Disability insurance companies don’t always make it easy for policyholders who have insomnia, sleep apnea, narcolepsy or restless legs syndrome to get the disability benefits they deserve.
How Disability Carriers View Claims for Insomnia, Sleep Disorders, Sleep Apnea, Narcolepsy or Restless Legs Syndrome
Disability carriers often argue that in your policy, coverage is excluded under the pre-existing condition clause, or that benefits are limited under the subjective limitation and/or mental/nervous clauses.
It is not uncommon for policyholders to have had insomnia, sleep apnea, narcolepsy or restless legs syndrome for years and not been disabled. You will have to overcome the carrier’s argument that you have been working with these problems for years and nothing has changed. It is crucial that your medical records develop the progression of your symptoms.
Carriers also say that if you took the right medication your insomnia would just go away and you could work.
Worse, carriers argue that your insomnia is a mental disability, not a physical one.
As a result, many disability claims for insomnia, sleep apnea, narcolepsy or restless legs syndrome are denied. And carriers have other reasons to deny claims. The disability insurance company will say:
(1) There is no objective basis of the insomnia, sleep apnea, narcolepsy or restless legs syndrome diagnosis as there are very few tests that can verify these conditions,
(2) There is no objective basis for the restrictions and limitations assigned by your physician, or
(3) There is no causal relationship between your insomnia, sleep apnea, narcolepsy or restless legs syndrome and/or your restrictions and limitations, and your inability to do your own or any occupation.
(4) The risk of increased symptoms or relapse if you return to work is not a relevant consideration, and
(5) The risk of falling asleep on the way to work is not a relevant consideration.
Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with claims for insomnia, sleep apnea, narcolepsy or restless legs syndrome. She overcomes a claims denial by working closely with you and your physician.
She will even hire a vocational rehabilitation counselor to address the impact your symptoms, the side effects of medication and stress have on your ability to return to your occupation or any occupation. Sleepiness, fatigue, or falling asleep on the way to work or at work can make it impossible for you to perform your occupation.
Your physician and the vocational evaluator also can explain how performing your occupation or any occupation creates a significant risk of harm. It is important that the medical and vocational aspects of your claim each are fully documented and explained.
If you are ready to file a disability application and want to improve your chances of getting disability benefits, or if your claim has been denied for insomnia, sleep apnea, narcolepsy or restless legs syndrome, it is time to call Nancy Cavey.
She offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.
What Are The Most Common Types And Symptoms of Sleep Disorders?
Insomnia can be a symptom of other physical or psychiatric conditions. This presents a significant problem for you, because the carrier will default to the condition that requires that they pay the least amount of benefits. You should be under the care of a board certified sleep specialist who can properly diagnose, treat and address the carrier’s deceptive reasons for denying your claim.
Sleep Apnea
The most common symptoms of sleep apnea are excessive daytime sleepiness, snoring, headaches and restless or unrefreshing sleep.
Narcolepsy
Common symptoms of narcolepsy are excessive daytime sleepiness alleviated with naps, and loss of muscle control called cataplexy.
Restless Legs Syndrome
Restless legs syndrome is characterized by an irresistible urge to move your legs after you get into bed. There can be a twitching feeling in your calves, feet, and thighs and even in your arms. These sensations can make it difficult to sleep.
How Do I Get The Disability Insurance Benefits I Deserve?
Insomnia, sleep apnea, narcolepsy or restless legs syndrome can make it difficult, if not impossible, to do things around your home and work. If you no longer can work or your doctor has told you to apply for disability benefits, you should take steps before you apply:
- Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove to get your benefits because of insomnia, sleep apnea, narcolepsy or restless legs syndrome.
Your policy can include a self-reported limitation that limits how long you can get benefits that result from self-reported symptoms. You also will want to read the “mental/nervous’’ limitations to see how sleep disorders are treated. You’ll want to know what’s in your policy before you apply for benefits.
- Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations. It is crucial you have testing to document the reason for your symptoms and the severity of those symptoms.
- Obtain a copy of your personnel file to see if your insomnia, sleep apnea, narcolepsy or restless legs syndrome has affected your work performance.
- Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
- Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
- Prepare a diary that explains and gives examples of how your symptoms interfere with your ability to do things on a daily basis and the side effects of your medication.
- Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
- Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.
Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live
Insomnia, sleep apnea, narcolepsy or restless legs syndrome can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits. Call today for a free consultation at 727-894-3188.
