Patients with gastritis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their gastritis 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 Gastritis?
Gastritis is a group of conditions in which the lining of the stomach becomes irritated and inflamed. Gastritis is common, with more than 200,000 cases in the United States each year. Symptoms of gastritis include stomach pain, nausea, vomiting, excessive belching, heartburn, and indigestion. Some people do not experience symptoms. For people that do not have symptoms, gastritis is often diagnosed when conducting medical tests for other, unrelated disorders. Many patients find that they do not feel hungry, even when they have not eaten for a while.
Most cases of gastritis are caused by infection by the same bacteria that cause stomach ulcers. Other causes include long-term use of non-steroid anti-inflammatory drugs (NSAIDs) like Tylenol, regular consumption of alcohol, and injury. Autoimmune disorders like Crohn’s disease, rheumatoid arthritis, and sarcoidosis can lead to gastritis. Older age can be a risk factor for developing gastritis, as the stomach’s lining becomes thinner with time.
Diagnosis of gastritis depends on both clinical exam and diagnostic testing. A physician will gather medical history and the patient’s symptoms, often palpating the abdomen to check for bloating and the location of the pain.
Diagnostic testing for gastritis includes:
- Bacteria testing for H. pylori in the blood, stool, or breath test;
- Endoscopy scope testing of the stomach, which can consist of biopsies of the stomach lining; and
- X-ray of the stomach, esophagus, and intestines.
Many cases of acute gastritis go away on their own and do not require any treatment. Other circumstances, especially for chronic gastritis, require more attention. Treating gastritis is dependent mainly on the underlying cause. For gastritis that it is the result of an infection, antibiotics are the cure. Antacids can relieve the pain and indigestion from existing stomach acid, while acid-blocking drugs can lower acid production. Reducing alcohol consumption and stopping long term NSAIDs can be necessary, even if it is not the cause. Eating smaller, more frequent meals can help the stomach in the healing process.
If gastritis does not go away on its own and is left untreated, it can lead to ulcers and stomach bleeding. Chronic, untreated gastritis has been linked to an increased risk of stomach cancer. Chronic gastritis patients should regularly see a physician. Passing blood in the stool or vomiting blood is a reason to head to the emergency room.
Disability Evaluation of Gastritis
Definition of Disability
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to complete the work duties of almost any occupation for the years following the initial 2-year period. Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled.”
Evaluating Disability for People with Gastritis
Most patients with gastritis are not considered disabled as the condition does not limit their life activities. Others may not be so fortunate. Patients seeking disability payments for their gastritis will have to prove that they are impacted in a way that they cannot perform their old job or any job that they could be trained to work.
To qualify for disability benefits, the condition must prevent the person from working in their own occupation (or – depending on the language in the LTD policy – in any occupation). They will need a Residual Functional Capacity (RFC) assessment that indicates how their symptoms affect and limit their life activities. For example, someone with severe chronic gastritis may vomit multiple times a day, necessitating urgent bathroom breaks.
Even if the person does not qualify for disability benefits for their gastritis alone, they may be eligible under their other conditions. It is essential to consider and convey the entire health of the patient when applying for disability.
What the Insurance Company Needs From You and Your Medical Providers
You should tell the insurance company about any doctor that has treated you for your gastritis. The insurance company will need to obtain all relevant medical records to get the full picture of your health. These records include office notes, clinical exams, diagnostic tests, and lab results. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself.
You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.
Working with a Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your gastritis. 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 expert 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 gastritis 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.