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Do I Qualify For Disability Insurance Benefits If I Have Lupus?

CaveyLaw.com > Practice Areas  > Long Term Disability & ERISA Lawyer  > Long Term Disability Disabling Conditions > Do I Qualify For Disability Insurance Benefits If I Have Lupus?

Disability insurance companies don’t always make it easy for policyholders who have lupus to get the disability benefits they deserve.  At least 1.5 million Americans have lupus, with 16,000 new cases every year.

A chronic autoimmune disease, lupus can damage your skin, joints and the internal organs. Normally the immune system produces antibodies that protect your body from viruses, bacteria and germs. With lupus, your immune system can’t tell the difference between foreign invaders and your body’s healthy tissue. Lupus creates antibodies that attack and destroy that tissue. The result: inflammation, pain and damage to your body.

The diagnosis of lupus is not easy. There are four types of lupus, and every lupus sufferer has different symptoms.

How Disability Carriers View Lupus Disability Claims

Unfortunately, many lupus claims are denied because the disability insurance company says:

(1) There is no objective basis for a diagnosis of lupus,

(2) There is no objective basis for the restrictions and limitations assigned by your physician, or

(3) There is no causal relationship between your lupus and/or your restrictions and limitations, and your inability to do your own or any occupation.

(4) There is no reason you can’t work in a sedentary capacity.

Common Reasons Carriers Deny Lupus Claims

Other reasons disability insurance companies use to deny claims:

  • Your testing is normal so you aren’t disabled,
  • You should be able to return to work despite your fatigue, headaches, rash, the swelling in your feet, legs, hands and painful joints,
  • You should be able to return to work if your symptoms are under control with medication,
  • Your symptoms are subjective,
  • Your symptoms come and go,
  • Your mental confusion is all in your head,
  • The risk of increased symptoms because of exposure to infectious people is not a relevant consideration, and
  • The stress of the work environment is not a relevant consideration.

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with lupus. She overcomes a claims denial by working closely with you and your physician to prove why your lupus prevents you from the physical aspects of your or any occupation.

She will even hire a vocational rehabilitation counselor to address the impact your symptoms, side effects of medication and stress have on your ability to return to your occupation or any occupation, from both a physical and cognitive standpoint. Fatigue, swelling and joint pain can make it impossible for you to perform your own or any occupation.

The key is documenting your inability to deal with stress, from both a medical and vocational standpoint.

Your physician and the vocational evaluator also can explain how performing your occupation or any occupation creates a significant risk of harm because of stress. It is important that both the medical and vocational aspects of your claim be fully documented and explained so the carrier understands what happens to you in stressful situations.

If you are ready to file a disability application and want to improve your chances of getting disability benefits, or if your claim for lupus has been denied, 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.

How Do I Get The Disability Insurance Benefits I Deserve?

Lupus 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:

  1. 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 lupus.

Your policy can include a self-reported limitation. It limits how long you can get benefits that result from self-reported symptoms, including joint pain, fatigue and headaches. You’ll want to know what’s in your policy before you apply for benefits.

  1. 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 that you have testing to document the reason for your symptoms and the severity of those symptoms.

  1. Obtain a copy of your personnel file to see if your lupus has affected your work performance.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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 for lupus. 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

Lupus 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.