Understanding Disability Claims for Restless Legs Syndrome

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder that causes an irresistible urge to move the legs. This urge is often accompanied by unpleasant sensations, such as itching, tingling, or a crawling sensation. These symptoms usually worsen in the evening or at night, making it difficult to fall asleep or stay asleep.

Because RLS can severely disrupt sleep, it frequently leads to daytime fatigue, difficulty concentrating, and decreased productivity. In more severe cases, the persistent discomfort and sleep loss can interfere with daily activities, making it difficult or even impossible to maintain regular work routines. For many people, this necessitates filing disability claims for restless legs syndrome.

What Causes Restless Legs Syndrome?

Researchers have yet to pinpoint an exact cause for restless legs syndrome, but genetics may play a role, especially if symptoms begin before the age of forty. There is also evidence suggesting a link between iron deficiency and RLS, and some women may experience symptoms during pregnancy, though these often resolve after childbirth.

Common Risk Factors

Some of the most notable contributors and risk factors for RLS include:

• Family History: There is evidence that RLS tends to run in families, particularly when symptoms appear before the age of 40. This suggests a possible genetic component, though the specific genes involved are still under investigation.
• Iron Deficiency: Low levels of iron in the brain are strongly linked to RLS symptoms. Even individuals who aren’t technically anemic can experience restless legs if their iron stores are low.
• Chronic Conditions: Certain health issues can be associated with RLS. These include peripheral neuropathy (nerve damage), chronic kidney disease, multiple sclerosis, and Parkinson’s disease.
• Pregnancy: Some women find that RLS appears for the first time during pregnancy, especially in the third trimester. The good news is, symptoms often disappear within a month after delivery.

Understanding your personal risk factors can be a helpful step in managing or even reducing your symptoms.

Symptoms and Complications

While anyone can develop RLS at any age, symptoms often become more severe with increasing age. Restless legs syndrome is characterized by the following symptoms:

The condition typically strikes during periods of rest—especially when sitting or lying down—and is temporarily relieved by movement, such as walking or stretching.

While RLS is primarily a neurological condition, it can sometimes occur alongside other medical issues. For instance, people with neuropathy, iron deficiency, or kidney failure may be more prone to experiencing RLS symptoms.

Certain lifestyle factors—such as the use of alcohol, tobacco, and caffeine—can also aggravate or trigger symptoms. Additionally, pregnancy is known to cause temporary restless legs syndrome in some individuals, typically resolving within about a month after delivery.

These connections can complicate both diagnosis and management, making it important to consider underlying causes or contributing factors when seeking treatment.

In severe cases, RLS can lead to mental health problems such as depression and anxiety, due to chronic sleep deprivation and constant discomfort.

How RLS Is Diagnosed and Documented

Because there are no specific diagnostic tests for restless legs syndrome, your doctor will rely on a thorough evaluation of your symptoms. This often involves:

• Clinical Assessment: Your doctor will conduct a physical exam and discuss your symptoms in detail, including when they occur and how severe they are.
• Blood Work: Tests may be ordered to rule out conditions like iron deficiency, which can cause or worsen RLS symptoms.
• Sleep Specialist Referral: If sleep disturbances are significant, your doctor may refer you to a sleep specialist for additional evaluation.
• Exclusion of Other Conditions: It’s important that your healthcare provider rules out other possible causes before confirming an RLS diagnosis.

By ensuring your medical records clearly outline this diagnostic process, you’ll strengthen your claim and help demonstrate the impact of RLS on your daily life and ability to work.

Qualifying for Long-Term Disability Benefits with RLS

If you have severe restless legs syndrome (RLS), the primary concern for most professionals is whether it prevents you from performing your job duties consistently and reliably. That is the central issue in most long-term disability (LTD) insurance claims.

Unlike Social Security, LTD claims are governed by the specific language in your disability policy. Many policies define disability during the first 24 months as the inability to perform the material duties of your own occupation. After that period, the definition often changes to whether you can perform any occupation.

With RLS, the disabling impact is often tied to:

• Chronic sleep disruption and resulting daytime fatigue
• Impaired concentration and cognitive slowing
• The need to frequently move, stretch, or walk
• Inability to sit still for prolonged periods
• Reduced productivity and reliability

Even if you technically remain employed, the real question is whether you can perform your occupational duties in a sustained, competitive manner.

Medical Evidence to Support Your RLS Claim

To support an LTD claim based on RLS, strong medical documentation is critical. This typically includes:

• Medical records confirming diagnosis, symptom severity, and treatment attempts
• Sleep studies showing objective evidence of disrupted sleep
• Treatment history, including medications such as dopamine agonists or anticonvulsants, and documentation of side effects
• Functional limitations, ideally supported by a well-completed Residual Functional Capacity (RFC) form that explains how your symptoms translate into work-related restrictions

The most common mistake I see claimants make is focusing only on the diagnosis instead of clearly documenting how RLS prevents them from performing the specific duties of their occupation.

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How Social Security Disability (SSDI) Fits In

The Social Security Administration does not have a specific listing for RLS. Instead, the condition must prevent you from performing any substantial gainful activity for at least 12 months. This is a stricter standard than most LTD “own occupation” definitions.

