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Short and Long Term Disability Due to Asthma

Long term disability due to asthma

Asthma is a chronic respiratory condition that affects millions of people worldwide.  It is characterized by inflammation of the airways, leading to difficulty breathing and potentially life-threatening complications.  While some people can manage their asthma with medication and lifestyle changes, others may experience severe symptoms that limit their ability to work and perform daily activities.


If you suffer from asthma and it prevents you from working, you may be eligible for short or long term disability insurance benefits. In this article, we will explain what these benefits are, how they differ, and what you need to do to apply for them.

 

Can I receive short or long term disability for asthma?


Yes, you can receive short or long term disability benefits for asthma if it significantly impacts your ability to work.  Asthma can manifest through various symptoms, including persistent coughing, wheezing, shortness of breath, and chest tightness.  These symptoms can vary in severity, potentially leading to frequent severe asthma attacks that necessitate emergency medical attention or interfere with daily activities.  Asthma is categorized into several types, such as allergic, non-allergic, occupational, exercise-induced, and severe asthma, each potentially affecting your ability to perform work-related tasks.

 

Short term disability (“STD”) benefits are typically available for a limited period, generally from a few weeks up to several months, providing financial support while you are temporarily unable to work.  Long term disability (“LTD”) benefits, however, are designed for more prolonged conditions that can last years, offering a longer-term financial safety net.  If you suffer from severe asthma and are covered by short and/or long term disability insurance (typically through your employer or purchased privately), you may qualify for disability insurance benefits.

 

Disability policies each have their own set of eligibility requirements, including how they define a disability and what evidence is required to prove it.  Understanding the nuances of your policy is crucial.  An attorney can play a crucial role in this process by helping you navigate the eligibility requirements, explaining the differences between STD and LTD, and ensuring you have a strong case.

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How do I know if my asthma is severe enough to qualify for short or long term disability benefits?


asthma inhalers long term disability

Determining if your asthma is severe enough to qualify for short or long term disability benefits involves evaluating the impact of your condition on your ability to work, in line with the specific criteria set forth by your disability insurance policy.  Generally, your asthma may be considered severe enough if:

 

  • You experience frequent, severe asthma attacks despite adhering to prescribed treatment plans, which may include the use of long-term control medications and quick-relief inhalers.

  • Your symptoms, such as persistent coughing, wheezing, shortness of breath, and chest tightness, significantly impair your daily activities and your ability to perform job duties.

  • You have documented evidence of hospitalizations, emergency room visits, or a need for urgent medical treatments related to asthma, indicating its severity and impact on your life.

  • Pulmonary function tests show diminished lung capacity below a certain threshold defined by your policy, which demonstrates the physiological impact of asthma on your ability to breathe.

 

It’s important to closely review your disability insurance policy to understand how it defines a qualifying disability and the evidence required to support a claim.  Policies vary in their definitions and requirements.  When considering filing a claim, consulting with an attorney experienced in disability claims can be invaluable.  A long term disability attorney can help you understand your policy’s specific requirements, ensure your claim is thoroughly documented, and represent you in the claims process or any appeals, should your initial claim be denied. Their expertise can significantly increase your chances of securing the benefits you need to manage your asthma.

 

What are the common reasons for denial of asthma-related disability claims?


Asthma-related disability claims may be denied for several common reasons, which often relate to the specifics of the disability policy and the documentation provided in support of the claim.  Understanding these reasons can help you better prepare your application or address issues in the event of a denial:

 

  • Insufficient Medical Evidence: One of the most frequent reasons for denial is the lack of sufficient medical evidence to demonstrate the severity of your asthma and its impact on your ability to work.

  • Lack of Objective Testing: Disability insurers often require objective testing to verify the severity of asthma.  This may include spirometry tests that measure lung function or peak flow monitoring that demonstrates variable airflow obstruction.  Claims lacking objective evidence may be denied.

  • Symptoms Not Severe Enough: Even with documentation, if your asthma symptoms do not meet the severity level defined in your disability policy as impairing your ability to work, your claim might be denied.  Policies vary in how they define disability, and some may not consider controlled asthma as qualifying.

  • Non-Compliance with Treatment: If there is evidence that you have not consistently followed prescribed treatment plans or taken prescribed medication, insurers may deny your claim on the basis that your condition might be controlled or improved with proper treatment.

  • Policy Exclusions or Limitations: Some disability policies have specific exclusions or limitations for conditions like asthma, especially if they consider it a pre-existing condition.  Review your policy carefully to understand any exclusions that may apply.

  • Discrepancies in Documentation: Inconsistencies in your medical records, employment records, and your claim application can lead to denial.  Insurers look for congruence in the information provided to support the severity and impact of your condition.

