Patients with ulcerative colitis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their ulcerative colitis 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 Ulcerative Colitis?
Ulcerative colitis is a chronic autoimmune condition in which the colon, or large intestine, is inflamed. The immune system attacks the colon, causing damage and inflammation. While this inflammation may never go away, people with ulcerative colitis frequently experience flare-ups in which symptoms become suddenly much more severe. Ulcerative colitis can present similarly to other autoimmune conditions that affect the digestive tract. Unlike conditions like Crohn’s disease, ulcerative colitis only affects the inner lining of the large intestine.
Symptoms of ulcerative colitis include bloody diarrhea, severe abdominal pain, cramps, and incontinence. Some patients experience alternating constipation and diarrhea. Weight loss, fatigue, and nausea are also common.
Diagnosing Ulcerative Colitis
Diagnosing ulcerative colitis starts with a clinical assessment by a physician, who examines the patient and takes a thorough medical history. The doctor will also ask questions about the patient’s family medical history and the patient’s daily environment, as both genes and environmental factors may play a role. Further diagnostic testing is necessary to make a diagnosis and rule out other conditions that have similar symptoms.
Diagnostic testing includes:
• Blood tests for anemia and inflammation;
• Stool samples to check for infections and blood as well as parasites;
• Flexible sigmoidoscopy where a flexible camera is inserted into the lower colon to examine the lining and take biopsies if needed; and
• Colonoscopy which examines the entire colon.
Treating Ulcerative Colitis
As ulcerative colitis is a chronic condition, treatment does not eliminate the condition. Proper treatment can relieve symptoms and prevent further damage to the intestine. The two major treatments for ulcerative colitis are diet and medication. Sometimes surgery is needed for advanced cases of ulcerative colitis.
Dietary changes are important for people with ulcerative colitis. Diet changes can help relieve irritation and inflammation. Dietary changes should be discussed with a doctor to ensure it provides adequate nutrition. Medications for ulcerative colitis include antibiotics to treat infections, anti-inflammatory medications, and steroids. Biologics, which are medications made from proteins in living cell tissue, may be necessary for those with more severe ulcerative colitis. Others with severe ulcerative colitis may need their colon partly or completely removed.
Disability Evaluation of Ulcerative Colitis
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 Ulcerative Colitis
Patients seeking disability payments for their ulcerative colitis 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. They will need a Residual Functional Capacity (RFC) assessment that indicates how their symptoms affect and limit their life activities.
Many patients with severe ulcerative colitis experience issues going to the bathroom and may need multiple extended bathroom breaks. They may not be able to work a job in which they cannot have free access to a bathroom. Fatigue can prevent the person from working at a fast-enough pace or cause attendance issues.
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 ulcerative colitis. 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
Since you are so limited by the appeals process, consider consulting an experienced disability attorney very early on. Even with a claim for ulcerative colitis, 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 ulcerative colitis and its impact on your ability to work, the Ortiz Law Firm offers a free case evaluation 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.
