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If you are suffering from a vascular disease, obtaining long term disability (鈥淟TD鈥�) benefits can provide essential financial support and peace of mind.  However, the process of securing these benefits can be complex and challenging, requiring thorough documentation and a clear understanding of your insurance policy鈥檚 requirements.

Below we鈥檒l explore the impact of vascular diseases on your work capabilities and strategies to strengthen your long term disability claim.  Understanding these key aspects will help you build a compelling case and increase your chances of receiving the LTD benefits you need to manage your condition and maintain your quality of life.

How can vascular diseases impact my ability to work?

Vascular diseases can severely impact your ability to perform job duties, affecting both your physical capabilities and cognitive functions.  These disorders encompass a range of conditions that affect the circulatory system, including arteries, veins, and lymphatic vessels.

Vascular diseases can lead to a range of debilitating symptoms that hinder work performance, limit mobility, and reduce overall productivity.  Understanding how these symptoms manifest and influence your daily tasks is essential for managing your condition and seeking long term disability benefits.

Potentially disabling symptoms of vascular diseases may include:

• • Chronic pain, especially in the legs or arms, can impair your ability to stand, walk, or perform manual tasks;
  • Fatigue caused by reduced blood flow can make it difficult to sustain energy levels throughout the workday;
  • Mobility issues can occur, as conditions like peripheral arterial disease (鈥淧AD鈥�) may cause claudication (pain caused by too little blood flow during exercise), which leads to difficulty in walking or standing for long periods;
  • Cognitive impairment may be caused by lack of adequate blood flow to the brain, which affects concentration, memory, and decision-making; and
  • Dizziness and fainting.

There are many types of vascular diseases that can lead to long term disability. Some of these conditions include:

• • Peripheral Arterial Disease (鈥淧AD鈥�): PAD causes pain and cramping in the legs and hips during activity, leading to mobility issues and reduced physical stamina.  In severe cases, PAD can result in sores or infections that do not heal well, further limiting mobility and physical capacity.
  • Aneurysms: Aortic or cerebral aneurysms can be life-threatening and may require surgical intervention.  Post-surgery recovery can be lengthy, and the condition itself can cause pain and mobility limitations.
  • Varicose Veins: Severe varicose veins can cause pain, swelling, and a feeling of heaviness in the legs, making prolonged standing or walking difficult.
  • Raynaud鈥檚 Disease: Raynaud鈥檚 disease causes reduced blood flow to extremities, leading to numbness, pain, and sensitivity to cold, which can interfere with tasks requiring fine motor skills.
  • Chronic Venous Insufficiency (鈥淐VI鈥�): CVI results in swelling, pain, and skin changes in the legs, making it hard to stand for long periods.  It can lead to leg ulcers, which are painful and require ongoing treatment.

Can I get long term disability if I have a vascular disease?

Yes, you can get long term disability (鈥淟TD鈥�) benefits if you have a vascular disease, provided you meet the eligibility criteria outlined in your disability insurance policy.  Understanding the specific definition of disability in your policy is crucial, as this will determine whether you qualify for benefits.

Your policy will have a specific definition of what constitutes a disability.  This often includes terms like 鈥渦nable to perform the material duties of your occupation鈥� or 鈥渦nable to engage in any occupation for which you are reasonably qualified by education, training, or experience.鈥�  To qualify for LTD benefits, you must demonstrate that your vascular disease prevents you from performing the essential duties of your job.  This means you must show that your condition significantly impairs your ability to carry out the tasks required by your profession.

There are two common definitions of disability in LTD policies. Under an 鈥�Own Occupation鈥� definition, you must demonstrate you are unable to perform the duties of your specific job or profession.  An 鈥�Any Occupation鈥� definition means you must prove you are unable to perform the duties of any job for which you are reasonably qualified by education, training, or experience.  The specific definition applicable to your policy will significantly impact your eligibility for benefits.

Meeting the eligibility criteria for LTD typically involves showing that your vascular disease substantially limits your physical or cognitive abilities.  By proving that you cannot perform your job鈥檚 material duties due to your condition, you can strengthen your claim for LTD benefits.

What medical evidence can support my LTD claim for a vascular disease?

Supporting your long term disability (鈥淟TD鈥�) claim for a vascular disease requires comprehensive medical evidence.  This evidence is crucial for demonstrating the severity of your condition and how it impairs your ability to work.  Providing thorough and detailed medical documentation helps establish the legitimacy of your claim and can significantly enhance your chances of approval.