 

If your asthma-related disability claim is denied, it’s beneficial to consult with an attorney who specializes in disability law.  An attorney can help you understand the specific reasons for the denial, assist in gathering additional evidence or information needed, and represent you in the appeals process.  Their expertise can be invaluable in navigating the complexities of disability insurance and advocating for your rights to secure the benefits you are entitled to.

 

What documentation do I need to file a disability claim for asthma?


documentation for asthma long term disability claim

To file a disability claim for asthma, you’ll need to provide comprehensive documentation that not only details the medical severity of your condition but also illustrates how it impairs your ability to perform your job.  This documentation should blend medical and vocational evidence to create a clear picture of your disability and its impact on your work life.

 

Medical evidence to support your asthma short or long term disability claim may include:

 

  • Detailed Medical Records: Include records from all healthcare providers involved in your asthma care, such as primary care physicians, pulmonologists, and emergency department visits.  These should document your diagnosis, treatment plans, response to treatments, and any changes in your condition over time.

  • Results of Pulmonary Function Tests: Tests like spirometry, which measures the amount and speed of air you can inhale and exhale, provide objective evidence of the severity of your asthma.  Other tests might include peak flow monitoring or methacholine challenge tests.

  • Documentation of Asthma Attacks: Records of hospitalizations, emergency room visits, or urgent care treatments due to asthma attacks are critical.  They demonstrate the severity and frequency of your attacks.

  • Medication and Treatment Compliance: Proof of your adherence to prescribed medications and treatments shows you have attempted to manage your asthma as recommended by healthcare professionals.

  • Functional Capacity Evaluation (“FCE”): A functional capacity evaluation is a comprehensive evaluation conducted by a healthcare professional (typically an occupational therapist) that assesses your physical abilities in relation to your job duties.  It can provide objective evidence about your capacity to work and might include tests of endurance, strength, and respiratory function tailored to simulate work tasks.

 

In addition to medical documentation, you may submit vocational evidence, including but not limited to:

 

  • Job Description: A detailed job description that outlines the duties and physical requirements of your position helps to establish the context for your disability claim.  It’s crucial to demonstrate how your asthma prevents you from performing specific job tasks.

  • Statement from Your Employer: A statement or documentation from your employer regarding any adjustments, accommodations, or absences related to your asthma can support your claim.  This can include changes in your work performance or the need for frequent breaks.

  • Personal Statement: A personal account of how asthma affects your daily life and work can provide insight into your condition’s impact beyond what clinical records can show.  Describe your symptoms, how they affect your ability to work, and the limitations you experience.

 

Collecting and organizing this documentation can be daunting.  Working with an attorney who specializes in disability claims can help streamline this process.  An ERISA attorney can assist in gathering the necessary evidence, ensuring that your documentation meets your insurance company’s requirements, and articulating how your asthma qualifies as a disability under the terms of your policy.  This professional assistance can be crucial in presenting a strong and compelling disability claim.

 

How can The Maddox Firm prove my asthma short or long term disability claim?


The Maddox Firm | Long Term Disability & ERISA

The Maddox Firm has helped many clients secure their benefits for pulmonary conditions, including asthma.  Our experienced team can provide comprehensive support in proving your asthma-related short or long term disability claim.  The Maddox Firm is prepared to navigate the complex claims process to ensure you receive the benefits you’re entitled to.

 

Here are a few ways we can prove your asthma short or long term disability claim:

 

  • We Examine Your Policy and Assess Your Claim: Our first step is to thoroughly review the specifics of your disability insurance policy.  Understanding the fine print allows us to assess your claim accurately, focusing on how your asthma meets your policy’s definition of disability.  We’ll guide you through the eligibility requirements and help you understand how your condition qualifies.

  • We Handle All Communications with Your Insurance Company: Dealing with insurance companies can be overwhelming, especially when managing a condition like asthma.  We take this burden off your shoulders by handling all communications on your behalf, ensuring your rights are protected and your claim is presented clearly and effectively.

  • We Help You Obtain Evidence to Support Your Claim: Proving the severity of asthma and its impact on your ability to work is crucial.  We assist in gathering all necessary medical and vocational evidence, including detailed medical records, results of pulmonary function tests, and documentation of how your asthma limits your work activities.  We may also recommend undergoing a Functional Capacity Evaluation (“FCE”) to provide objective data about your limitations.

  • We Handle Appeals and Litigation: If your claim is unfairly denied, we’re prepared to fight for your rights through the appeals process and, if necessary, litigation.  Our team has the expertise to challenge denials, negotiate with insurance companies, and represent you in court to secure the disability benefits you deserve.

 

A short term disability or long term disability claim for asthma can be a complicated process. If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help.  The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.

 

 

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