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Primary sclerosing cholangitis, a rare condition affecting the bile ducts, can significantly impact a person’s ability to work. When faced with a denial of a long-term disability claim, we can help you take the necessary steps to secure the financial support you deserve. Call Ortiz Law Firm at (888) 321-8131 for a free case review with a long-term disability attorney.
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.
Symptoms of Primary Sclerosing Cholangitis
Symptoms of PSC can appear like those of 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, and bile salts building up in body tissues can cause chronic itching.
Primary sclerosing cholangitis can cause enlarged liver and spleen in its earlier stages. Hepatic encephalopathy, a decline of brain function resulting 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. Individuals of Northern European descent 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 about symptoms, lifestyle, and medical history. Diagnostic testing can include:
- Imaging tests can show characteristic patterns of widening and narrowing within the bile ducts, which 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 and liver enzymes.
- Urine tests are performed to check for the absence of urobilinogen, which is produced when bile is broken down in the gastrointestinal tract.
Treating Primary Sclerosing Cholangitis
Unfortunately, no medication on the market 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. To receive a liver transplant, you will need a matching donor. Without a transplant from a matching donor, liver failure can be fatal.
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 evaluate their claim to see if they qualify under the plan’s definition of disability.
You Must Meet the Definition of Disability In Your Policy
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 a strenuous job. They may not have the energy to complete tasks, and fatigue may interfere with cognition and concentration. Even sedentary work may be impossible if someone struggles to understand or stay on task. 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, 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 the 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.
Evidence the Insurance Company Needs to Approve Your Claim
Insurance providers typically require definitive proof of your medical diagnosis, ongoing symptoms, and their impact on your daily life to approve a disability benefits claim. You will need to tell your insurance company about any doctors who have treated you for your primary sclerosing cholangitis. They will review your medical records from those doctors when they evaluate 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, you must be sincere and transparent with your healthcare providers.
Specialized disability 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.
A Disability Attorney Can Help You Appeal a Long-Term Disability Denial
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. National disability attorney Nick Ortiz has represented disability claimants since 2005 and can help you, too.
If your long-term disability claim has been denied or terminated, we offer a free disability case evaluation. We will focus on your disability claim so you can focus on your health. There are no fees unless we win your claim. To learn more about how Ortiz Law Firm can help you win your long-term disability appeal and get the benefits you deserve for your primary sclerosing cholangitis, call us at (888) 321-8131.
