Patients with Wilson’s disease may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their Wilson’s disease 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 Wilson’s Disease?
Wilson’s disease is a rare genetic disorder in which the body does not properly eliminate copper. Copper is a part of a healthy diet and normally eliminated through the liver and kidneys. In people with Wilson’s disease, copper builds up in the organ. The most commonly affected organs are the liver, kidneys, and brain.
People with Wilson’s disease are born with the condition, but often do not show symptoms until they are in their early twenties. Symptoms of Wilson’s disease include swelling, erratic movements, loss of muscle control, fatigue, and abdominal pain. Patients can also experience psychological problems like personality changes and depression. If the disease progresses without treatment, patients can experience organ failure, severe brain damage, and death.
Diagnosing Wilson’s Disease
Wilson’s disease can be difficult to diagnose because the symptoms are like other diseases that affect the liver. Doctors look at the patient’s symptoms and diagnostic testing when making a diagnosis. Diagnostic tests include:
- Blood tests for liver function, kidney function, and levels of ceruloplasmin, the protein that binds copper;
- Urine tests for copper excreted from the body ;
- Eye exams for Kaiser-Fleisher rings caused by excess copper in the eyes;
- Liver biopsy for high levels of copper; and
- Genetic testing for the mutations that cause Wilson’s disease.
Treating Wilson’s Disease
As Wilson’s disease is a genetic condition, it is incurable, and treatment lasts for the life of the patient. If caught early and properly treated, people with Wilson’s disease can generally live a long and healthy life. If not treated, accumulation of copper can reach life-threatening levels.
Treatment for Wilson’s disease is focused on lowering the levels of copper in the body and preventing buildup from occurring in the future. Changing the diet to reduce the amount of copper consumed is usually the first treatment. Chelating medications cause the organs to release copper, which is then excreted normally from the body. Other medications, such as zinc acetate, prevent the body from absorbing copper found in the diet. Medication is taken for the life of the patient to prevent levels from rising. For patients with severe Wilson’s disease, liver transplants may be necessary.
Even with proper treatment, patients can experience lifelong side effects. These can include psychological disorders and neurological problems such as difficulty walking and talking. Physical therapy is often needed to address neurological effects. Organ damage is not always reversible.
Disability Evaluation of Wilson’s Disease
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 Wilson’s Disease
Patients must prove that their condition is severe enough to qualify as disabling. Patients seeking disability payments for their Wilson’s disease 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.
Patients with difficulty walking or with tremors may have difficulty working in any job that requires lifting or fine motor skills. Those with speech difficulties may not qualify to work in a job that requires communications, such as in a call center or in customer service. Medications may cause side effects that require frequent trips to the bathroom or multiple doctors’ appointments.
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 Wilson’s disease. 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 Long Term Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your Wilson’s disease. Even if you have been denied benefits, your chance is not 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 Wilson’s disease 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.
