Dealing with a disability claim can be overwhelming, especially when managing a disorder such as epilepsy. Seizures, cognitive changes, and the emotional impact of epilepsy can disrupt your work and daily life. If you find you cannot work because of your epilepsy-related symptoms, short and long term disability benefits can offer crucial financial help.
In this article, we’ll share how epilepsy causes disability, what to keep in mind when applying for benefits, and how a long term disability attorney can help win your short or long term epilepsy disability claim. By understanding the challenges unique to epilepsy-related disability claims, you can improve your chances of getting your benefits approved.
Can I Get Short and/or Long Term Disability for Epilepsy?
Yes, it is possible to qualify for short term and/or long term disability benefits if you have epilepsy, but your eligibility depends on various factors. These include the severity of your condition, the limitations your epilepsy imposes on your ability to work, and the specific terms of your disability insurance policy.
Here’s how it generally works:
Short Term Disability (“STD”): Short term disability benefits are typically available for a limited period, often ranging from a few weeks to a few months, depending on your policy. If your epilepsy episodes (seizures) or related medical treatments prevent you from working for a temporary period, you may be eligible to receive a portion of your salary or income through a short term disability insurance policy offered by your employer or obtained independently.
Long Term Disability (“LTD”): If your epilepsy is expected to impact your ability to work for an extended period (usually beyond the duration of short term disability coverage), you may qualify for long term disability benefits. Long term disability benefits provide a portion of your income over a longer duration, often until retirement age, if you are unable to work due to your medical condition.
In order to get approved for short or long term disability, you must demonstrate to your insurance company how your epilepsy causes disability and prevents you from working.
How Does Epilepsy Cause Disability?
Epilepsy can potentially cause disability due to the unpredictable nature of seizures and the potential physical, cognitive, and emotional impacts that can result from them. The degree of disability can vary widely depending on the type of epilepsy, the frequency and severity of seizures, and the effectiveness of treatment.
Here are some ways in which epilepsy can lead to short or long term disability:
Inability to Work: If epilepsy significantly impairs your ability to perform your job duties, you may be eligible for short or long term disability benefits. Seizures, especially if they are frequent or severe, can disrupt work tasks, create safety hazards, and prevent consistent attendance, all of which can lead to an inability to maintain employment.
Safety Concerns: Certain occupations involve a higher risk of injury or accidents if a seizure were to occur. For example, jobs that require operating heavy machinery, working at heights, or driving may be unsafe for individuals with uncontrolled or unpredictable seizures. You may be eligible for benefits if your epilepsy poses substantial safety risks at your workplace.
Medical Treatment and Side Effects: The treatments for epilepsy, such as medication regimens, can have side effects that impact your ability to work. Cognitive impairments, drowsiness, or other medication-related issues might hinder job performance and lead to a disability claim.
Cognitive Impairments: Epilepsy sometimes causes cognitive difficulties, including memory problems and difficulties with focus and concentration. These cognitive impairments can affect your productivity and your ability to carry out job tasks effectively.
Emotional and Psychological Impact: The emotional toll of epilepsy, including secondary anxiety and depression, can affect your mental health and work performance. If the emotional impact is severe enough to interfere with your ability to function at work, a short or long term disability claim might be warranted.
How Do Insurance Companies Evaluate Epilepsy Disability Claims?
When filing for short or long term disability for epilepsy, your insurance company will evaluate your claim to determine if you meet the eligibility criteria set out in your policy. Typically, this requires providing your insurance company with proof of your condition, symptoms, and demonstrating how they interfere with performing your occupational duties.
There are specific challenges and considerations unique to epilepsy disability claims. When filing a disability claim for epilepsy, you should be aware of the following factors:
Unpredictable Nature of Seizures: Epileptic seizures are often unpredictable, which can make it challenging to demonstrate consistent limitations to your insurance company. The sporadic occurrence of seizures may lead to skepticism from your insurance company regarding the severity of your disability.
Subjective Nature of Symptoms: Some symptoms of epilepsy, such as cognitive impairments or mood changes, can be subjective and harder to prove through objective means compared to physical symptoms. For example, fatigue and pain are not always easily measured with testing or imaging. These are referred to as “self-reported” symptoms. While your insurance company is supposed to take these into consideration, without substantial objective evidence, they may remain skeptical of your epilepsy’s impact on your work performance and deny your claim.
Impact on Different Occupational Roles: Epilepsy’s effects on work may vary depending on the type of work your occupation entails. It can be challenging to demonstrate how epilepsy limits job-specific tasks, especially if your role is primarily sedentary or requires cognitive skills rather than physical.
Intermittent Nature of Disability: You may experience periods of stability where you can work effectively with your epilepsy, followed by periods of increased seizure activity or medication adjustments that limit your ability to work. This intermittent nature of disability can be difficult to assess within the framework of a disability claim.
Invisible Disability: Epilepsy is often considered an “invisible” disability, as many symptoms are not immediately obvious to others. Insurance companies have a tendency to question the legitimacy of claims for conditions that aren’t readily visible.
Stigma and Misunderstanding: Stigma surrounding epilepsy can lead to misconceptions and biases during the claims process. Your insurance company may not fully understand the impact of epilepsy on daily life and work. If, for example, your insurance company believes that epilepsy is easily controlled and managed by medication, and that it should not interfere with your ability to work, they may deny your claim.
