If you’re grappling with managing your diabetes and holding down a job, you might be wondering how to secure long-term disability insurance. This post will cover the essentials of how to qualify for benefits, the obstacles you might face, and how to overcome them. You’ll gain practical tips to navigate insurance claims successfully.
Understanding Diabetes
Diabetes is a medical condition that occurs when the body does not produce sufficient insulin to process glucose. In a properly functioning circulatory system, the blood carries glucose to all the cells in the body in order to produce energy and the pancreas produces insulin to help the body absorb excess glucose. High levels of glucose in the blood indicate that the body is not producing enough insulin, or that the insulin produced is not working to help the body absorb glucose as it normally would, indicating a diabetic condition.
Diabetes is often controlled with treatment — a combination of medication and diet. As a person ages, however, diabetes cannot be controlled at times. However, when it is uncontrolled it can be a very serious disease that can result in high blood pressure, damage to the eyes, nerve damage, kidney disease, damage to internal organs, heart disease, blindness, stroke, and other medical problems. A long-term diabetic may even lose limbs to amputation because of poor circulation.
There are three types of diabetes:
- Type 1, or “juvenile” diabetes;
- Type 2, or “adult onset” diabetes, and
- Gestational diabetes.
Diabetes mellitus is the medical term for both type 1 and type 2 diabetes. Pre-diabetes is a diagnosis made when blood glucose levels are elevated. This elevation indicates that an individual is at risk of developing diabetes.
Symptoms of Adult Diabetes
Symptoms of type 1 diabetes and type 2 diabetes include frequent urination or urge to urinate, unusual thirst and hunger (especially between meals), and extreme fatigue. Those with type 2 diabetes also can suffer from numbness or tingling in the hands and feet, and blurred vision. Symptoms may also include weight loss, and/or general feelings of irritability.
Many diabetics report dry, itchy skin and trouble with genital itching, and frequent fungal infections. Finally, the skin of many diabetics is slow to heal from cuts, wounds, skin abrasions, or sores.
Complications of Adult Diabetes
The following are some complications from diabetes:
- Retinopathy (eye and vision problems);
- Nephropathy (kidney disease);
- Hypertension / high blood pressure;
- Heart disease;
- Stroke;
- Gastroparesis (a type of nerve damage that interferes with digestion);
- Peripheral arterial disease (reduced blood flow to the limbs- arms and legs);
- Cellulitis (skin infections);
- Depression;
- Hyperglycemia;
- Hypoglycemia;
- Diabetic retinopathy, which may cause blurred vision, poor visual acuity, and/or poor peripheral vision;
- Diabetic nephropathy (kidney disease), where the kidneys are no longer filtering properly and you require daily dialysis or there is evidence of too much protein or creatine in your plasma;
- Diabetic peripheral neuropathy, which is a form of nerve damage in the hands, feet, arms, or legs (to qualify for benefits due to this complication, you should be able to show that your neuropathy causes a significant disruption of your ability to walk, stand, or use your hands in a skilled way;
- Diabetic ketoacidosis, which is an abnormal increase in the acidity of bodily fluid and may be documented by blood tests;
- Cardiovascular problems. Diabetes can lead to coronary artery disease, chronic heart failure, peripheral vascular disease, and an irregular heartbeat;
- Poorly healing skin and bacterial infections. You may have ulcerating skin lesions that make it difficult for you to walk or use your hands for work;
- Amputation of an extremity. If you’ve had a hand, foot, arm, or leg amputated due to nerve damage and poor circulation caused by diabetes, you may qualify for LTD benefits.
Diagnosis of Diabetes
Diabetes can be diagnosed through three types of blood tests, which include:
- A fasting plasma glucose test, which is typically given after an 8-hour fast;
- An oral glucose tolerance test, which may be given after an 8-hour fast followed by the administration of a glucose-containing beverage and an additional 2-hour wait; or
- A random plasma glucose test, which measures blood glucose without any kind of fast.
However, the random plasma glucose test cannot be used to test for pre-diabetes. If the test results are indicative of a diabetic condition, the patient must undergo additional tests to confirm the diagnosis.
Long-Term Disability For Diabetes
If you have uncontrolled diabetes and you are unable to work, then you may qualify for long-term disability (LTD) benefits. To qualify for disability benefits, the problems caused by your diabetes must severely limit what you can do. To determine your limitations, the insurance company will conduct a residual functional capacity (RFC) analysis (see below). If you have diabetes and another severe medical impairment, such as severe depression or obesity, the insurance company may consider the combined effects of your impairments when conducting your RFC analysis.
How Limiting Is Your Diabetes?
Your insurance adjuster will assess your ability to work by evaluating your residual functional capacity (RFC). A residual functional capacity form assesses the extent of activity you can undertake despite your diabetes. For instance, the RFC might indicate that you can handle medium, light, or sedentary tasks. To ascertain your RFC, the insurance company evaluates your medical records, corroborated medical opinions from your doctor detailing your functional limitations, and testimonials from you, your family, and your friends.
The insurance adjuster handling your claim will look for information that shows how well you can use your arms and hands, stand, and walk. For example, if you have peripheral sensory neuropathy that limits the sensation in your legs or feet, you may have difficulty walking or using foot controls. This would obviously limit your ability to perform jobs that require those activities.
The insurance company will also assess your ability to concentrate on tasks, collaborate with others, and maintain regular attendance at work. For instance, if you experience unstable glucose levels throughout the day, it may be determined that you struggle to maintain focus over extended periods. Mental health challenges like depression or significant fatigue could indicate an inability to consistently meet work commitments. Neuropathy in your legs from diabetes might limit your capacity to stand or walk for extended durations.
Moreover, if your vision is compromised, your RFC could specify that tasks demanding clear vision are unsuitable for you. As an example, if your visual acuity is at 20/80 or below, you might be deemed unfit to drive or operate hazardous machinery.
Appealing a Denial of Benefits
Many people who apply for disability based mostly on diabetes are denied benefits and need to file an administrative appeal. An experienced disability lawyer can help you develop the evidence necessary to satisfy your burden of proof by using strategies like combining the effects of multiple impairments, evidencing you have reduced productivity, and proving you cannot perform even sedentary work.
Get Help with Your Long-Term Disability Claim
While the process can be daunting, an experienced 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 diabetes 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.
