Liver disease is more common than you might imagine. According to the Centers for Disease Control and Prevention, 4.5 million Americans have a diagnosed liver disease, and roughly 42,000 people die every year as a result.
If you or someone you love is suffering from chronic liver disease that affects your ability to do your job, you should understand your options for pursuing long-term disability benefits. While liver disease may be covered by your policy, obtaining disability benefits for liver disease won’t necessarily be easy, and you may need the help of a disability attorney to gather the necessary medical evidence, handle the paperwork, and negotiate with your employer and the insurance company on your behalf.
In this blog, the Bryant Legal Group team will outline what you need to know about liver disease, how it affects the body, and how you can strengthen your long-term disability claim.
What Is the Liver and How Does It Function?
The liver is one of the most critical organs in your body. Roughly the size of a football, the liver can be found on the right side of your abdomen underneath the ribcage.
When your liver functions normally, it filters toxins out of the blood and produces bile that helps you digest food. The liver also helps process iron, pro6duces amino acids, and helps convert waste products into urine.
The liver is the only organ in the body that can help replace cells once they’re damaged. However, when the liver itself becomes damaged as your liver disease progresses, it will no longer be able to function at 100%, and it may not be able to meet your body’s needs.
- Related Article: 5 FAQs About Private Disability Insurance Claims
What Causes Liver Disease?
Liver disease can be inherited or caused by behaviors, medications, or certain viruses. Common causes include:
- A family history of liver disease
- Infected needles from drug use, tattoos, or piercings
- Exposure to other people’s body fluids, especially through unprotected sex
- Alcohol abuse
- Overuse of acetaminophen
Some other causes and complications can impact your likelihood of developing liver disease. If you have questions about your health and options, contact your doctor right away.
How Liver Disease Affects Your Body
There are many different types of liver disease, including alcoholic liver disease, viral infections (hepatitis), genetic disorders, and cancer. All present unique challenges. But no matter what kind of liver disease you have, they all generally progress in a similar way.
Inflammation
In the early stages of liver disease, the liver becomes inflamed. People with early-stage inflammation of the liver rarely feel symptoms. However, if the inflammation persists, it can damage the liver permanently.
Fibrosis
If left unchecked, the inflamed liver tissue will scar; this process is known as fibrosis. The new scar tissue replaces healthy, functioning liver tissues, which means the liver’s ability to do its job decreases as the scar tissue forms. If you can catch the damage at this stage, there’s still a chance your liver can recover.
Cirrhosis
Once hard scars have replaced the liver’s soft, healthy tissue, the scar tissue can no longer help the body or function properly. If enough of the liver becomes scar tissue, the liver begins to fail, which can lead to complications. Many people only discover they have chronic liver disease at this stage. Symptoms can include:
- Abdominal pain
- Severe swelling
- Jaundice
- Bruising easily
- Fatigue
- Diarrhea
- Mental disorientation
- Excess fluid in the abdomen and limbs
- Insulin resistance
Getting treatment at this stage can help prevent your chronic liver disease from progressing.
Cancer or End-Stage Liver Disease
End-stage liver disease (also called liver failure) is a severe condition that can’t be reversed. People with severe decompensation, or organ failure, are almost exclusively treated with a liver transplant. Liver cancer can develop at any stage, but it commonly affects severely damaged livers.
Liver disease is a serious disease with many painful and debilitating symptoms. Struggling to cope with your new limitations and abilities is normal. If you need help managing your symptoms and professional responsibilities, contact your doctor right away.
Long-Term Disability and Liver Disease
If your chronic liver disease is severe enough to keep you from working, you may qualify for disability benefits under a long-term disability policy. However, getting those benefits approved may take some work—particularly if you have had liver disease for years and this is the first time you are pursuing benefits.
After you file your claim, an adjuster from the insurance company will begin to review and evaluate your medical records. Part of their job will be to assess your “residual functional capacity,” or in other words determine whether or not you are still able to work in some capacity despite your diagnosis.
Because this adjuster works for the insurance company, they are incentivized to determine that you are “fit for duty,” even if you and your treating physician disagree.
