Autoimmune Disorders and Disability Benefits: Navigating Claims With Confidence

If you have been diagnosed with an autoimmune disorder and it is impacting your ability to work, you may qualify for disability benefits based on your condition.  Disability benefits protect your income if you cannot continue working due to your medical condition.  This article will discuss the principal issues to consider when filing a claim for disability benefits based on an autoimmune disease and key considerations to keep in mind as you navigate the claim process.

What Are Autoimmune Disorders?

Autoimmune diseases develop when your immune system attacks your own healthy organs and tissue instead of protecting them.  There is also a rising prevalence of autoimmune disorders in modern times.  Approximately 50 million Americans suffer from one or more autoimmune diseases today.  There are also over 100 different types of known autoimmune diseases.  Common examples of autoimmune disorders include:

Multiple sclerosis (MS) Rheumatoid arthritis (RA) Psoriatic arthritis Systemic lupus erythematosus (SLE) Sjogren’s syndrome Chron’s disease Celiac disease Ulcerative colitis

Graves’ disease Hashimoto’s thyroiditis Dermatomyositis Psoriasis Hashimoto’s thyroiditis Type 1 diabetes Vasculitis

How Can Autoimmune Disorders Impact Work?

Despite the prevalence of autoimmune disease diagnoses today, the severity of the disease can vary significantly from person to person and even day to day.  Common symptoms associated with autoimmune disorders include:

Fatigue Inflammation Muscle aches, pains, and weakness Joint pain, stiffness, and swelling Cognitive changes/impairment Digestive issues Skin rashes and itching Numbness and tingling

Dizziness Lightheadedness Headaches Blurry vision Impaired sleep Chest pain Rapid or irregular heartbeat Shortness of breath Temperature sensitivity

The experience of “good” and “bad” days and the waxing and waning in the severity of symptomology from day to day are also standard features of autoimmune diseases.  The insurance company or plan administrator may only focus on what you can do when you are at your best, but they will need to consider the full spectrum of your symptoms over a sustained period in assessing your ability to work.

When Do Autoimmune Disorders Qualify for Disability Benefits?

Any of the autoimmune disorders listed above can be severe enough to qualify an individual for the receipt of disability benefits.  Nevertheless, it is essential to understand that a diagnosis alone does not establish a disability.  The critical inquiry for any disability assessment is understanding how your particular medical condition manifests itself in specific mental, cognitive, and/or physical restrictions and limitations that prevent you from working.  There can be significant variance in symptoms between autoimmune disorder diagnoses, even between individuals with the same diagnosis.  For example, if you have multiple sclerosis, your symptoms can be purely physical, cognitive, or a combination of both.

How Do You Build an Effective Disability Claim Based on Autoimmune Disorders?

For any disability benefits claim, it is critical to ensure that the insurance company or administrator has access to a complete copy of all your relevant treatment records, along with any diagnostic exams, lab work, or other testing that has been conducted to evaluate and monitor your condition.  In some instances, it can also be helpful to keep a daily symptom log or create a “day in the life” video to fully document the extent of your symptoms.

What if Your Claim for Disability Benefits for Autoimmune Disorders Is Denied?

If your claim for disability benefits claim is denied, you have options.  You should first have the opportunity to submit an internal appeal to the insurer or plan administrator.  As part of your appeal, you should submit additional medical evidence detailing the classification, extent, and severity of your autoimmune disease(s) and any other co-morbid impairments you may have.  Such evidence can include pharmaceutical records, office notes, diagnostic exams, and witness statements from your family and friends.  If the insurance company still refuses to overturn the denial of your claim on appeal, you should have the option to file a lawsuit in court for the benefits due.

If you suffer from an autoimmune disorder and are considering filing a claim for disability benefits, you should consult with an expert, like the attorneys at DeBofsky Law, who can advise you on your plan’s specific terms and limitations, and assist you in building the strongest claim possible.  If you have already filed a claim for disability benefits, but it was denied or terminated before you have been released to return to work, it is not too late to seek legal counsel and guidance.  The attorneys at DeBofsky Law are here to help you navigate the complicated disability benefits claim process so you can focus on your health.