Polymyositis can cause serious muscle weakness that makes working impossible—but proving this to a disability insurance company isn’t always easy. This post explains how polymyositis is diagnosed, what evidence insurers look for, and how you can strengthen your long-term disability claim.
What Is Polymyositis?
Polymyositis is a rare inflammatory disease that causes weak muscles on both sides of your body. This disease can make it difficult for you to reach overhead, lift objects, rise from a seated position, or climb stairs.
Polymyositis is most commonly found in adults between the ages of 30 and 60 and occurs in black people and women more often than white people and men. Symptoms usually develop gradually over time, from several weeks to several months.
The medical field has yet to discover the exact cause of polymyositis, but it acts like autoimmune disorders, where your immune system will mistakenly attack your own body tissues. There is no cure for polymyositis, but treatment can help you improve your muscle function and strength.
Diagnosing Polymyositis
A diagnosis of polymyositis might require that you submit to the following tests:
Blood Tests: These are conducted to identify indications of muscle inflammation and to detect unusual proteins associated with autoimmune diseases.
Electromyelogram (EMG): This test is performed to detect abnormal electrical activity in the impacted muscles.
MRI: Utilizing powerful magnets and advanced computer imaging, this test identifies areas of inflammation within the body.
Muscle Biopsy: Small tissue samples are extracted and then examined under a microscope to gain further insights.
Long-Term Disability Claims for Polymyositis
The long-term disability (LTD) insurance company bases its decision on the information you and your doctors provide during the application and appeals processes. The following information will give you tips on what the insurance company is looking for when evaluating your LTD claim based on polymyositis.
The Definition of Disability
You are considered disabled under most LTD policies if you are (1) unable to perform your work duties at your current occupation for the first two years of the policy, and (2) unable to perform the job duties of any occupation you might qualify for after the first two years of the policy. The disability definition varies with each individual policy, so please review your own long-term disability policy to find out how “totally disabled” and “disability” are defined in your specific case.
Providing Proof of Polymyositis
To apply for LTD benefits, you must submit medically acceptable laboratory and clinical findings to prove the existence of polymyositis. While the effects of your symptoms may be considered during the insurance company’s disability decision, symptomatology and a simple diagnosis are not enough for approval.
Evaluating Disability Due to Polymyositis
Some insurance policies require reports documenting objective laboratory and clinical findings. While your physician may diagnose your polymyositis using your stated symptoms, your diagnosis may need to be backed up with objective evidence to receive LTD benefits.
The LTD insurance company will assign an insurance adjuster to review your claim. They may also work with a medical professional to form an opinion about your level of impairment. You may also be required to attend an independent medical exam or a functional capacity evaluation.
Working with an Experienced Long-Term Disability Attorney
Working with an experienced disability lawyer will give you the best chance of getting the benefits you deserve for your polymyositis. We know the process can be daunting, but we will guide you through it. W have successfully represented disability claimants across the United States, and we do not get paid until you win your case. If you would like to talk to an experienced disability attorney about your LTD denial, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how we can help you through the appeal process.
