What is Psoriasis?
Psoriasis is a chronic autoimmune condition in which the body’s immune system triggers the skin to overproduce skin cells. This causes a buildup of skin in certain areas of the body that is usually seen as red patches covered in flaky white bumps or scales. While they can occur anywhere in the body, the most common places are on the scalp, lower back, and the joints like knees and elbows. Patches may heal and reappear throughout the person’s life.
The most common type of psoriasis is plaque psoriasis, which causes red patched and scaled flaking skin. Pustular psoriasis causes red skin with pus-filled pustules on the hands and feet. Guttate psoriasis mainly affects children and adolescents and is characterized by small red spots on the limbs and torso. Inverse psoriasis causes bright red sores in the folds of the skin and armpits. Erythrodermic psoriasis causes large-scale skin shedding and extremely red sores. It must be treated immediately to prevent severe illness.
Psoriasis is a common skin condition and for many people their symptoms are mild. Some people experience severe psoriasis that can prevent them from their previous life activities. Even though psoriasis is not contagious, people with psoriasis can suffer from the stigma that a visible skin condition carries. People with severe psoriasis may suffer from social isolation or feel that they cannot participate in activities like swimming or sunbathing. Psoriasis may lead to a condition called psoriatic arthritis, which causes swollen and painful joints.
Diagnosing psoriasis can be as simple as a clinical exam by a physician, usually a dermatologist. The doctor may ask about the patient’s family history to see if any family members suffer from psoriasis. A medical history, including previous medications, will also be taken. Some medications are known to trigger psoriasis outbreaks. Diagnostic testing or imaging is usually unnecessary, though skin biopsies may be taken to rule out infections.
Treatments for psoriasis can improve symptoms, but the condition cannot be cured. Treatments can slow the growth of new skin cells, treat itching and pain, or suppress the immune system.
Topical treatments include steroid creams, moisturizers, and coal tar (usually for scalp psoriasis). Prescription creams include retinoid creams, vitamin d ointment, and stronger coal tar solutions. Oral medication may be used alone or in tandem with the topical treatments. Because of the high risk of side effects, oral medication is generally only used in moderate to severe cases. Light therapy can be used in conjunction with other therapies for any level of severity.
Besides treating symptoms, it is important for psoriasis patients to avoid triggers that can cause flare-ups of symptoms. Common triggers include cold weather, stress, infections, and injury. It may be necessary to cut out triggers such as alcohol, tobacco, and certain medications. Some people find relief by following low-inflammation diets.
Disability Evaluation of Psoriasis
Many people find their psoriasis to be inconvenient and uncomfortable, but some people are unable to work or perform normal life activities because of their symptoms. Patients with severe pain, skin infections, and joint pain may be prevented from continuing employment. Patients who find themselves unable to work because of their psoriasis must apply for Long Term Disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
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 complete the work duties of almost any occupation for the years following the initial 2-year period. 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 Psoriasis
Psoriasis is not a condition that is considered automatically disabling. Patients are assessed on a case-by-case basis on how their symptoms prevent them from working. The Social Security Administration (SSA), which handles federal disability claims, considers psoriasis under their dermatitis criteria. To qualify under these criteria, the person must have extensive skin lesions that have lasted for at least three months and have not responded to any treatments. Even if you do not qualify under these criteria, you may still qualify for benefits by other symptoms and conditions or by proving how your symptoms affect your life.
Patients seeking disability payments for their psoriasis will have to prove that they are impacted in a way that they cannot perform their old job or any job that they could be trained to work. To qualify for disability benefits, the condition must prevent the person from working for a least one full year. If they do not meet the qualifications set by the SSA, they will need a Residual Functional Capacity (RFC) assessment that indicates how their symptoms affect and limit their life activities.
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 psoriasis. 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 any 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. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.
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 psoriasis. Even if you have been denied benefits, your chance is not 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 expert 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 one of our experienced disability lawyers about your psoriasis and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and discuss how to help you through the appeal process.