see a doctor for a medical examination or functional capacity evaluation to determine your level of impairment. Your adjudicator will use that evidence to make their decision. If they feel they cannot make a decision without more information, you may be required to provide additional evidence.
You should also turn in medical documentation with acceptable clinical and laboratory findings. Symptoms and diagnoses are not enough. Your LTD benefits company is looking for a scientifically proven disability, so they’ll require all of your doctor’s objective findings.
In order to qualify for long term disability, your cancer must substantially interfere with your personal, work, school, and social activities. You must also experience four or more of the following symptoms for at least six months:
- Excessive thirst;
- Numbness or weakness in the legs;
- Loss of body weight;
- Frequent infections;
- Tiredness and fatigue;
- Mental confusion or fog;
- Appetite loss;
- Nausea or vomiting; and
- Bone pain, especially in the chest or spine.
You’ll need to have medical documentation that proves you fit these criteria and that none of your symptoms were caused by something prior to the onset of your multiple myeloma.
Long Term Disability and Multiple Myeloma
When you suffer from multiple myeloma, you may find it impossible to perform your work duties on a full-time basis. If this happens, long term disability benefits can help improve your financial situation. You’ll need to apply for benefits and wait for the insurance company to decide if you qualify as disabled as determined by the LTD insurance policy.
The insurance company will make that decision based on the documentation from your doctors and the information you provide on your application. Wondering what the long term disability insurance company is looking for when they evaluate your LTD claim for multiple myeloma? The following information may be helpful.
What is Disability?
Because insurance policies differ, you need to find out how the terms “disability” and “totally disabled” are defined for your particular plan. Most policies are split into “any occupation” and “own occupation.”
Any occupation policies are strict. You’ll be expected to prove that you cannot perform any position you would qualify for based on your education, training, and experience, as opposed to your specific job. An own occupation policy, on the other hand, considers you disabled if you are incapable of performing the duties of the position you currently hold.
How to Prove Multiple Myeloma
You cannot be approved for LTD based on symptoms alone, though their effects are usually taken into consideration. You’ll need to provide medical documentation from your health providers that back up your claims with clinical and laboratory findings. Sometimes an insurance company will use medical information alone to make their decision if it definitively proves that you are disabled.
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your multiple myeloma. Even if you have been denied benefits, that does not mean your fight is over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be daunting, your experienced disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to an experienced disability lawyer about your multiple myeloma and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the appeal process.