Patients with polychondritis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their polychondritis 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 Polychondritis?
Polychondritis, frequently called relapsing polychondritis, is a rare autoimmune condition that causes painful and destructive inflammation in cartilage and connective tissues. People with relapsing polychondritis experience flare-ups of painful swelling that can last weeks or months before subsiding. They may not experience any symptoms for months or years before experiencing another flare-up. This cycle of relapsing symptoms causes increasing damage to the body and symptoms that often become more severe as time goes on.
The most common symptoms of polychondritis include tenderness and inflammation in the nose and ears, which can cause visible redness to the skin. Inflammation of the chest, ribcage, and throat is also common. Patients often develop arthritis in the joints affected by polychondritis. If inflammation is left unchecked, it can cause deformities to the affected area. In rare cases, relapsing polychondritis can cause deadly airway collapses, kidney damage, and perforation of the cornea.
Men and women are equally affected by polychondritis, and symptoms generally appear once a person has reached middle age. In rare cases, children can also be affected. There is no known cause of relapsing polychondritis. There does seem to be some correlation between infections or autoimmune conditions such as rheumatoid arthritis or lupus.
People with relapsing polychondritis usually have shorter lifespans, though newer treatments have helped to lessen the chances of death. Damage to the heart, lungs, or vascular systems can be deadly and requires early interventions.
Clinical examinations usually diagnose relapsing polychondritis. A physician will look at the symptoms, including the pattern of symptoms and when they occur, when making a diagnosis. Doctors look for at least three of the following symptoms to develop:
- Inflammation of one or both ears;
- Inflammation of the nose;
- Inflammation of the eye;
- Swelling in multiple joints;
- Difficulty balancing or hearing; and
- Damage to the cartilage of the respiratory system
Blood tests are used to detect inflammation levels in the body and the possible presence of an autoimmune condition. Because blood tests can have a wide range of acceptable levels, doctors often look at a person’s blood tests over time and when using this as an additional method of diagnosis.
Sometimes a cartilage biopsy is used to examine abnormalities. Biopsy samples usually come from the outer ear. This method of diagnosis is less common and not required for a diagnosis of relapsing polychondritis. Other diagnostic tests can include CT scans of the neck and chest or pulmonary function testing (PFT).
Some cases of polychondritis do not require medical treatment. In mild or early cases, patients may find relief through anti-inflammatory drugs such as NSAIDs. People with moderate or severe cases may benefit from corticosteroids or immune-suppressing drugs. Often corticosteroids are reduced once a patient experiences relief, but sometimes a patient needs to take them for a more extended period. Since the long term use of these drugs can be damaging, this is usually only done in severe cases where a patient does not otherwise experience relief.
If a person’s relapsing polychondritis has caused other symptoms, such as kidney damage or arthritis, treatment must include addressing the additional symptoms. Airway collapse can require surgical intervention. Patients may find they need physical therapy or speech therapy. A healthy lifestyle that consists of a healthy diet and exercise is essential. Some patients have found alternative methods of pain relief to be helpful, such as acupuncture or cognitive behavioral therapy. While these alternative therapies do not change the eventual course of the disease, they can make life more comfortable and enjoyable.
Disability Evaluation of Polychondritis
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 current job for the first two years of the policy and 2) be unable to work in any other position for the years following the initial 2-year period. Every plan is different, so it is important to review your policy for its specific requirements.
Evaluating Disability for People with Polychondritis
A person may not initially be considered disabled by their polychondritis but may qualify as their symptoms become more severe. The higher the severity and scope of symptoms, the better the chance is that a person will be considered disabled by their polychondritis.
Someone may not be able to work in strenuous jobs because of pain, difficulty moving or breathing problems. Inflammation and damage to the throat can cause difficulty speaking, which can disqualify someone from working in many sedentary positions. If the nerves in the inner ear are affected, a person may have difficulty balancing, hearing, or seeing.
Even if their polychondritis is not severe enough to qualify for disability benefits, a person may still be eligible if they have other disabling conditions. Evaluators look at a person’s overall health when making a consideration, so it is essential to list all relevant medical conditions when applying for benefits.
What the Insurance Company Needs From You and Your Medical Providers
You will need to let the insurance company know about any doctors that have treated you for your polychondritis. They will need to get your medical records from those doctors when they are evaluating your claim. You may need to send those records yourself if your insurance company cannot get them from your doctors. If you have other medical conditions that can impact your quality of life, it is essential to include those records as well.
The insurance company will need to see proof of your diagnosis and your ongoing symptoms, as well as evidence of how those symptoms affect your life. 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 a correct RFC for you.
Working with an Experienced Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your polychondritis. 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 polychondritis 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.