What is Primary Sclerosing Cholangitis?
Primary sclerosing cholangitis (PSC) is a rare liver condition that involves hardening and inflammation of the bile ducts within and around the liver. Like other liver conditions, it can cause troublesome symptoms that may eventually lead to liver failure.
Symptoms of primary sclerosing cholangitis can appear like other conditions of the liver. Fatigue, fever, chills, unexplained weight loss, and pain in the upper abdomen all point to liver disorders. In cases of severe bile duct obstruction, bile can leak into the bloodstream. Bile salts building up in body tissues can cause chronic itching. In its earlier stages, PSC can cause enlarged an enlarged liver and spleen. If it is not adequately treated, PSC can lead to cirrhosis and possibly liver failure. People with primary sclerosing cholangitis are at a higher risk of getting cholangiocarcinoma (bile duct cancer).
Like other “primary” conditions, primary sclerosing cholangitis isn’t a part of another condition but is associated with some other disorders. It is related to autoimmune conditions like Crohn’s disease and ulcerative colitis. Some research suggests that primary sclerosing cholangitis may also be an autoimmune condition. People with a family history of PSC or who have been exposed to certain environmental toxins are more likely to develop the disease. People who are descendent of Northern Europeans are at a higher risk of developing PSC.
Diagnosing Primary Sclerosing Cholangitis
Since symptoms of primary sclerosing cholangitis can look like symptoms of other liver conditions, doctors must determine which condition is causing symptoms. A doctor will examine the patient and ask questions about symptoms, lifestyle, and medical history. Diagnostic testing can include:
- Medical imaging tests can show the characteristic patterns of widening and narrowing within the bile ducts that resemble beads on a string.
- Endoscopic retrograde cholangiopancreatography (ERCP), where contrast is injected directly into the bile ducts so that X-rays will show narrowing and hardening of the tissue.
- Blood tests for elevated bilirubin, liver enzymes.
- Urine tests for an absence of urobilinogen, which is produced when bile is broken down in the gastrointestinal tract.
Treating Primary Sclerosing Cholangitis
Unfortunately, there is not a medication that is on the market that can prevent PSC from progressing. Once the liver is no longer functioning correctly, a liver transplant is necessary. If a match is not found, liver failure can be fatal.
Disability Evaluation of Primary Sclerosing Cholangitis
Primary sclerosing cholangitis may prevent someone from working, especially at the later stages of the disorder. People who cannot work must apply for Long Term Disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that 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 complete the work duties of almost any occupation for the years following the initial 2-year period. Some plans are a bit different, so it’s essential to understand your specific policy and its limitations when applying for benefits.
Evaluating Disability for People Who Have Primary Sclerosing Cholangitis
Severe fatigue may keep someone from working in a strenuous job, as they may not have the energy to complete tasks, and may interfere with cognition and concentration. If someone is struggling to understand or stay on task, even sedentary work may be impossible. Patients may need to miss periods of work for treatment. In cases where liver transplants are necessary, long stretches of hospitalization and rest are required.
Primary sclerosing cholangitis can also lead to severe complications. Colon and bile duct cancer, possible results of PSC, can be disabling. Repeated infections can lead to extensive treatments. If an infection is a concern, a person may not be able to work in an environment that can cause transmission of diseases such as a hospital or pharmacy setting.
Since primary sclerosing cholangitis can lead to other severe disorders, it is vital to communicate to the insurance company the entire picture of your health. Even if your PSC is not severe enough to be considered disabling, you may still qualify for benefits when your other conditions are taken into consideration.
What the Insurance Company Needs From You and Your Medical Providers
You will need to tell your insurance company about any doctors that have treated you for your primary sclerosing cholangitis. They will need to get your medical records from those doctors when they are evaluating your claim. If the insurance company cannot get those records directly, you may need to get them from your doctors and send them in yourself.
The insurance company will need to see proof of your diagnosis and your ongoing symptoms, as well as evidence of how those symptoms affect your life. 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 a correct RFC for you.
Working With a Disability Attorney
You do not have to fight the insurance companies alone. The experienced disability attorneys at the Ortiz law firm can help you through every step of the process, from initial application to potential appeals. They only get paid if you win. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz law firm will focus on your case so you can focus on your illness. To see how we can help you win your long-term disability case and get you the benefits you deserve for your primary sclerosing cholangitis, call us at (888) 321-8131.