Long Term Disability for Scleritis
Scleritis may prevent someone from working. People who cannot work 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 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 look over your policy to see how it determines disability.
Evaluating Disability for People with Scleritis
Scleritis can cause permanent changes in vision and lasting eye pain. While there are accommodations that can be made for a blind person in the workplace, it is generally much harder for people with severe vision loss to find and maintain employment. There are some jobs that a person with a loss of vision may be unable to perform, such as a driver or anything involving dangerous machinery. Because lights often exacerbate eye pain, someone with scleritis may be unable to work with computers or in a workplace that is not dimly lit. Even traveling to a workplace may cause severe eye pain in someone with lasting photophobia.
Even if their scleritis 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 scleritis. 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 important 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.
What is Scleritis?
The sclera, sometimes called the “whites of the eyes,” is the dense white part of the eye. It makes up 80% of the surface area of the eye, extending from the front portion surrounding the cornea to the back of the eye that includes the optic nerve. Because of its rigid and sturdy composition, it helps maintain the proper shape of the eye as well as protecting the inner potions of the eye from damage or injury. The outermost part of the sclera, called the episclera, is the part of the eye that is generally affected by mild eye conditions such as pinkeye.
Scleritis is a severe inflammation of both the sclera and the episclera. It is a more painful and serious condition than the more common cases of eye inflammation, which usually affect only the episclera. Scleritis most commonly affects women aged 30-50 years old that have connective tissue disorders or disorders that involve chronic inflammation.
There are three types of scleritis: diffuse, nodular, and necrotizing. Diffuse scleritis, the most common and benign type of scleritis, includes widespread inflammation of the eye tissue. Nodular scleritis causes hard nodules of inflammation within the tissue. Necrotizing scleritis, the most severe, can cause perforations of the eye globe and even severe enough destruction of eye tissue to lead to the removal of the eye.
All types of scleritis involve similar symptoms. Often patients experience increasingly severe eye pain before any signs of inflammation or irritation are visible. Pain can be so severe that patients may be unable to sleep or eat. Patients may suffer from worsening eye pain in the presence of light, even dim ones. Eye redness and swelling can affect a part of or the entire eye. Excessive tear production, blurry vision, loss of vision, and the inability to move the eye can also result.
Since the sclera makes up most of the visible sections of the eye, it is often easy to immediately tell if someone has a condition affecting the sclera and episclera. Even if some symptoms are readily apparent, a physician must still examine a patient and perform diagnostic testing to make a diagnosis of scleritis.
During a clinical exam, a physician will collect information on the patient’s medical history and their symptoms. Slit-lamp examination is used to examine the sclera more closely. Smear testing may be ordered to check for infectious scleritis.
Additional testing may be ordered to rule out other conditions that could cause similar symptoms. Medical imaging tests such as MRIs and CT scans of the head can rule out tumors and pseudotumors, while blood tests may rule out conditions such as thyroid ophthalmopathy. Once a diagnosis of scleritis is confirmed, a doctor may order further tests to determine what may be causing the scleritis. Depending on the patient’s medical history, this can include bloodwork to test for autoimmune conditions or x-rays to check for rheumatoid arthritis.
Since scleritis can cause permanent damage to the eye, it is crucial to treat scleritis as soon as possible. Steroids, both oral medications and eye drops, are the first line of treatment. Non-steroid anti-inflammatory drugs, such as Ibuprofen, are usually prescribed to treat pain and inflammation. Immunosuppressant drugs are prescribed in cases where the patient has a systemic vascular disease or eye lesions. If medications do not adequately address the condition, surgery may be necessary. Surgery can include corneal grafting, surgical reinforcement of the eye tissue, or removal of the affected eye.
Working with a Disability Attorney
You do not have to fight the insurance companies alone. An experienced disability attorney will guide you through the process and give you the best chance of getting the benefits you deserve for your scleritis.
The Ortiz Law Firm is experienced in disability law and can help you through every step of the process, from initial application to potential appeals. You can seek help without worrying about upfront costs or unexpected bills. Our law experts will focus on your case so you can focus on your illness.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. To see how we can help you win your long-term disability case, call us at (888) 321-8131.