What is Nephrotic Syndrome?
Nephrotic syndrome is a kidney disorder where the body excretes excessive amounts of protein in the urine. Nephrotic syndrome is caused by damage to the blood vessels in the kidneys by a disease that affects either only the kidneys or the entire body. The most common causes are diabetes, focal segmental glomerulosclerosis (FSGS), and minimal change disease.
Symptoms include swelling around the eyes, legs, and feet, foamy urine, and weight gain from fluid retention. People with nephrotic syndrome may struggle with loss of appetite and fatigue.
Diagnosing Nephrotic Syndrome
A clinical exam, usually by a nephrologist (kidney doctor), is the first step to getting diagnosed. The doctor will ask about your symptoms, what improves or worsens your symptoms, what medications you take, and your medical history. Further testing is needed to make an accurate diagnosis of nephrotic syndrome. Diagnostic tests include:
- Urine tests;
- Blood tests; and
- Kidney biopsy.
Treating Nephrotic Syndrome
There is no cure for nephrotic syndrome, but treatments can help. Treating the underlying condition is important in order to prevent further damage and complications. Medicines like diuretics can relieve swelling and fluid retention. Medicines to treat high blood pressure and cholesterol can reduce the risk of heart attacks and strokes. Dietary and lifestyle changes can lower symptoms as well. If the kidneys are unable to function, dialysis or kidney transplants are necessary.
Disability Evaluation of Nephrotic Syndrome
If you cannot work because of your nephrotic syndrome, you must apply for long term disability (LTD) benefits. The insurance company will review claim to see if you meet the definition of disabled outlined by your plan.
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 work in almost any job after that. Each LTD plan has a different definition of “disability”, so look over your plan policy to see how your plan determines “disabled.”
Evaluating Disability for People with Nephrotic Syndrome
You must prove that your nephrotic syndrome prevents you from working at your old job or any job that you could be trained to work and that the condition will last for at least a year. Your insurance company will evaluate your symptoms from your nephrotic syndrome as well as any other disorders that may affect your ability to work. The insurance company will look at the Residual Functional Capacity (RFC) form to determine the extent of your symptoms and how they may keep you from working. Even if you do not qualify for benefits for your nephrotic syndrome, you may qualify when all your symptoms and illnesses are considered.
What the Insurance Company Needs From You and Your Medical Providers
You should tell the insurance company about any doctors you may have seen for your nephrotic syndrome. The insurance company will need to obtain all relevant medical records to get the full picture of your health. 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 should include the physician notes from doctor visits as well as the records from any diagnostic testing.
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.
Working with a Disability Attorney
Since you are so limited by the appeals process, consider consulting a disability attorney very early on. Even with a claim for nephrotic syndrome, it can be tricky to navigate the claims and appeals process. Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve. If you have been denied disability benefits, do not lose hope. Many people are denied benefits the first time they apply. You have the right to file an appeal and to get more information that may help your case.
While the process can be daunting, your expert disability attorney will be able to guide you through the process. Getting expert help is often the difference between being denied and being approved for benefits. An experienced long term disability attorney can help you stay on top of your deadlines, help you gather your documents, assist you during field interviews, and give you guidance that will help you get your claim approved. 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 nephrotic syndrome and its impact on your ability to work, the Ortiz Law Firm offers a free consultation with no obligation to use our firm. During the call, you can ask any questions you have regarding your claim, and we will answer them. To see how we can help you win your long-term disability case, call us at (888) 321- 8131.