Patients with diabetes may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their diabetes 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 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 as it should to help the body absorb glucose, 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 when blood glucose levels are elevated, indicating that an individual has a high risk of developing full-fledged 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;
- 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);
- 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.
Qualifying for Long Term Disability Benefits with Diabetes
If you have uncontrolled diabetes and you are unable to work, then you may be eligible 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?
To determine whether your diabetes limits your daily functioning so much that you cannot sustain work activity, the LTD insurance adjuster assigned to your claim will assess your residual functional capacity (RFC).
Your RFC is a measurement of the level of activity that you can still perform despite your diabetes. For example, an RFC could conclude that you are capable of performing medium work, light work, or sedentary work. To determine your RFC, the insurance company will review your medical history, your doctor’s opinion(s) (if they detail your functional limitations and are backed up by medical evidence), and statements 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 be interested in whether you can focus on tasks, get along with others, and go to work on a regular basis. For example, if you have poorly controlled glucose levels during the day, the insurance adjuster might find that you are unable to concentrate for long periods of time. If you suffer from depression or extreme fatigue, your RFC might state that you cannot perform work on a consistent and regular basis. If you have neuropathy in your legs due to your diabetes, you may be unable to stand and walk for long periods of time. If you have blurred vision, your RFC may state that you cannot perform jobs where vision is important. For example, if your visual acuity is 20/80 or worse, your RFC might state that you cannot drive or work around 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.
Work With an Experienced Long Term Disability Attorney
While the process can be daunting, your 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 polio 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.