Sufferers of hidden disabilities, or disabilities that are not immediately apparent, can face additional struggles in their insurance claims. An invisible disability like chronic fatigue or fibromyalgia doesn’t show up on an X-ray or MRI but can still have a significant effect on a person’s daily life and ability to earn income.
The insurance system is structured around conditions that are easy to measure, which means that invisible disabilities are harder to prove and harder to argue. However, someone suffering from a hidden disability often still has a valid claim for disability insurance.
Let’s discuss how to strengthen your insurance claim when you are suffering from an invisible disability.
What Are Hidden Disabilities?
Hidden or invisible disabilities are those that are not immediately visually apparent. A person suffering from an invisible disability may appear at first glance not to have any noticeable challenges. However, the limitations they face from their condition may become more evident the longer you get to know them and observe their daily lives.
According to Disabled World, about 10% of Americans have a medical condition that could be considered a hidden disability. These conditions can take many different forms.
Cognitive Conditions
Traumatic brain injuries (TBI), dementia, intellectual disabilities, and stroke-related impairments can significantly reduce a person’s executive functions, ability to make rational decisions, emotional stability, and more. These changes can appear gradually, making them particularly difficult to demonstrate to an insurance company.
Neurological Conditions
Epilepsy, migraines, and nerve pain are all neurological conditions that impair a person’s ability to participate in daily activities. They can be unpredictable, varying in both severity and frequency. However, without the ability to prove them diagnostically, those who suffer from these conditions may face an uphill battle against disability insurance.
Pathological or Autoimmune Conditions
Crohn’s disease, ulcerative colitis, multiple sclerosis (MS), lupus, Lyme disease, diabetes, heart problems, and respiratory problems can all fall under this category of hidden disabilities. While people suffering from these conditions may function well between flare-ups, bad days can easily incapacitate them and prevent them from performing simple tasks. Since they often have a variety of symptoms that may come and go, the extent of the disability can be difficult to quantify for insurance claim purposes.
Mental Health Conditions
Conditions such as anxiety, PTSD, schizophrenia, bipolar disorder, and depression can be debilitating. However, seeking help traditionally has been stigmatized, which can compound the problem. In addition, symptoms can be different from one day to the next, making it more difficult to prove the effects on daily life.
Other Chronic Conditions
Chronic pain conditions such as fibromyalgia, arthritis, degenerative disc disease, chronic fatigue syndrome (ME/CFS), Ehlers Danlos Syndrome (EDS), and similar conditions can cause widespread physical limitations. They are also more difficult to prove diagnostically, so those suffering from these conditions need additional support in order to prove their disability claims.
RELATED: Can I Get Long-Term Disability Benefits for Chronic Fatigue Syndrome?
Filing a Disability Claim for a Hidden Disability
If you or someone you love is suffering from a condition that is affecting daily activities and the ability to earn an income, it’s time to consider what options may be available.
Many people have short- and long-term disability insurance available through their employer. Others may have purchased private disability insurance. Lastly, people who qualify for Social Security Disability Insurance (SSDI) may have access to federal funds for their disability. Bryant Legal Group has extensive experience helping people like you navigate these insurance options, although we only take on SSDI claims when they are in tandem with long-term or private insurance disability claim.
The first step is to look at the terms of your insurance to see if your condition qualifies. Insurance benefits are unique to a particular policy, so not all policies will cover all conditions in the same way. For SSDI, covered conditions are in the SSDI Blue Book listing of impairments.
The second step is to identify what information you need to support your claim. This typically includes gathering medical evidence or records, detailed statements from medical providers, work history, and more. If it’s possible to provide diagnostic test results that confirm your condition, these will be essential to your case. But for many invisible disabilities, these objective test results do not exist.
Your disability insurance provider may require an Independent Medical Examination (IME) as part of your claims process. An IME is often looking for a way to deny or reduce your claim, and you should do your best to prepare for your IME appointment with these 5 tips.
RELATED: How Do You Prove You Are Disabled Under a Disability Insurance Policy?
Strengthening Disability Claims for Hidden Disabilities
The biggest danger with invisible disability claims is that they will be rejected due to insufficient medical evidence. To strengthen your claim, you should gather as much evidence as possible to show that your condition is serious, ongoing, and affects your daily life.
This can include information such as:
- Detailed Medical Records. You want to show consistent, ongoing care for your condition, where you follow the prescribed treatment plan as closely as possible. These records should include how your condition affects your inability to perform work-related tasks.
- Functional Capacity Evaluation (FCE). The FCE is an objective assessment of your physical and mental abilities, which can help demonstrate physical and mental limitations that may not show up on other medical tests.
- Cardiopulmonary Exercise Testing (CPET). The CPET uses objective measures to accurately assess an individual’s capacity to work. It is applicable to any condition where fatigue and reduced functioning are present. The 2-day testing protocol is particularly helpful in documenting post-exertional malaise (PEM) and whether symptoms worsen following physical activity.
- A Symptom Journal. Keeping a daily record of the severity of your symptoms, including how they affect your ability to participate in your daily activities, can be used as ongoing evidence of your condition.
- Written Statements from Healthcare Providers. These supplementary documents can demonstrate your limitations that are not listed elsewhere from the credible and objective view of a medical professional.
- Psychological or Neuropsychological Evaluations. For mental health conditions, these evaluations are treated as objective evidence of the severity of the condition. They demonstrate your level of cognitive function and how it can affect your ability to work.
To successfully put together a strong claim, you may face challenges when asking healthcare professionals for help. Written statements, referrals to specialists, and specific tests may be difficult to obtain.
An attorney who specializes in disability insurance law can help connect you with the right professionals and the right evidence. At Bryant Law, we can help you put together a strong case, using our in-depth knowledge and experience to find medical experts who can affirm the severity of your condition.
Long-term disability insurance claims for hidden disabilities can be complex and time-consuming. An attorney can help you navigate the insurance policy requirements, advise you on the best steps forward, and negotiate with the insurance company on your behalf. The sooner you involve your attorney, the better your chances are for a positive outcome.
Contact Bryant Legal Today
At Bryant Legal Group, we know the challenges of a hidden disability. Even your own medical providers, friends, and family may think you’re exaggerating your symptoms. Convincing the insurance company that your condition is real and debilitating can be very difficult.
That’s why we’re offering our help. We’ll fight to get you the insurance benefits that you deserve, while treating you with the compassion that you need.
Get started as soon as possible with a free consultation. You can call us at 312-561-3010 or use our online contact form, where we will review the specifics of your insurance claim and let you know your legal options.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.