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Do I Qualify For Disability Insurance Benefits If I Have Had A Stroke?

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

A stroke occurs when blood supply to a part of your brain is interrupted or reduced. With brain tissue deprived of oxygen and nutrients, brain cells begin to die.

Not everyone who has had a stroke is entitled to disability benefits. Disability insurance companies don’t always make it easy for policyholders who are disabled because of stroke or its complications to get the disability benefits they deserve.

What Are The Types Of Stroke And What Are The Symptoms?

  1. Ischemic Stroke is caused by a blocked artery. The two most common ischemic strokes are thrombotic or embolic.
  2. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Hemorrhagic strokes include intracranial or subarachnoid hemorrhages.
  3. Transient ischemic attack (TIA) is a temporary decrease in blood supply to a part of the brain.

The symptoms can include:

  • Trouble speaking and understanding,
  • Paralysis or numbness of the face, arm or leg,
  • Trouble seeing in one or both eyes as a result of blurred, blackened or double vision,
  • Headache, and
  • Difficulty walking or problems with balance and coordination.

What Are The Disabling Complications Of A Stroke?

A stroke can cause temporary or permanent disability. The extent and nature of any disability depends on how long the brain didn’t have blood flow and which part of the brain was affected. The common disabling complications include:

  1. Paralysis or loss of muscle movement,
  2. Difficulty talking or swallowing,
  3. Memory loss or thinking problems,
  4. Emotional problems, and
  5. Pain.

How Disability Carriers Handle Stroke Claims

Disability carriers are notorious for denying and terminating many stroke claims. Carriers commonly argue that:

  1. Coverage is excluded by the pre-existing condition clause of your disability policy.
  2. Benefits are limited under the subjective limitation clause. Pain can be your most disabling symptom, but carriers routinely dispute pain and the impact of other subjective symptoms.
  3. You are just having emotional problems. At best, your benefits are limited under the mental nervous policy provisions.
  4. You have no proof of any cognitive or memory problem because there is no neurocognitive testing that proves these problems.
  5. There is no objective testing that supports the severity your physical problems.
  6. There is an inconsistency between your medical records and what you put on the Activity of Daily Living forms and the surveillance we have of you.
  7. Your doctor is just relying on your subjective complaints when assigning restrictions and limitations.

Many disability claims are denied. Carriers deny claims for other reasons. They’ll say:

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

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

(3) There is no causal relationship between your stroke diagnosis 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, or

(5) There is no reason you can’t work with accommodation.

Why You Need Nancy Cavey

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

Ms. Cavey obtains, as needed, a Functional Capacity Evaluation to objectively document your physical limitation such as difficulty walking, standing and sitting.  If you haven’t had neuropsychological testing to document your cognitive and memory problems, Ms. Cavey will help you arrange that testing.

She even hires a Vocational Evaluator to explain why your symptoms prevent you from doing your occupation or any occupation.

Nancy Cavey 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?

A stroke and its complications can interfere not only with your daily activities but with your ability to 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 and if there are limitations in your coverage.

Your policy might limit conditions that are based on subjective complaints without objective evidence of a diagnosis. Be sure to review the mental nervous limitation clause and determine how the carrier might apply the clause to limit the payment of 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.
  1. Obtain a copy of your personnel file to see if your stroke or complications have affected your work performance. Your productivity may have suffered because you may have limited ability to use your hands, walk, stand or sit for any length of time. Worse, your cognitive problems might prevent you from doing the “thinking” part of your occupation.
  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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

A stroke 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.