Common Reasons Why Your Disability Claim Might Be Denied
Although there are many reasons why your claim might be denied, some of the most common issues include:
- Definition of disability: Some long-term disability insurance policies have an “own occupation” definition, meaning you qualify for disability benefits if you cannot perform your current job. Others have an “any occupation” definition, meaning you need to be completely unable to work, including jobs outside your current occupation. An own occupation policy provides much stronger protection.
- Pre-existing conditions clause: Many people live with chronic liver disease for years without even realizing it, or work around it. If your policy has a pre-existing conditions clause, the insurance company may argue that you should still be able to work despite your diagnosed medical condition. You will need to provide solid medical evidence showing how your symptoms have progressed to the point where you are no longer able to continue working.
- Lack of evidence: Potentially disabling liver disease symptoms, such as pain and excessive fatigue, can be subjective. Unfortunately, you may be accused of making up or exaggerating your symptoms, particularly if you don’t have robust medical records and a letter from your treating physician backing you up.
Substance Use Could Affect Your Disability Insurance Claim
Alcohol and drug abuse are two critical factors that can affect your liver health. If your liver disease was caused or impacted by excessive alcohol use, you should understand your disability claim options, as well as the terms of your long-term disability plan, which may include limitations on benefits resulting from substance abuse disorders. In this difficult situation, it’s in your best interest to contact a disability claims attorney who can help you navigate the process.
What About Social Security Disability Benefits?
In addition to long-term disability benefits, you may also qualify for Social Security benefits. Many liver diseases, including cirrhosis, autoimmune hepatitis, and others are listed in the Social Security Administration Blue Book, which outlines specific disabling impairments.
However, in general, your symptoms must be very severe in order to meet the listing requirements for automatic approval, so proving that your liver disease prevents you from working will require extensive diagnostic evidence.
While Bryant Legal Group primarily focuses on helping clients secure disability insurance benefits from private employer-sponsored plans, if your case also qualifies for Social Security disability insurance, we are happy to help you with this as well. Please note that we do not handle stand-alone Social Security claims.
How to Strengthen Your Disability Case
If you want to give yourself the best chance at a quick approval of your disability benefits, or a successful appeal, it is important to work with medical and legal experts who have knowledge, experience, and credibility.
Make Sure You Get Appropriate Medical Treatment
If you’re dealing with any kind of liver disease, make sure you get a clear diagnosis and that you’re receiving adequate medical care.
There are a variety of medical tests that can diagnose and evaluate chronic liver disease, including blood tests, imaging tests (ultrasound, CT scan, MRI), and even a liver biopsy. Your doctor can help you understand what stage of development your disease is at, suggest lifestyle changes to support your liver health, or prescribe medication to help address symptoms.
Not only is ignoring your doctor’s orders bad for your health, but it also gives the insurance company a reason to deny your disability claim.
Talk With an Experienced Long-Term Disability Attorney
Getting approved for disability benefits is a complex process. Most insurance companies will require the completion and submission of several forms, including claim forms from the insured and their employer, medical authorization forms, medical records, physician statements, and more.
While your long-term disability insurance policy will cover all the requirements and procedures you’ll need to follow when you file, these documents usually contain dense legal language and are difficult for claimants to follow. Unfortunately, unintentional mistakes you make during the claims process can lead to lengthy delays, or even denials of otherwise legitimate claims.
An experienced long-term disability attorney can carefully review your policy, handle the documentation and discussion with the insurance company on your behalf, and fight for you if your claim is unfairly denied or the insurance company makes unreasonable requests.
Bryant Legal Group: Experienced Chicago Disability Lawyers
If you or someone you love has liver disease and needs to understand the available legal options and how to navigate the long-term disability claim options, the Bryant Legal Group team is ready to guide you through the claims and appeal process. We work with clients throughout Illinois with their disability insurance claims, no matter how complex. We’re proud of our reputation for a client-focused, no-nonsense approach to handling cases.
To request a consultation, please complete our online form or call us at 312-634-6160. We’ll connect you with one of our experienced disability lawyers to get started.
We look forward to hearing from you!