Patients with cirrhosis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their cirrhosis 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 Cirrhosis?
Cirrhosis is the late stage of scarring of the liver created by advanced diseases like hepatitis and chronic alcohol use. Each time the liver is damaged, it tries to repair itself. Each time it tries to repair itself, scar tissue forms leaving it difficult for your liver to function properly. Cirrhosis cannot be reversed, and advanced stages are life-threatening. If diagnosed early, treatment and lifestyle changes can help slow down the disease progression.
Cirrhosis often has no symptoms until there is liver damage. When you do start showing symptoms, seek medical treatment. Some signs and symptoms can be but are not limited to:
- Weight loss;
- Yellow discoloration of the eyes or the skin;
- Itchy, flaky skin;
- Loss of appetite; and
- Drowsiness and confusion.
There are many causes of cirrhosis. The most common are chronic alcoholism and hepatitis, but many other diseases can cause cirrhosis like fatty liver disease, iron build up in the body, autoimmune hepatitis, and even some medications.
Treatment plans for cirrhosis will vary as there is no cure. Treatments for the underlying cause of the disease can be alcohol treatment programs, weight loss, and blood sugar monitoring plans, and medications so slow down liver damage.
Treatments for advanced cirrhosis can be low sodium diets to help combat the fluid build up, periodic blood tests and liver ultrasounds to monitor for cancer signs, and medications to treat hypertension associated with cirrhosis. Liver transplants are an option for the most advanced cases.
Cirrhosis and Long Term Disability
It is essential to request a copy of your long term disability policy and read the qualifications. Not all but some insurance policies exclude paying benefits for employers that have a disease related to substance abuse. If you have cirrhosis due to alcohol abuse, you want to check your policy. If you developed the disease in a non-alcohol related way, you still need to get a copy of your policy and read the terms.
The insurance company will base its decision on the information provided by your medical provider. A positive diagnosis will need to be provided by your doctor. Your doctor will also need to provide a treatment plan for you. Your doctor will need to provide a list of restrictions that cause you not to be able to perform your duties at work by completing a functional capacity report.
Definition of Disability
Under most LTD policies, an individual is considered disabled if he or she is: (a) unable to perform the material duties of his or her own occupation for the first two years of the policy; and (b) unable to perform the duties of just about any occupation after the first two years of the policy. The definition of disability is specific to each individual policy, so you must review your own LTD policy to determine how the term “disability” or “totally disabled” is defined for you.
Proof of Disability
Evidence of symptoms alone will not be sufficient for a successful long term disability claim. You will need to provide medical documentation to support your claims. This will include medical reports from your doctors, hospitals, and laboratories that have treated you. If you provide the insurance company with a list of all the locations that treated you for cirrhosis, they should be able to obtain your records directly. If they cannot, it will be up to you to obtain them. Some examples are results from your MRI, CAT Scan, liver ultrasound, liver biopsy, liver enzyme levels tests, and liver protein levels.
It is important to remember to get any mental health records you may have regarding treatment for cirrhosis. This serious and chronic disease can cause you to need to seek counseling for depression and anxiety. Provide the insurance company with your therapy notes.
If the insurance company decides that there is not enough evidence to process your claim, they may ask you to be evaluated by a doctor that works for them to ensure they have all the documentation they need to reach a decision.
Work with a Long Term Disability Insurance Attorney to Ensure You Get the Benefits You Deserve
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your cirrhosis. 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 cirrhosis 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.