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Do I Qualify For Disability Insurance Benefits If I Have A Vestibular Disorder?

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

Vestibular disorder can cause dizziness, vertigo, fainting and imbalance that impact your ability to do daily activities and to work. More than 8 million Americans have chronic problems with balance; an additional 2.4 million have chronic problems with dizziness.

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

What Is The Vestibular System?

The vestibular system is your gyroscope. It works with your eyes (the visual system) and your bones and joints (skeletal system) to maintain the position of your body at rest or in motion. It does this by detecting mechanical forces, including gravity, that act on your vestibular organs when you move.

The vestibular labyrinth in your inner ear is the organ of balance. Balance is the ability to maintain your body’s center of mass over the base of support. It requires the coordinated input of your eyes, muscles and joints, and the vestibular system.

If your vestibular system isn’t functioning properly you can experience a loss of balance. A vestibular disorder also can cause problems with vision, hearing and impair your cognitive abilities.

What Are The Most Common Vestibular Disorders And Symptoms?

Carriers just don’t understand the common disabling vestibular disorders or the symptoms.

These can include:

Benign paroxysmal positional vertigo (BPPV), occurs because of a change in the position of your head. You might experience it when you roll over in bed, look over your shoulder or looking up. The vestibular system sends conflicting signals to the brain about the position of the head. Vertigo is the result.

Vestibular neuronitis, an inflammation of the vestibular nerve, causes vertigo.

Perilymph fistula, a leakage of your inner ear fluid into the middle ear, can occur after a head injury, ear surgery or change in pressure as a result of scuba diving. It causes dizziness, nausea and unsteadiness with walking and standing. It increases with activity.

Mal de debarquement syndrome (MdDS), a balance disorder that makes you feel like you are continuously rocking or bobbing.

Meniere’s disease, a disorder of the inner ear, causes spontaneous episodes of vertigo, fluctuating hearing loss, ringing in the ear and a sensation of fullness in one or both ears.

These vestibular disorders cause profound problems. They can be treated with vestibular rehabilitation and/or surgery.      

How Disability Carriers Handle Vestibular Disorder Claims

Disability carriers are notorious for denying and terminating many vestibular disorder 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. Dizziness, vertigo, fainting and imbalance can be your most disabling symptoms, but carriers routinely dispute their impact.
  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 dizziness, vertigo, fainting and imbalance problems because there is no objective testing that proves these problems.
  5. There is no objective testing that supports the severity of your complaints so you can’t be as disabled as you claim.
  6. Your electronystagmography (ENG) rotation, vestibular evoked myogenic potential (VEMP), computerized dynamic posturography (CDP), hearing and scans are normal.
  7. There is no neurocognitive testing that supports your cognitive complaints.
  8. There is an inconsistency between your medical records and what you put on the Activity of Daily Living forms and the surveillance we have.
  9. Your doctor is just relying on your subjective complaints when assigning restrictions and limitations.

Many disability claims are denied.

Other reasons carriers deny claims:

(1) There is no objective basis of the vestibular disorder 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 vestibular disorder 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 accommodations.

Why You Need Nancy Cavey

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders who have had vestibular disorders and its 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 limitations.  If you haven’t had neuropsychological testing to document your cognitive and memory problems, she 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 vestibular disorder 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 vestibular disorder 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 vestibular disorder 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.