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You are here: Home / Practice Areas / ERISA Long-Term Disability Attorney / Medical Conditions that Qualify for Long Term Disability / Primary Sclerosing Cholangitis and Long Term Disability

Primary Sclerosing Cholangitis and Long Term Disability

What is Primary Sclerosing Cholangitis?

Primary sclerosing cholangitis (PSC) is a rare liver disease that involves hardening and inflammation of the bile ducts within and around the liver. PSC is a progressive disease, often leading to primary biliary cirrhosis (also known as primary biliary cholangitis or PBC) within 10 to 15 years. Like other forms of chronic liver disease, PSC and PBC can cause troublesome symptoms that may eventually lead to liver failure. If you suffer from primary sclerosing cholangitis you may qualify for disability benefits.

Primary Sclerosing Cholangitis and Long Term Disability Claims

Primary sclerosing cholangitis may prevent someone from working, especially at the later stages of the disease. People who cannot work due to PSC should apply for Long Term Disability (LTD) benefits. The disability insurance company will conduct an evaluation of their claim to see if they qualify under the plan’s definition of disability.

Definition of Disability

Most disability insurance 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 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 Disability for People Who Have Primary Sclerosing Cholangitis

The severe fatigue associated with decreased liver function may keep someone from working in a strenuous job, as they may not have the energy to complete tasks, and fatigue may interfere with cognition and concentration. If someone is struggling to understand or stay on task, even sedentary work may be impossible. Patients may need to miss periods of work for treatment. In cases where liver transplants are necessary, long stretches of hospitalization and rest are required.

Primary sclerosing cholangitis can also lead to severe complications. Colon and bile duct cancer, which are both possible results of PSC, can be disabling. Repeated infections can lead to extensive treatments. If an infection is a concern, a person may not be able to work in an environment that can cause transmission of diseases such as a hospital or pharmacy setting.

Since primary sclerosing cholangitis can lead to other severe forms of liver disease, it is vital to communicate to the insurance company the entire picture of your health. Even if your PSC alone is not severe enough to be considered disabling, you may still qualify for disability benefits when your other conditions are taken into consideration.

Documentation Requirements for Disability Benefit Approval by Insurance Companies

To secure approval for a disability benefits claim, insurance providers typically require definitive proof of your medical diagnosis, ongoing symptoms, and their impact on your daily life. You will need to tell your insurance company about any doctors that have treated you for your primary sclerosing cholangitis. They will need to review your medical records from those doctors when they are evaluating your claim.

While you might assume that your medical records would suffice, these documents are often too concise to provide a detailed account of your symptoms. In many cases, additional evidence in the form of a Residual Functional Capacity (RFC) assessment may be necessary to augment your existing medical records and strengthen your claim for disability benefits.

An RFC assessment serves as a valuable resource in this context. It outlines how your medical condition affects you and identifies the types of work activities you may still be capable of performing despite your limitations. For the most accurate RFC, it’s vital to be completely honest and transparent with your healthcare providers. Specialized law firms like Ortiz Law Firm can even generate customized RFC forms tailored to the unique aspects of your medical condition.

By providing detailed and accurate information and ensuring that the insurance company has a clear picture of your limitations and capabilities, you improve your chances of a successful disability claim.

Symptoms of Primary Sclerosing Cholangitis

Symptoms of PSC can appear like any other chronic liver disease. Fatigue, fever, chills, loss of appetite, unexplained weight loss, and pain in the upper abdomen all point to liver disease. In cases of severe bile duct obstruction, bile can leak into the bloodstream. Bile salts building up in body tissues can cause chronic itching.

In its earlier stages, primary sclerosing cholangitis can cause enlarged liver and spleen. Hepatic encephalopathy, which is a decline of brain function with results from an accumulation of toxins in the blood, is another risk associated with PSC. If it is not adequately treated, PSC can lead to cirrhosis and possibly end-stage liver failure. People with PSC are at a higher risk of getting cholangiocarcinoma (bile duct cancer).

Approximately 80% of patients with PSC have inflammatory bowel disease, more commonly ulcerative colitis than Crohn’s disease. Some research suggests that PSC may also be an autoimmune condition. People who are related to someone with a history of primary sclerosing cholangitis or who have been exposed to certain environmental toxins are more likely to develop the disease. People who are descendants of Northern Europeans are also at a higher risk of developing the condition.

Diagnosing Primary Sclerosing Cholangitis

Since symptoms of PSC can look like symptoms of other liver conditions, such as PBC, doctors must determine which condition is causing symptoms. A doctor will examine the patient and ask questions about symptoms, lifestyle, and medical history. Diagnostic testing can include:

  • Medical imaging tests can show the characteristic patterns of widening and narrowing within the bile ducts that resemble beads on a string.
  • Endoscopic retrograde cholangiopancreatography (ERCP), where contrast is injected directly into the bile ducts so that X-rays will show narrowing and hardening of the tissue.
  • Blood tests for elevated bilirubin, liver enzymes.
  • Urine tests for an absence of urobilinogen, which is produced when bile is broken down in the gastrointestinal tract.

Treating Primary Sclerosing Cholangitis

Unfortunately, there is not a medication that is on the market that can prevent this chronic liver disease from progressing to the end-stage. Most treatment for PSC is focused on minimizing symptoms. Once the liver is no longer functioning correctly, a liver transplant is necessary. In order to receive a liver transplant, you will need a matching donor. If a match is not found, liver failure can be fatal.

Working With a Disability Attorney

If you are unable to work due to primary sclerosing cholangitis or some other form of chronic liver disease you may qualify for disability benefits. Fortunately, you do not have to fight your insurance company alone.

The experienced disability attorneys at the Ortiz Law Firm can help you obtain the disability benefits you deserve. Your attorney will only get paid if you win, so you can seek help without worrying about upfront costs or unexpected bills. Our law firm will focus on your disability claim so you can focus on your health.

Ortiz Law Firm would welcome the opportunity to review your disability claim to see how we can help you qualify for disability benefits. To see how we can help you win your long-term disability and get you the benefits you deserve for your primary sclerosing cholangitis, call us at (888) 321-8131. We offer a free disability case evaluation if your long-term disability claim has been denied or terminated.

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