Patients with Graves’ disease may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their Graves’ 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 Graves’ Disease?
According to PubMed Health, a consumer health Web site produced by the National Center for Biotechnology Information (NCBI), a division of the National Library of Medicine (NLM) at the National Institutes of Health (NIH), Graves disease is an autoimmune disorder that typically leads to hyperthyroidism (overactivity of the thyroid gland).
Causes, Incidences, and Risk Factors
The thyroid gland is an important organ of the endocrine system. It is located in the front of the neck just below the voice box. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is critical for regulating mood, weight, and mental and physical energy levels.
If the body makes too much thyroid hormone, the condition is called hyperthyroidism. (An underactive thyroid leads to hypothyroidism.)
Graves disease is the most common cause of hyperthyroidism. It is caused by an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormones. Graves disease is most common in women over age 20. However, the disorder may occur at any age and may affect men as well.
- Breast enlargement in men (possible);
- Difficulty concentrating;
- Double vision;
- Eyeballs that stick out (exophthalmos);
- Eye irritation and tearing;
- Frequent bowel movements;
- Goiter (possible);
- Heat intolerance;
- Increased appetite;
- Increased sweating;
- Menstrual irregularities in women;
- Muscle weakness;
- Rapid or irregular heartbeat (palpitations or arrhythmia);
- Restlessness and difficulty sleeping;
- Shortness of breath with exertion;
- Tremor; and
- Weight loss (rarely, weight gain).
Signs and Evidentiary Tests
Physical examination evidences an increased heart rate. Examination of the neck may show that the thyroid gland is enlarged (goiter).
Other tests include:
- Blood tests to measure levels of TSH, T3, and free T4; and
- Radioactive iodine uptake.
The purpose of treatment is to control the overactivity of the thyroid gland. Beta-blockers such as propranolol are often used to treat symptoms of rapid heart rate, sweating, and anxiety until the hyperthyroidism is controlled. Hyperthyroidism is treated with one or more of the following:
- Antithyroid medications; and
- Radioactive iodine.
If you have radiation and surgery, you will need to take replacement thyroid hormones for the rest of your life, because these treatments destroy or remove the gland.
Some of the eye problems related to Graves’ disease usually improve when hyperthyroidism is treated with medications, radiation, or surgery. Radioactive iodine can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after the hyperthyroidism is cured.
Sometimes prednisone (a steroid medication that suppresses the immune system) is needed to reduce eye irritation and swelling.
You may need to tape your eyes closed at night to prevent drying. Sunglasses and eye drops may reduce eye irritation. Rarely, surgery or radiation therapy (different from radioactive iodine) may be needed to return the eyes to their normal position.
Expectations or Prognosis
Graves’ disease often responds well to treatment. However, thyroid surgery or radioactive iodine usually will cause hypothyroidism. Without getting the correct dose of thyroid hormone replacement, hypothyroidism can lead to:
- Mental and physical sluggishness; and
- Weight gain.
Antithyroid medications can also have serious side effects.
Complications from surgery may include:
- Hoarseness from damage to the nerve leading to the voice box;
- Low calcium levels from damage to the parathyroid glands (located near the thyroid gland);
- Scarring of the neck; and
- Eye problems (called Graves’ ophthalmopathy or exophthalmos).
Heart-related complications, including:
- Rapid heart rate;
- Congestive heart failure (especially in the elderly); and
- Atrial fibrillation.
Thyroid crisis (thyrotoxic storm), a severe worsening of overactive thyroid gland symptoms.
Increased risk for osteoporosis, if hyperthyroidism is present for a long time
Complications related to thyroid hormone replacement:
- If too little hormone is given, fatigue, weight gain, high cholesterol, depression, physical sluggishness, and other symptoms of hypothyroidism can occur; and
- If too much hormone is given, symptoms of hyperthyroidism will return.
Calling Your Health Care Provider
Call your health care provider if you have symptoms of Graves’ disease, or if your eye problems or general symptoms get worse (or do not improve) with treatment.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of hyperthyroidism with:
- Decrease in consciousness;
- Fever; and
- Rapid, irregular heartbeat.
Graves’ Disease and Disability
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your Graves’ disease. Even if you have been denied benefits, that does not mean your fight is 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 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 Graves’ 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.