To substantiate your LTD claim for a vascular disease, you may include the following types of medical documentation:

• • Diagnostic Testing: Include results from diagnostic tests such as Doppler ultrasound, angiography, ankle-brachial index (鈥淎BI鈥�), and other relevant vascular studies that confirm your diagnosis and indicate the severity of your condition.
  • Imaging: Submit imaging studies like MRIs, CT scans, or X-rays that show the extent of vascular abnormalities or damage.
  • Office Visit Notes: Provide detailed notes from your healthcare provider documenting your symptoms, the progression of your condition, and the impact on your daily activities and ability to work.
  • Medications and Treatment: List all medications prescribed for your vascular disease, including dosages and any side effects.  Document other treatments such as physical therapy, surgical interventions, or specialized procedures you have undergone.
  • Hospitalization Records: Include records of any hospitalizations or emergency room visits related to your vascular disease.  This can further illustrate the severity and frequency of your symptoms.
  • Specialist Reports: Obtain detailed reports from specialists such as vascular surgeons, cardiologists, or neurologists who have treated you.  These reports should highlight the specific nature of your vascular disease and its impact on your health and functionality.

Gathering and presenting this comprehensive medical evidence will help build a strong case for your long term disability claim, demonstrating how your vascular disease prevents you from working.

How can I strengthen my LTD claim for a vascular disease?

Strengthening your long term disability (鈥淟TD鈥�) claim for a vascular disease involves thorough documentation and proactive management of your condition.

Here are some key strategies to enhance your claim:

• • Keep a Symptom Diary: Regularly record your symptoms, including their severity, frequency, and how they affect your daily activities and ability to work.  Note any patterns or triggers that exacerbate your condition.  A detailed symptom diary provides a personal account of your struggles and supports your medical evidence.
  • Regular Medical Check-Ups: Attend all scheduled appointments with your healthcare providers.  Regular check-ups ensure that your vascular disease and symptoms are consistently monitored and documented.  This ongoing medical attention demonstrates the seriousness and persistence of your vascular disease.
  • Collect Detailed Medical Documentation: Ensure that your medical records are thorough and up-to-date.  This includes diagnostic test results, imaging studies, office visit notes, and records of medications and treatments.  Comprehensive medical documentation from specialists like vascular surgeons, cardiologists, or neurologists can provide detailed insights into your condition.
  • Consistent Treatment Compliance: Follow your healthcare provider鈥檚 treatment plan consistently.  This demonstrates your commitment to managing your condition and can show that despite following medical advice, your symptoms still impair your ability to work.
  • Communicate with Your Healthcare Providers: Maintain open and honest communication with your doctors about all of your symptoms and how they impact your daily life.  Request detailed medical reports and letters that explicitly state how your vascular disease limits your ability to perform your job duties.

Additional medical and vocational evaluations can significantly help bolster your LTD claim for your vascular disease. Options for further assessments include:

• • Functional Capacity Evaluation (鈥淔CE鈥�): Undergoing a Functional Capacity Evaluation can bolster your claim if you experience significant physical limitations due to your vascular condition.  An FCE assesses your physical capabilities and limitations.  It provides objective evidence of your inability to perform specific job tasks, which is crucial for substantiating your LTD claim.
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  • Neuropsychological Evaluation: If your vascular disease affects your cognitive abilities, a neuropsychological evaluation can objectively document impairments in memory, concentration, and other cognitive functions.
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  • Vocational Assessment: A vocational assessment evaluates how your vascular disease affects your ability to work in your current occupation and other potential jobs.  It considers your skills, education, and experience in light of your medical limitations, providing a comprehensive view of your work capacity.

By following these tips, you can build a robust LTD claim that clearly demonstrates the extent of your vascular disease and its impact on your ability to work.

What role does my doctor play in my LTD claim for a vascular disease?

Your doctor plays a crucial role in supporting your long term disability (鈥淟TD鈥�) claim for a vascular disease.  Detailed medical reports and supportive statements from your healthcare provider are essential components of a successful claim.

Here鈥檚 how your doctor can help support your LTD claim:

• • Detailed Medical Reports: Your doctor should provide comprehensive and detailed medical reports that document your diagnosis, symptoms, treatment plan, and how your vascular disease impacts your ability to work.  These reports should include diagnostic test results, imaging studies, and thorough notes from office visits.  Detailed documentation from your doctor helps establish the severity of your condition and its effect on your daily life and work capacity.
  • Supportive Statements: Supportive statements from your healthcare provider, especially a specialist, can significantly strengthen your claim.  Specialists, such as vascular surgeons or cardiologists, have in-depth knowledge of your condition and can provide expert opinions on how it affects your functionality.  A specialist鈥檚 endorsement adds credibility to your claim and demonstrates that your condition is being managed by a professional with specific expertise.
  • 鈥淎ppropriate Treatment鈥� Condition: Most LTD policies include a condition that requires claimants to receive 鈥渁ppropriate treatment鈥� for their condition.  This means you must follow your doctor鈥檚 recommended treatment plan to the best of your ability.  Adhering to prescribed treatments and attending regular check-ups not only helps manage your symptoms but also shows your insurer that you are taking active steps to improve your health.

What are common reasons insurers deny LTD claims for vascular conditions?

Insurance companies often deny long term disability (鈥淟TD鈥�) claims for vascular conditions due to various reasons. Understanding these common denial reasons can help you better prepare your claim and address potential issues proactively.