So why does Social Security Disability Insurance (SSDI) matter to your LTD claim? Many LTD policies require you to apply for SSDI. If you are approved, your LTD insurer may reduce your monthly benefit by the SSDI amount (an offset).

However, SSDI approval does not automatically guarantee LTD approval. Insurance companies often conduct their own review and apply their policy definitions differently.

For claimants with severe RLS, both claims should be handled strategically, with consistent medical evidence that clearly explains how sleep disruption, fatigue, and functional limitations prevent sustained work activity.

Tips for a Successful Disability Claim

Navigating the complexities of disability claims can be overwhelming, especially when dealing with the debilitating symptoms, but following these tips can help you build a strong case.

1. Keep Detailed Records: Document all your symptoms, treatments, and how RLS affects your daily life.
2. Follow Your Doctor’s Advice: Consistently follow prescribed treatments and attend all doctor’s appointments.
3. Communicate Clearly: Describe how RLS affects your ability to work, focusing on the physical and emotional toll.

Medical tests tell the insurance company what you have, but your daily experience proves how it disables you.

How to Create a Symptom Diary That Insurers Can’t Ignore

This is where a detailed symptom diary becomes one of the most powerful tools for your long term disability claim. Think of it less as a personal journal and more as a legal logbook. Every day, document the severity of your leg sensations, the hours of sleep you lost, and the intensity of your daytime fatigue on a scale of 1 to 10.

The most critical step, however, is to explicitly connect a bad night to a bad workday. Your log shouldn’t just say, “Slept 2 hours.” It needs to say, “Slept 2 hours due to leg sensations; as a result, I arrived 30 minutes late to work and couldn’t focus in the afternoon meeting, forcing me to ask a colleague to finish my report.” This creates a clear cause-and-effect chain that an insurance adjuster cannot easily dismiss.

Because so much of your struggle happens when no one is watching, a witness statement adds crucial validation. This is a letter from a spouse, partner, or family member describing what they see firsthand—the constant pacing at 3 a.m., the distress, and the visible exhaustion the next day. It provides powerful, third-party confirmation of how RLS symptoms are affecting your sleep and concentration, corroborating the story your diary tells.

Together, your meticulous log and a compelling witness statement transform your claim from a simple diagnosis into a vivid, undeniable picture of daily disruption. They provide the human context for the medical data, building a comprehensive case that shows exactly why you can no longer perform the duties of your job.

Why Insurers Often Deny RLS Claims (And How to Speak Their Language)

The biggest hurdle in getting disability for restless legs syndrome is simple: the insurance adjuster can’t see your pain. This is why RLS is considered an “invisible illness.” While you know the nightly torment and daytime exhaustion are real, an insurer sees a person who may look fine on paper. They need more than your description of the creepy-crawly sensations; they need concrete evidence of how it stops you from performing your job. This is the first step in learning how to prove RLS is disabling.

To provide that evidence, you must learn to speak the insurance company’s language. They separate information into two buckets: subjective symptoms (what you feel) and objective limitations (what you can or cannot physically do). A claim that only describes your subjective feelings—like the “uncontrollable urge to move”—is often seen as weak. You must show how that symptom causes a specific, measurable limitation, such as an “inability to remain seated for more than 30 minutes,” which is an objective fact.

Your goal is to connect your feeling to a functional fact. These specific RLS work limitations are what build a convincing case. Instead of only stating you are tired, explain how severe sleep deprivation prevents you from concentrating on complex tasks or safely operating machinery. This translation from personal experience into provable, job-related restrictions is the key to a successful claim. Building this case starts with your doctor, who can help turn your diagnosis into the powerful evidence an insurer requires.

RELATED POST: Why Your Doctor Must Document Your Functional Limitations

What To Do If Your RLS Disability Claim Is Denied

Unfortunately, insurance companies often deny disability claims for restless legs syndrome—sometimes for reasons as simple as insufficient medical evidence or even surveillance suggesting inconsistencies in your reported symptoms. Receiving a denial can be discouraging, but it is not the end of the road.

You have the right to appeal, but this process can be complex, overwhelming, and time-consuming—especially while you are already managing a chronic condition. A disability attorney can guide you through each step of the appeal, making sure deadlines are met and avoiding common mistakes that could hurt your case.

How a Disability Attorney Can Help

An experienced disability attorney can provide valuable assistance by:

• Gathering Medical Evidence: Helping you compile comprehensive medical records and supporting documentation.
• Filing Appeals: Assisting with appeals if your claim is denied, ensuring that all necessary information is submitted.
• Representation: Representing you in lawsuits against and negotiations with insurance companies.
• Maximizing Your Chances: Increasing the likelihood of a successful claim by understanding the nuances of disability law and the specific requirements of your insurance company.

With experience handling denials and appeals, your attorney can help reduce the stress of dealing with insurance companies, advocate for your rights, and give you the best chance of securing the benefits you deserve.

Get Help with Disability Claims for Restless Legs Syndrome

If you are struggling with restless legs syndrome and need help with your disability claim, contact the Ortiz Law Firm for a free case evaluation. Nick Ortiz and his team are experienced in handling disability claims and can help you navigate the process to secure the benefits you deserve. Call us at (888) 321-8131 or fill out our contact form to learn more.