Peripartum Cardiomyopathy and Long Term Disability Insurance Benefits

What is Peripartum Cardiomyopathy?

Peripartum cardiomyopathy is a rare heart condition caused by pregnancy. The heart muscle becomes weak and enlarged in the last month of pregnancy and up to six months after delivery. While there is no singular cause, risk factors include obesity, substance abuse, viral infections, and coronary heart disease. Women who have had multiple children or who have children later in life are also more likely to develop peripartum cardiomyopathy. African American women are more likely to develop the condition than other racial groups.

Symptoms of peripartum cardiomyopathy include swelling in the legs and feet, shortness of breath, and generalized weakness. Since mild symptoms also present like typical symptoms in late-stage pregnancy, symptoms may be overlooked. Sometimes symptoms become suddenly severe shortly before, during, or after birth.

Most women recover quickly and experience no lasting symptoms. Recovery generally occurs between two weeks to six months after giving birth. In rare cases, women can experience symptoms past this period. They may recover some, but not all, heart function.

Diagnosing Peripartum Cardiomyopathy

Ejection fraction, or the amount of blood the heart can pump with each beat, is used to diagnose peripartum cardiomyopathy. It measures how effectively the heart can work. Ejection fraction is measured by:

  • Echocardiogram
  • Cardiac catheterization
  • Magnetic Resonance Imaging (MRI)
  • Computerized tomography (CT) scan
  • Nuclear medicine scan

Doctors may also use additional testing to rule out other causes of symptoms, such as blood tests for diabetes and other conditions.

 Treating Peripartum Cardiomyopathy

Many women are put on bed rest while they are experiencing symptoms, particularly before birth. If they have not recovered enough heart function after giving birth, they may not be able to leave the hospital until they are stable. Medications to support heart function and remove extra fluid from around the lungs may be necessary. Beta-blockers and diuretics are the most common prescription medication.

In severe cases, surgical interventions may be necessary. Surgeons may drain fluid from the chest or, in very rare cases, perform a heart transplant.

Women with peripartum cardiomyopathy should give birth in a hospital, as symptoms can become suddenly severe and require medical attention. Depending on the severity of symptoms, having additional children may not be recommended. Even in mild cases, becoming pregnant can trigger heart failure.

Disability Evaluation of Peripartum Cardiomyopathy

Peripartum cardiomyopathy can prevent some people 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 Claimants with Peripartum Cardiomyopathy

Since most women recover within six months, many with peripartum cardiomyopathy would not qualify for long-term disability benefits. However, women who are severely affected for longer than 6 months may qualify for “long term disability” benefits.

Severe peripartum cardiomyopathy can include all the limitations of any other type of heart failure. Women may be too exhausted and unable to perform strenuous physical activity or perform even mild physical activity over an extended period. Bending, lifting, and carrying heavy objects can trigger symptoms. Women with peripartum cardiomyopathy may require periods of bed rest or hospitalization, which can prevent them from working even sedentary jobs.  

Even if their peripartum cardiomyopathy is not severe enough to qualify for disability benefits, a person may still be eligible if they have other disabling conditions. The insurance claims adjuster will review the claimant’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 peripartum cardiomyopathy. 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.  

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 an accurate RFC for you.

Working with an Experienced 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 peripartum cardiomyopathy.

The experienced disability attorneys at the Ortiz Law Firm can help you through the process, from appeals to potential litigation. They only get paid 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 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 850-308-7833.