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You are here: Home / Practice Areas / Long Term Disability & ERISA Attorney / What Medical Conditions Qualify for Long Term Disability? / Pancreatitis and Long Term Disability Insurance Claims

Pancreatitis and Long Term Disability Insurance Claims

What is Pancreatitis?

The pancreas is a digestive gland placed behind the stomach and between the small intestine and spleen, which can harm functions of metabolism and digestion when it becomes inflamed. Pancreatitis is a condition in which the pancreatic digestive enzymes that are meant to digest food in the small intestine become active in the pancreas instead, which then attacks itself. The illness can be acute, quick and sudden, or chronic, lasting for up to several years and causing serious digestive damage.

Causes of Pancreatitis

The most common causes of pancreatitis are gallstones and excessive alcohol use. Gallstones are crystalline concretions formed of bile in the gallbladder, which often pass through other parts of the biliary tract, which includes the pancreatic duct. Environmental and genetic reasons have also been known to cause pancreatitis along with other common causes like mumps, scorpion venom, certain medications, steroids and trauma to the abdomen.

Symptoms of Pancreatitis

Pancreatitis usually causes severe pain in the upper abdomen that often stretches to the back. Other symptoms include high fever, nausea, vomiting, abnormally rapid pulse, low blood pressure, dehydration, rapid weight loss, and internal bleeding. Chronic pancreatitis may also lead to signs of diabetes or pancreatic cancer. A diagnosis of pancreatitis can often be easily made with an inexpensive abdomen ultrasound, which can clearly see whether or not the pancreas is inflamed and can also detect gallstones and an alcoholic fatty liver.

Treating Pancreatitis

A pancreatitis attack can be a medical emergency, typically requiring hospitalization. If chronic pancreatitis is contracted, the patient may need to be admitted to an intensive care unit. Such hospital visits can cause serious financial difficulty and you may wish to apply for disability benefits from your Long Term Disability Insurance Company. If so, you will need an experienced disability lawyer like Nick Ortiz. Call his office at (888) 321-8131 for more information and assistance.

Disability Evaluation of Pancreatitis

If your pancreatitis prevents you from working, you may qualify for long term disability (LTD) benefits. The insurance company will review claim to see if you meet the definition of “disabled” outlined by your 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 work in almost any job after that. Each LTD plan has a different definition of “disability”, so look over your plan policy to see how your plan determines “disabled.”

Evaluating Disability for People with Pancreatitis

You must prove that your pancreatitis keeps you from doing your old job (or – depending on the language of the long term disability insurance policy –  any job that you could be trained to work ). Your insurance company will evaluate your symptoms from your pancreatitis as well as any other disorders that may affect your ability to work.

The insurance company will also look at the Residual Functional Capacity (RFC) form to determine the extent of your symptoms and how they may keep you from working.

What the Insurance Company Needs From You and Your Medical Providers

You should tell the insurance company about any doctors you may have seen for your pancreatitis. 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. You should include the physician notes from doctor visits as well as the records from any diagnostic testing. Important documents to include are:

  • Physician notes
  • Diagnostic test results
  • Blood tests

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

A knowledgeable disability attorney will give you the best chance of getting the disability benefits you deserve for your pancreatitis. Even if you have previously been denied, that does not mean you are out of options. It is not unusual to be denied the first time you 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 intimidating, your disability attorney is an expert on the process. You can seek help without worrying about upfront costs or unexpected bills because they are paid out of any awarded funds.

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 pancreatitis 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.

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