Stroke and Disability Insurance: A Claimant’s Guide, FAST for Stroke
Someone in the United States experiences a stroke every 40 seconds. During a stroke, survivors can suffer permanent brain damage that negatively impacts their ability to think, move, communicate, and perform their daily routine. In many cases, survivors can no longer work, so they turn to short-term and long-term disability policies for financial support.
If you or a loved one is a stroke survivor considering a disability insurance claim, you may have a lot of questions. Below, the disability professionals at Bryant Legal Group discuss the essentials of a stroke-related disability claim.
What Is a Stroke?
Strokes occur when something cuts off blood flow to the brain, causing brain cells to die. There are several types of stroke.
During an ischemic stroke, blood clots block a blood vessel and stop its flow to the brain. These blood clots can form anywhere in the body but often build up in the heart or arteries. Nearly 90% of strokes are ischemic.
Hemorrhagic strokes occur when an aneurysm bursts or a blood vessel leaks or breaks in the brain. As blood collects in the brain, it causes swelling and pressure that can damage and kill delicate brain tissues. While more rare than ischemic strokes, hemorrhagic strokes cause about 40% of stroke deaths.
Transient Ischemic Attack (TIA)
Technically, a TIA is not a stroke, although it creates stroke-like symptoms. During a transient ischemic attack, blood flow to the brain is temporarily halted but eventually continues. While a TIA rarely causes permanent brain damage, it places victims at a higher risk of stroke in the future.
According to the National Stroke Association, there are roughly seven million stroke survivors in the United States.
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FAST for Stroke
A quick response is vital when someone is having a stroke. While untreated, a stroke patient loses roughly 1.9 million neurons per minute. Doctors sometimes use the acronym FAST to help identify someone who needs immediate stroke treatment:
- Face: When the person smiles, does one side of their face droop?
- Arms: If they lift both of their arms, does one arm drift down?
- Speech: When the person repeats a simple phrase, do they slur or garble their words?
- Time: If you see any of these symptoms, call 911 immediately.
Other stroke symptoms can include sudden confusion, numbness, vision problems, dizziness, balance issues, and severe headache.
Sometimes, doctors can reduce the impact of a stroke by administering medications and performing surgeries. However, the longer it takes to diagnose and treat the individual, the more likely they are to suffer permanent and disabling brain damage.
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How Do Doctors Treat and Rehabilitate Stroke Patients?
Every stroke recovery is different. Some stroke survivors (about 10%) quickly return to their pre-stroke lifestyle and abilities, while others struggle with debilitating limitations. Roughly 10% of stroke survivors require skilled nursing care — and about 40% experience moderate-to-severe disabilities that require ongoing care and accommodations.
Typically, before you start a stroke treatment and rehabilitation program, your doctors will assess your function with the NIH Stroke Scale (NIHSS). This scale evaluates a stroke survivor’s abilities using 11 different factors — including level of consciousness, response to visual stimuli, and motor skills.
Based on your test results and NIHSS scores, your medical team may suggest a variety of treatment options, including:
- Medical Care: Addresses underlying health issues that increase your risk for another stroke — such as high blood pressure, cholesterol, heart disease, and diabetes.
- Monitoring: Your doctors will likely request consistent follow-up care and medical supervision, especially for hemorrhagic strokes.
- Occupational Therapy: Therapy designed to re-teach everyday skills and strengthen motor and sensory abilities.
- Physical Rehabilitation and Therapy: Therapy that helps rebuild strength and function in the limbs and teaches methods to regain independence despite stroke-related limitations.
- Speech and Language Therapy: Improves communication skills, re-teaches social cues, and helps rebuild swallowing abilities.
You may also require a stay in a more intensive rehabilitation hospital or facility, or you might need nursing or home care for a period of time. For many survivors, stroke recovery lasts a lifetime.
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Should I File for Disability Insurance Benefits After a Stroke?
If you are unable to work or maintain a job due to your stroke, you may qualify for short-term or long-term disability benefits. However, many factors can impact the strength of your disability insurance claim — including the severity of your residual limitations, your other medical conditions, your occupation, and the terms and conditions of your insurance policy.
Before you apply for disability benefits, you should consult with your doctors and an experienced disability attorney. Together, these professionals can help you fully understand your prognosis, work restrictions, the disability insurance policy’s requirements, and your legal options.
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If you, your doctors, and your disability attorney agree that it’s time to file for disability insurance benefits, your claim could go through several stages.
Application for Benefits
During the initial stage of an employer-sponsored disability insurance claim, you and your lawyer will collect evidence that supports your claim, including:
- Medical records
- Rehabilitation and therapy notes
- Records from long-term care or nursing facilities
- Psychological and cognitive studies
- Statements from your physicians and therapists
- Information about your pre-stroke job and skills
Once you’ve built a comprehensive record, you’ll submit this information and an application for benefits to the insurance company.
An insurance adjuster will review your claim and may ask for additional information. Once their investigation and review are complete, you will receive a letter in the mail that either approves or denies your claim.
If the insurance company denies your application for benefits, you may want to file an appeal. At this stage, it’s vital to provide any missing information that supports your claim to the insurance company. Again, the insurance company will either approve or deny your claim.
Federal Court Appeal
Once the insurance company issues a final decision about your stroke-related disability claim, you can file a federal lawsuit. However, you cannot submit additional evidence to the judge. Because ERISA claims are complex, you’ll typically need a lawyer’s guidance.
If your stroke disability claim involves private insurance rather than an employer-sponsored plan, you’ll follow a different process. A disability lawyer can help you understand the procedures and rules that apply to your specific claim.
Bryant Legal Group: Advocates for Disabled Stroke Survivors
Bryant Legal Group is one of Illinois’ preeminent disability law firms. We focus on complex insurance claims and provide our clients with personalized advice, practical strategies, and exceptional service. To request a complimentary evaluation, please contact Bryant Legal Group by calling 312-561-3010 or completing this brief online form.
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Surviving stroke: What you need to know about stroke and long-term disability (2016, August 8). National Stroke Association. Retrieved from https://www.stroke.org/stroke-and-long-term-disability-pdfversion/
Understand stroke (n.d.). National Stroke Association. Retrieved from https://www.heart.org/en/health-topics/consumer-healthcare/order-american-heart-association-educational-brochures/understanding-stroke-brochure-are-you-at-risk
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