Patients with syringomyelia may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their syringomyelia 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 Syringomyelia?
Syringomyelia is a medical condition where fluid-filled cysts, called syrinx, form inside a person’s spinal cord. When the normal flow of cerebrospinal fluid that protects the brain and spinal cord is blocked, it can enter the central spinal cord canal and create a cyst. It can be caused by Chiari malformation or spinal trauma.
Chiari I malformation pushes part of the brain downward into a person’s spinal canal which blocks the normal flow of fluid between the brain and the spine, creating a cyst in some patients. Post-traumatic syringomyelia occurs when a cyst forms in a damaged part of the spinal cord. It can be caused by any of the following:
- Tethered spinal cord;
- Spinal tumors;
- Spinal cord injuries;
- Meningitis; or
- Swelling of the spinal cord covering.
When syringomyelia happens for unknown reasons, doctors call it idiopathic syringomyelia.
Disability Evaluation of Syringomyelia
Long term disability companies most commonly refer to the CDC (Center for Disease Control) to evaluate syringomyelia. The CDC recognizes syringomyelia if your symptoms have no other physical cause, have a definite onset date, and substantially interfere with your school, work, personal, or social activities. You must also experience at least four of the following symptoms for six months or longer:
- Uncoordinated movements;
- Involuntary muscle contractions and twitches;
- Rapid changes in blood pressure levels;
- Paralysis for severe cases;
- Shoulder or neck pain, and sometimes hand or arm pain;
- Piercing, burning, tingling, or numb feeling;
- Muscle weakness in the shoulders, hands, or arms;
- Inability to feel cold and hot in the upper chest, arms, hands, or fingers;
- Excessive sweating;
- Changes in bladder and bowel function; and
- Scoliosis (curvature of the spine).
Syringomyelia can also cause Horner syndrome if the cyst damages the nerve that controls the muscles in the face and eyes. Symptoms include decreased sweating on the affected side of the face, reduced pupil size, narrowing of the opening between the eyelids, or droopy eyelids.
Your medical records should document the above criteria to prove your diagnosis and show that your symptoms didn’t start before the onset of syringomyelia.
Definition of Disability
An individual is considered disabled under most long-term disability policies if she or he is (a) unable to perform the job duties of her or his primary occupation for the first two years of the policy; and (b) unable to perform the job duties of any occupation after the first two years of the policy. Each individual policy defines disability differently, so review your own LTD policy to discover how “total disabled” and “disability” are defined in your case.
Proof of Syringomyelia
You will need to submit medically acceptable laboratory and clinical findings with your application to prove the existence of your syringomyelia. Symptoms and a simple diagnosis are not enough, though the effects of your symptoms may be taken into consideration when the insurance company decides whether you are disabled.
Evaluating Disability for a Syringomyelia Diagnosis
The insurance company will assign an insurance adjuster, called an adjudicator, to your claim. With the help of a psychologist, physician, or another medical disability examiner, he or she will give an opinion on your level of impairment. You may be required to have a compulsory medical examination or functional capacity evaluation. The adjudicator will then look at all of the available evidence, from treatment to the impact of the illness on your body.
If the adjudicator finds that there’s not enough evidence to make a formal decision, you may be contacted to provide additional documentation. In some cases, you can submit this information yourself. In others, an independent medical source may be required.
While your doctor may diagnose syringomyelia based on symptomatology, you’ll need medical tests to back it up to qualify for long-term disability. The insurance company will want reports documenting your objective laboratory and clinical findings, so be sure your physician submits everything available concerning your condition, even if they may point to another disorder or condition.
Disability Attorney For Syringomyelia
Syringomyelia can be a painful and debilitating disorder. If you suffer from these unwanted cysts or another mental or physical disorder that keeps you from adequately performing your job duties, long-term disability benefits can be financial help. Sadly, these benefits can be difficult to obtain, so speaking with legal counsel is imperative.
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your syringomyelia. 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 syringomyelia 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.