Epilepsy, a neurological disorder characterized by recurrent seizures, can significantly impact various aspects of life, including one’s ability to work. Individuals managing epilepsy can find navigating the complexities of long-term disability claims daunting. In this article, we’ll discuss the nuances of epilepsy’s impact on work, the LTD claim process, and strategies for ensuring a successful claim.
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Understanding Epilepsy and Its Impacts
Epilepsy encompasses a spectrum of seizure disorders, each presenting unique challenges in both daily life and the workplace. Focal seizures, also known as partial seizures, originate in specific regions of the brain and may cause symptoms ranging from subtle sensations to involuntary movements or altered consciousness. These seizures can be disruptive to work routines, especially if they affect cognitive function or physical abilities required for job tasks. On the other hand, generalized seizures involve widespread electrical disturbances in the brain, resulting in loss of consciousness, convulsions, or muscle stiffening. The unpredictability and severity of generalized seizures can pose significant barriers to sustained employment, necessitating comprehensive documentation for disability claims to accurately reflect their impact on work capacity.
Documenting Disability Insurance Claims for Epilepsy
If you suffer a seizure or think you may have a seizure disorder, the first step is to make an appointment to see a neurologist. A neurologist will perform an electroencephalogram (EEG) to detect abnormal brain activity. If the EEG is normal, your neurologist may recommend you wear an EEG device that will monitor for seizures for 24 hours or longer. EEG evidence of seizure activity proves that you suffer from epilepsy and is considered objective evidence, which is extremely helpful. Although it is possible to receive disability benefits due to seizures without an abnormal EEG, it is much more challenging.
Other types of evidence that help prove disability due to epilepsy include statements from your doctors. Your lawyer can provide you with physician questionnaires specifically designed to elicit restrictions and limitations concerning your condition. If you don’t have a lawyer, such forms can be found here.
In addition, symptom diaries can document the frequency and severity of your seizures. Similarly, statements from family, friends, or colleagues who have witnessed you having a seizure can help prove disability. Your employee personnel file may also contain useful information for proving disability, especially if you suffered a seizure while at work or had to request a reasonable accommodation based on seizures.
Lastly, if you have received Social Security disability benefits, that can provide important corroborative evidence of disability. Be sure to obtain and submit your Social Security exhibit file to the insurance company, but first review it to make sure it does not contain evidence that is unfavorable to you.
What Restrictions and Limitations Can Epilepsy Cause?
Epilepsy can impose various restrictions and limitations on a worker depending on the severity and frequency of seizures, as well as the nature of their job. Some potential restrictions and limitations may include:
1. Driving Restrictions: In many jurisdictions, individuals with epilepsy may face restrictions on driving, especially if they have experienced seizures within a certain timeframe. This can limit their ability to commute to work or perform job duties that require driving.
2. Workplace Safety Concerns: Depending on the nature of the seizures and the workplace environment, safety concerns may arise. For example, if a person works with heavy machinery or at heights, uncontrolled seizures could pose a risk to themselves and others. Likewise, the risk of seizure may limit an employee’s ability to use personal protective equipment (such as N95 face masks), due to the concern that the employee may suffer a seizure and suffocate.
3. Medication Side Effects: Some medications used to manage epilepsy can cause drowsiness, fatigue, or cognitive impairment. These side effects may impact a worker’s ability to perform certain tasks effectively or safely.
4. Cognitive Impairment: Following a seizure, you may suffer from fatigue and cognitive impairment for hours or even days. Chronic seizures can cause memory impairment and other cognitive deficits. If you believe you suffer from cognitive decline due to seizures, you may want to consider neuropsychological testing, though we recommend first consulting a lawyer to discuss the pros and cons of undergoing such testing.
5. Stress Management: Stress can be a trigger for seizures in some individuals with epilepsy. Jobs with high levels of stress or pressure may need to be avoided or modified to reduce the risk of triggering seizures.
6. Shift Work: Irregular or overnight shifts can disrupt sleep patterns, which may exacerbate epilepsy symptoms. Workers with epilepsy may need accommodations such as consistent schedules or flexible hours to manage their condition effectively.
Addressing Common Claim Challenges
The unique nature of epilepsy gives rise to a unique set of challenges when it comes to disability claims. Here are some common reasons disability insurance companies give to deny claims related to epilepsy:
1. Normal or Inconclusive EEG: While a normal EEG does not exclude a diagnosis of epilepsy, it can make proving disability due to seizures more challenging, particularly if the rest of the evidence is based on self-report. That was the ruling of the court in Breen v. Reliance Standard Life Ins. Co., No. 22-3688, 2023 U.S. Dist. LEXIS 177760, (E.D. Pa. Oct. 2, 2023). The ruling affirmed a denial of disability benefits to a claimant with a normal EEG, notwithstanding her award of Social Security disability benefits. If your EEGs are normal, consider asking your doctor for a wearable EEG monitor that can be worn for days or weeks at a time to improve your chances of documenting a seizure episode.
2. Seizures Controlled on Medication: Your disability insurer may assert that your seizures are controlled on medication; therefore, you are not disabled. If your seizure medications produce significant side effects that interfere with your ability to work, however, you may be able to collect disability benefits on that basis.
3. Seizures Are Infrequent: If your seizures are relatively few and far between, your disability insurer may assert that they do not preclude you from performing your occupation or other occupations. However, if the occupation in question requires high-stakes presentations, negotiations, or decision-making, an argument can be made that the episodic and unpredictable nature of your seizures precludes you from performing that occupation. Moreover, as the court noted in Evans v. UnumProvident Corp., 434 F.3d 866 (6th Cir. 2006), work stress can aggravate seizure disorders. Thus, the fact that a claimant may have relatively few seizures while on disability leave does not mean he or she will not suffer seizures upon returning to work.
The Role of Legal Assistance in Epilepsy Claims
Claimants may encounter various challenges when filing for epilepsy disability benefits, such as providing sufficient proof of symptoms or demonstrating the impact of seizures on work performance. Legal support can significantly enhance the likelihood of a successful epilepsy disability claim. Experienced disability attorneys understand the complexities of the claims process and can advocate for claimants’ rights.
Key Takeaways for Epilepsy Disability Benefits Claims
Navigating the disability claim process for epilepsy requires a comprehensive understanding of the disorder, policy terms, and legal considerations. By prioritizing medical evidence, seeking legal assistance when needed, and preparing a thorough claim, individuals with epilepsy can increase their chances of securing the disability benefits they deserve. Proactive and informed actions are key to navigating the challenges of epilepsy in the workplace and accessing the support needed for financial stability and peace of mind.
