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Do I Qualify For Disability Insurance Benefits If I Have Macular Degeneration or Macular Edema?

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

Disability insurance companies don’t always make it easy for policyholders who have macular degeneration or edema to get the disability benefits they deserve.

Over 3 million cases of macular degeneration are diagnosed each year in the United States, but not each case of macular degeneration qualifies for disability benefits.  Macular edema can be caused by diabetes (DME) or as a side effect of cataract surgery.

The Common Reasons Macular Degeneration or Macular Edema Claims Are Denied

You will have to show profound visual changes and 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 reflect the progression of your symptoms and why you no longer can perform your occupation.

Carriers also commonly argue that accommodations can be made to allow you to continue to work.

Many disability claims for macular degeneration are denied because the disability insurance company says:

(1) There is no objective basis of the macular degeneration diagnosis,

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

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

(4) You could work with accommodations.

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with macular degeneration. She overcomes a claims denial by working closely with you and your physician.

She often employs a vocational expert to address the disability carrier’s argument that you have been able to work or that you could work with accommodation.

Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim, particularly if you are a physician or work with computers on a daily basis.

What Is Macular Degeneration and What Are The Symptoms?

Macular degeneration is a degenerative condition that is often age-related (AMD). AMD results in a loss of vision in the center of the visual field, called the macula, because of damage to the retina. This makes it difficult or impossible to read or even recognize faces. It is a major cause of blindness in those older than 50. There is rarely a loss of peripheral vision.

There are two forms of macular degeneration that result in atrophy or scarring of the retina (dry) or leaking or hemorrhaging (wet).

The disabling symptoms include:

  1. Blurred vision,
  2. Shadows or missing areas of vision,
  3. Trouble discerning colors, and
  4. Loss of contrast sensitivity.

The loss of central vision profoundly impacts your visual functioning.

What Is Macular Edema and What Are The Symptoms?

Macular edema happens when fluid and protein deposits collect on or under the yellow part of the retina, called the macula.

It can be caused by diabetes (DME) or as a result of fluid collection in the outside layers of the retina, known as cystoid macular edema (CME).

This causes swelling or thickening, called edema. The swelling can distort your central vision, which allows you to see sharp and clear detail, form and color.

How Do I Get The Disability Insurance Benefits I Deserve?

Macular degeneration or macular edema can interfere with your daily activities and with your ability to work. If you no longer can work because of macular degeneration or macular edema, or if 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 and if there are limitations in your coverage.
  2. 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.
  3. Obtain a copy of your personnel file to see if your macular degeneration or macular edema have affected your work performance.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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

Macular degeneration or macular edema and its complications 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.