In order to get approved for long term disability benefits due to your IBS, it鈥檚 important to know how best to put forth your claim with your insurance company. Understanding how to substantiate your Irritable Bowel Syndrome long term disability claim will signficantly increase your chances of approval.
Here鈥檚 what you need to know before filing your IBS long-term disability claim.
Whether or not your Irritable Bowel Syndrome (IBS) qualifies as a disability depends almost entirely on how your symptoms affect your ability to work. An IBS diagnosis alone will not be enough to get your long term disability claim approved. Beyond a diagnosis, your insurance company will want to know your personal symptoms, their severity and frequency, and the ways in which they impair your job performance.
The symptoms of Irritable Bowel Syndrome can be uncomfortable and distressing. An IBS flare-up can last anywhere from 2 to 4 days or longer, depending on the severity of your condition. Generally, IBS symptoms include:
IBS symptoms can also impact different parts of the body. These additional symptoms can include:
Another factor to consider is the secondary emotional symptoms that may occur with IBS. IBS can be an embarrassing and stressful condition; you may experience significant anxiety and depression as a direct result.
If your emotional symptoms (i.e. anxiety, depression) develop due to being disabled by your IBS, these can be included to support your disability claim.
However, it will be vital for your doctor(s) to make clear to your insurance company that your emotional symptoms are secondary to and resulting from your IBS. Otherwise your insurance company may try to characterize your Crohn鈥檚 disease as a mental illness. In most long term disability insurance policies, benefits paid due to mental illness disabilities are limited to 12-24 months 鈥 meaning you would only receive benefits for up to two years at most, regardless of whether you remain totally disabled beyond that time.
The symptoms of Irritable Bowel Syndrome can be severe and disabling. However, the insurance company may not understand the nature and significance of your symptoms, or how they impact your job. To increase your chances of long-term disability claim approval, you can explain how and why each of your symptoms prevents you from performing your job duties.
For example, diarrhea or the need to move your bowels 3 or 4 times before you leave the house may cause you to be late for work constantly. As a result, you may miss an important meeting or telephone call with a big client. Once you get to work, your symptoms may force you to always be in close proximity to a bathroom in case of an IBS emergency.
Your unexpected, frequent trips to the bathroom may force you to put a telephone call on hold, ditch a meeting, or cut a presentation short. Worse yet, the prolonged, frequent bathroom visits can cause you to be "off task" for a significant portion of the workday. This productivity reduction can be particularly problematic if you are required to meet strict deadlines.
In addition, your diarrhea and frequent bowel movements may cause you to be up all night running back and forth to the bathroom, resulting in severe fatigue the following day. Alternatively, your constipation may cause severe abdominal pain and cramping, thereby reducing your ability to concentrate or focus on your job tasks. Your excess gas can not only be embarrassing but can also be distracting to co-workers 鈥 leading to further reduced productivity.
Your IBS may also result in mental health issues, such as an anxiety or depression. You may be so on edge about having constant bathroom access that you develop generalized anxiety, or become depressed due to the embarrassment, inconvenience, and chronic pain of your condition.
Fully understanding how your various symptoms specifically disrupt and impair you from performing your job will help you explain it to your insurance company.
There are different types of evidence your insurance company will consider when deciding your long term disability claim for IBS. This includes evidence supporting your diagnosis, symptoms, and how your condition prevents you from working in your occupation.
The insurance company will require proof of your Irritable Bowel Syndrome diagnosis for long-term disability. Unfortunately, it鈥檚 often difficult to provide your diagnosis because your IBS symptoms can mimic other digestive disorders. Diagnosis of Irritable Bowel Syndrome is also frequently delayed because many patients are reluctant or too embarrassed to seek treatment.
When treatment is sought, there are no specific imaging or laboratory tests that can diagnose IBS. The first step is to talk to your doctor. Your doctor will likely take a complete medical history. For example, your doctor may ask:
After taking your history and learning about your symptoms, your doctor will likely conduct a physical examination to check for abdominal bloating, listen to bowel sounds within your abdomen, and tap on your abdomen to check for tenderness or pain.
Then, your doctor may administer testing to rule out other causes or conditions that produce IBS-like symptoms. For instance, your doctor may recommend:
If specific signs or symptoms suggest another condition, further testing may be warranted. Once other conditions are ruled out, your doctor can make the diagnosis of Irritable Bowel Syndrome.
When determining whether your Irritable Bowel Syndrome is disabling, the your insurance company will want the opinions of your treating doctor(s). Your doctor鈥檚 support is key.
A letter from your doctor outlining your IBS and its disabling impact on your ability to work can go a long way with your insurance company. Your doctor's report should detail the frequency and severity of your symptoms, any positive physical examination findings, their direct observations of you during office visits, and the specific restrictions and limitations that prevent you from working.
While objective medical evidence carries the most weight with your insurance company, it can be extremely helpful to personally explain how your symptoms prevent you from performing your job. You can do this by preparing a written, detailed narrative for your insurance company.
Make sure your narrative addresses all of your symptoms by listing them separately. Because the symptoms of IBS can be episodic, your narrative should address the frequency of your symptoms, as well as the frequency and length of your trips to the bathroom, and the ways in which your various symptoms (physical, cognitive, and emotional) disrupt your ability to work.
When evaluating your Irritable Bowel Syndrome (IBS) long term disability claim, your insurance company will want to see that you鈥檙e receiving appropriate treatment. Your insurance company can easily use non-compliance and lack of appropriate care as a reason to deny your IBS long term disability claim.
Unfortunately, IBS has no cure 鈥 the goal of treatment is to help alleviate symptoms. Because doctors do not know what causes Irritable Bowel Syndrome, 褨t can be extremely challenging to treat. Some treatment methods include:
Make sure to follow all of the treatment recommendations of your doctors, and to check in with your doctors on a regular basis. Infrequent care and treatment can lead to your disability claim being denied 鈥 and potential benefit termination if you鈥檝e already been approved.
Just because Irritable Bowel Syndrome (IBS) is very common doesn鈥檛 mean it cannot be disabling. However, there are many hurdles when filing for long term disability for IBS. It is very difficult to diagnose, treatment can prove challenging, and your insurance company may be eager to write your IBS symptoms off as primarily a mental illness.
An experienced long term disability attorney can make all the difference. At Riemer Hess, we know what medical evidence your insurance company requires, how to outline your disabling symptoms, and ways to make sure your IBS is recognized as a physical disability. We can substantiate your IBS long term disability claim to significantly increase your chances of approval.
If you are suffering from IBS and need to file for long term disability, Riemer Hess can assess your situation, explain your legal rights and options, and answer any questions you have about long term disability insurance. To schedule your free consultation, call 糖心直播, Attorneys at Law, today at 212-297-0700.