• • Insufficient Medical Evidence: One of the most common reasons for denial is the lack of sufficient medical evidence to prove the severity of your vascular disease.  Insurers may claim that your medical records do not adequately demonstrate how your vascular disease impairs your ability to work.
  • Lack of Objective Findings: Insurers often look for objective findings, such as diagnostic test results and imaging studies, to support your claim.  If your medical evidence primarily consists of subjective reports of pain or fatigue without corroborating objective data, your claim may be denied.
  • Non-Compliance with Treatment: Failure to follow your doctor鈥檚 recommended treatment plan can lead to a denial.  Insurers may argue that your condition could improve with proper treatment and that you are not taking necessary steps to manage your health.
  • Pre-Existing Condition Exclusion: Many LTD policies include a pre-existing condition clause, which excludes coverage for conditions that existed before the policy鈥檚 effective date.  If your vascular disease is considered a pre-existing condition, your claim may be denied.
  • Insufficient Documentation of Work Impact: To qualify for LTD benefits, you must show that your vascular disease significantly affects your ability to perform your job duties.  If your documentation does not clearly link your vascular condition to your work limitations, your insurer may deny your claim.
  • Inconsistent Medical Records: Inconsistencies in your medical records can lead to a denial.  If different healthcare providers provide conflicting information about your vascular disease or if your reported symptoms vary significantly between visits, your insurer may question the validity of your claim.
  • Surveillance or Social Media Evidence: Insurers sometimes use surveillance or monitor your social media activities to gather evidence that contradicts your claim.  For example, if you claim to be unable to walk long distances but are seen engaging in physical activities, your claim may be denied.
  • Policy Definition of Disability: Your LTD policy鈥檚 specific definition of disability plays a crucial role in the approval process.  If your insurer determines that you do not meet the definition of disability as outlined in your policy, your claim will likely be denied.  This can include distinctions between 鈥渙wn occupation鈥� and 鈥渁ny occupation鈥� definitions.

To avoid these common pitfalls, ensure that your medical evidence is thorough and consistent, follow your treatment plan diligently, and clearly document how your vascular disease impacts your ability to work.  Consulting with a knowledgeable long term disability attorney can also help you navigate the complexities of the LTD claims process and improve your chances of a successful outcome.

How can a long term disability attorney help me with my vascular disease LTD claim?

A long term disability attorney can provide invaluable assistance with your vascular disease long term disability (鈥淟TD鈥�) claim.  At Riemer Hess, we have over 25 years of experience securing LTD benefits for our clients, including those who suffer from vascular diseases.  We understand the tactics insurers use to commonly deny claims and how to overcome them.  Our understanding of the LTD claims process can significantly increase your chances of a favorable outcome, allowing you to focus on managing your health without the added stress of confronting legal hurdles alone.

Below is an example of a client with a vascular disease who we successfully helped win benefits.

Client Case Study

Our client 鈥淟aura鈥� was a successful stockbroker until she was diagnosed with peripheral arterial disease (鈥淧AD鈥�).  Her job required frequent, rapid, and accurate judgments, as well as making complex decisions with significant stakes.  She had to maintain intense mental concentration throughout the workday, despite the distraction of multiple people nearby seeking her attention.  Additionally, her job demanded that she stand rather than sit during the normal course of business.  The symptoms of PAD, including pain and mobility issues, made it impossible for Laura to continue working.

Laura filed for long term disability (鈥淟TD鈥�) benefits and was initially approved.  After years of receiving benefits, her insurer sent her for an Independent Medical Examination (鈥淚ME鈥�).  The IME doctor was curt, hostile, and dismissive, ultimately concluding without basis that she was no longer disabled.  The insurer used this IME report to justify terminating her benefits.

Desperate and in need of assistance, Laura turned to Riemer Hess to appeal the termination.  The attorneys at Riemer Hess quickly formulated a strategy for her claim.  First, we requested her complete claim file, as the denial letter from Laura鈥檚 insurer did not adequately describe the reason the IME doctor believed she was not disabled.  We discovered that the IME report was equally vague.  Next, Riemer Hess referred Laura to a trusted vendor for a Functional Capacity Evaluation (鈥淔CE鈥�) and recommended she get updated imaging to reflect her current symptoms.

The new evidence from the FCE and the updated medical records confirmed that Laura鈥檚 condition had worsened since she originally filed for LTD.  Riemer Hess coordinated with Laura鈥檚 cardiologist to review the FCE and write an opinion letter supporting her LTD claim.  Alongside this substantial new evidence, Riemer Hess submitted a comprehensive appeal letter rebutting each justification the insurer gave for termination Laura鈥檚 benefits.

In light of the compelling evidence, the insurer reversed the termination of Laura鈥檚 LTD claim and restored her benefits.  Grateful for the successful outcome, Laura retained Riemer Hess to protect her benefits on an ongoing basis.