Patients with dystonia may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their dystonia 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 Dystonia?
Dystonia is a neurological movement disorder characterized by uncontrolled muscle contractions. These contractions can make the affected body part experience cramping, irregular movements, or abnormal postures. Dystonia can affect just one body part (focal dystonia), two or more adjoining body parts (segmental dystonia), or the entire body (general dystonia). The condition can occur either by itself or as a result of another condition or disease.
The early signs of dystonia are usually mild and occur only during certain activities. Symptoms can vary depending on which body part is affected. For instance, dystonia affecting the eyelids can cause rapid or irregular blinking or the eyes to close randomly. If the tongue or throat is affected the person can experience slurred speech, difficulty swallowing, or drooling. Symptoms often become worse with stress or fatigue. Over time, the symptoms can worsen or spread to other areas of the body.
Complications can vary depending on which parts of the body are affected. Pain, stiffness, and fatigue can result from muscle contractions. Changes in mood and ability to concentrate can be a particularly distressing symptom for patients. Difficulty eating or speaking can result. Any person living with dystonia can experience social anxiety and depression from the symptoms.
People experiencing dystonia should see their physicians as soon as possible as it could be the result of a serious illness. Dystonia can be diagnosed from a clinical exam and patient medical history. Diagnostic tests are used to determine the root cause and can include:
- Blood and urine tests to screen out poisoning and toxicity;
- MRI to see any abnormalities like lesions, scarring, or signs of a stroke; and
- Electromyography (EMG) to test how well the muscles respond to an electrical stimulus.
Dystonia is not curable, but some treatments can help. Working to eliminate symptom triggers and lessen stress can also help reduce the occurrence and severity of symptoms. Medications, physical therapy, and surgery are all options for treatment. Botox injections can decrease or eliminate troublesome muscle movements. Oral medications target the brain chemicals responsible for muscle movement. Physical therapy can lessen symptoms, improve working function, and ease the pain. As a last resort, surgery is used to sever or control the nerves or specific regions of the brain.
Disability Evaluation of Dystonia
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 work duties for the first two years of the policy and 2) be unable to work in almost any job for the following years. Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled.”
Evaluating Disability for People with Dystonia
Patients seeking disability benefits for dystonia must prove that they are impacted in a way that they cannot perform their old job (or depending on the language of the long term disability insurance policy – any job that they could be trained to work). The insurance company will look to see if the patient’s symptoms are so severe as to prevent full time employment, and to see if the medical records support that level of impairment.
The primary qualifier for many patients seeking disability benefits will be the Residual Functional Capacity (RFC) assessment that indicates how dystonia affects and limits their life activities. You may not be able to use fine motor skills for a long period of time, preventing you from working at a job that requires a lot of writing, typing, or using your hands. If you have difficulties speaking, even a call center job may be out of the picture. The irregularity and unpredictable nature of symptoms can prevent many people from working if their symptoms are severe.
If your dystonia is caused by another condition, you may be meet disability requirements for that condition. You may be eligible for benefits even if your dystonia is not severe enough to qualify.
What the Insurance Company Needs From You and Your Medical Providers
You should tell the insurance company about any doctor that has treated you for your dystonia or related conditions. The insurance company will need to obtain all relevant medical records to get the full picture of your health. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself.
Your doctors should send their complete exam notes and all relevant medical testing and lab results. You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. 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.
Working with a Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your dystonia. If you have been denied disability benefits, do not lose hope. 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 expert disability attorney will be able to guide you through the process. Since they receive their payment from awarded funds, they do not get paid unless you win your case. You can seek help without worrying about upfront costs or unexpected bills.
Work With an Experienced Long Term Disability Attorney
The Ortiz Law Firm has successfully represented people in disability cases across the United States. We have represented claimants in claims with Cigna, Hartford, Lincoln, MetLife, Prudential, Reliance Standard, Unum, and a variety of other disability insurance companies. If you would like to talk to one of our experienced disability lawyers about your dystonia 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.