Heart Attack and Long Term Disability Insurance Claims

What is a Heart Attack?

A heart attack, also called a myocardial infarction, is a severe medical event that requires immediate treatment. During a heart attack, the normal blood flow to the heart is blocked. This blockage is usually caused by fatty deposits in the arteries called plaque. Plaque is typically attached to the walls of the arteries but can break off into chunks called clots. These clots can block off the artery, causing the tissue that no longer receives blood flow to become damaged or destroyed.

There are sometimes warning signs that a person is leading up to a heart attack. One of the early symptoms is angina, or chest pain, that gets worse with exertion and better with rest. Symptoms of a heart attack can present as symptoms of other conditions, such as heartburn, so patients may not immediately realize that they have a heart attack. Symptoms can include:

  • Chest pain and pressure that can spread into the arms and back
  • Abdominal pain
  • Difficulty breathing
  • Dizziness
  • Fatigue
  • Confusion
  • Nausea, indigestion, and heartburn

Not every patient experiences the more stereotypical symptoms of a heart attack. Symptoms of a heart attack can be different in men and women. Women are more likely to experience more generalized symptoms, such as difficulty breathing.

Coronary heart disease is the primary cause of heart attacks. Spasms in the arteries can also cause a heart attack. These spasms are usually a result of drug use. High cholesterol and blood pressure are risk factors for developing a heart attack. Diabetes, preeclampsia, and autoimmune conditions can also put a person at risk of developing a heart attack. If a person is obese, sedentary, or experiences high levels of stress, they are more likely to develop a heart attack.

Diagnosing a Heart Attack

Heart attacks are generally diagnosed in the emergency room when the person receives emergency treatment. If the person is conscious, the doctor will take a medical history and listen to the patient’s symptoms. If the person is not conscious, they will have to rely on diagnostic testing alone. Diagnostic tests can include:

  • Blood tests to check for proteins that are released when the heart muscle is damaged
  • Electrocardiogram (ECG) to check for irregular heart rhythms that occur because of a heart attack

Once a heart attack is diagnosed, additional testing is often ordered to check for the areas and extent of the damage. This can include chest x-rays, echocardiograms, and a cardiac MRI or CT scan.

Rarely, heart attacks may be diagnosed after the fact when a doctor is examining the heart. These are most often cases of minimal damage to the heart since severe heart attacks can be fatal.

Treating a Heart Attack

Heart attacks require immediate emergency treatment. The faster the person receives medical attention, the better the chances of surviving the heart attack and receiving less damage to the heart muscles. While waiting for other medical treatment, a doctor may recommend taking a nitroglycerin tablet or aspirin. Medications to dissolve the clot are often administered, along with blood thinners to reduce the chances of the clot redeveloping. Sometimes pain medications are given if the patient is experiencing severe pain.

If medications do not adequately treat the heart attack, surgery may be necessary. A surgeon can perform a cardiac angioplasty and stenting, where a catheter can open a blocked artery and a stent is inserted to keep the artery open. Bypass surgery can be performed both during and after a heart attack. During bypass surgery, the arteries and veins are surgically rerouted around the blockage.

Heart attacks can lead to complications, which can be fatal. If the heart attack damages too much of the heart muscle, the heart may be unable to pump enough blood or may even stop beating. Heart attacks can cause dangerous heart rhythms and arrhythmias. If the electrical system of the heart stops working correctly, the person will experience heart failure, which is fatal without immediate intervention.

Cardiac rehabilitation programs are successful at helping a person recover from a heart attack and preventing future heart issues. Medications can reduce a person’s likelihood of developing a heart attack or having another one. Lifestyle changes, such as losing weight and exercising, can reduce the risk of heart attack and improve the heart function after one. Managing a chronic condition that can lead to heart attacks is crucial to both overall health and preventing complications.

Long Term Disability Evaluation of Heart Attacks

A heart attack can lead to symptoms that prevent someone from working. People who cannot work may qualify for Long Term Disability (LTD) benefits. The insurance company will review their claim to see if the medical problems qualify for benefits under the terms of that specific disability plan.

Definition of Disability

Most LTD plans consider a person disabled if the claimant has a medical condition that causes the claimant to (1) be unable to perform his or her own occupation 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. Some plans are a bit different, so it’s essential to understand your specific policy and its limitations when applying for benefits.

Evaluating Long Term Disability Claims For Individuals Who Have Experienced a Heart Attack

A heart attack is not automatically disabling. Some people can return to normal functioning as soon as they recover from their heart attack. However, depending on the severity of symptoms, others may be unable to work or perform normal life activities after a heart attack and may qualify for disability benefits.

Angina, chest pain that gets worse with exertion and better with rest, can be a lasting symptom after a person experiences a heart attack. If a person has severe angina, they may be unable to complete even basic tasks without having long rest periods. Workplaces may be unable to accommodate these rest breaks. Shortness of breath can cause issues with strenuous jobs and even simple tasks such as getting up from a seated position. Pain and other symptoms can cause difficulties in concentrating or completing work.

Even if the symptoms of a heart attack are not enough to qualify for disability benefits on their own, a person may still be eligible when considering all of their medical conditions in combination. Side effects of medications should also be listed, as they can interfere with work tasks. It is essential to include all relevant information when submitting a claim for long-term disability benefits.

What the Insurance Company Needs From You and Your Medical Providers

You will need to tell the insurance company about all of the medical providers that have treated you for your heart attack. They will need to get your medical records from those doctors when they are evaluating your claim. You should include diagnostic testing, treatment records, and records of ongoing medical care to treat you for your heart attack. If you have other medical conditions, you should include those records as well. If the insurance company cannot get those records directly, you may need to get them from your doctors and send them in yourself.

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 Experience 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 obtaining the benefits you deserve for your heart attack.

The experienced disability attorneys at the Ortiz Law Firm can help you respond to a wrongful denial or termination of a claim, and can assist in the appeals process. They are only paid a fee if you win. 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 treating your medical problems.

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.


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