Limited Objective Tests: Unlike some medical conditions, there are limited objective tests that can definitively prove the extent of epilepsy-related limitations.
As private companies, insurance companies have a monetary incentive to deny claims. Without compelling evidence of your epilepsy symptoms and their impact on your ability to perform occupational duties, your insurance company may deny your claim. It’s always recommended that you consult with a long term disability attorney before filing, appealing, or litigating an epilepsy disability claim. A knowledgeable disability attorney can provide you with guidance, bolster your claim with evidence, and help you avoid the common mistakes people make when navigating the claims process alone.
What Evidence Can I Use to Support My Epilepsy Disability Claim?
To get approved for short or long term disability, you must gather strong and comprehensive evidence to support your epilepsy claim. Here are various types of evidence that you may use to demonstrate the impact of your epilepsy on your ability to work and function:
Diagnostic Records and Imaging: This includes detailed medical records confirming your epilepsy diagnosis, including the type of seizures you experience (e.g., tonic-clonic, absence, focal). Epilepsy is commonly diagnosed via EEG (electroencephalogram), MRI, and/or CT scans. These imaging reports should demonstrate abnormal brain activity consistent with epilepsy and reveal any structural abnormalities or underlying causes of your epilepsy.
Seizure Description: Medical notes from your treating doctors should describe the characteristics of your seizures, including frequency, duration, and any post-seizure effects.
Treatment History and Medication Records: This includes office visit notes from your doctor appointments, documentation outlining your treatment plan, prescribed medications, dosages, and any changes made over time. Your treatment records should detail any side effects or adverse reactions you experience from epilepsy medications that impact your daily functioning.
Seizure Diary or Log: Maintain a personal seizure diary or log that documents the date, time, duration, and description of each seizure episode. Include the severity of the episode, all symptoms that occurred before and after, and the length of those symptoms.
Physician Statements and Reports: A detailed statement from your neurologist or epileptologist describing the severity of your epilepsy, its impact on your daily life, and work-related limitations can be very impactful when submitting a short or long term disability claim. A specialist is always preferable over your primary care doctor for these statements, as they can provide an expert opinion on how your epilepsy affects your ability to work, concentrate, and perform activities of daily living.
Functional Limitations Documentation: If your epilepsy-related symptoms affect your physical functioning, consider undergoing a Functional Capacity Evaluation (“FCE”). The FCE focuses on measuring your level of functioning in different physical tasks, such as standing, sitting, walking, bending, hand dexterity, etc. The results of the FCE provide your insurance company with objective data on how your epilepsy-related symptoms directly impact your ability to perform specific physical job tasks and responsibilities.
Neuropsychological Evaluation: If you experience significant cognitive impairment due to your epilepsy, undergoing a neuropsychological evaluation may be beneficial for your disability claim. The neuropsychological evaluation is an objective medical assessment detailing any cognitive limitations, memory problems, or attention deficits resulting from epilepsy.
Witness Statements: Statements from colleagues, supervisors, friends, or family members who have observed the impact of your epilepsy on your work and daily life can help support your disability claim. It may be appropriate to request a statement from any individuals who have witnessed your seizures, describing their characteristics and the impact on your functioning.
Video Documentation: If available, video recordings of seizure episodes can provide visual evidence of the nature of your seizures. It can be harder for your insurance company to brush off the severity of your epilepsy when presented with this evidence.
Mental Health Professionals’ Reports: If applicable, you may submit reports from mental health professionals addressing any emotional or psychological effects of epilepsy, such as anxiety or depression, to your insurance company in support of your claim.
Vocational Assessment: A vocational assessment, performed by a vocational expert, provides your insurance company with an in-depth analysis of how your epilepsy-related limitations affect your ability to perform your current job or other suitable occupations.
Collecting and presenting a combination of these types of evidence will provide a comprehensive picture of how epilepsy impacts your ability to work and function, strengthening your short or long term disability claim.
How Can The Maddox Firm Help Me With My Epilepsy Disability Claim?
The Maddox Firm has helped hundreds of individuals successfully file, appeal, or litigate their short or long term disability claims. Epilepsy disability claims can be difficult to prove—you may have “good” days where your symptoms don’t impair your functioning, but then experience “bad” days where you cannot function at the level necessary to perform your job duties. Our experienced team understands the complexity of epilepsy disability claims and what is required by your insurance company to prove your condition prevents you from working.
Here are a few ways The Maddox Firm can help you with your epilepsy disability claim:
Understanding Your Policy: The Maddox Firm will examine your policy and help you understand the eligibility criteria, timelines, and any pre-condition clauses, condition exclusions, or benefit limitations. Your policy sets the stage for our strategy.
Collecting and Organizing Evidence: The Maddox Firm will obtain and organize medical evidence from your providers to support your disability claim. This includes medical records, test results, physician statements, and other documentation that demonstrates the impact of epilepsy on your ability to work.
Developing Evidence for Your Claim: Medical records don’t always provide the full picture of your symptoms and their severity. The Maddox Firm will coordinate with your treating healthcare providers to obtain supplemental letters of support and complete paperwork from your insurance company. In addition, we can recommend you for further testing with trusted providers, such as the FCE, neuropsychological evaluation testing, or a vocational assessment.
Handling Communication with Your Insurance Company: The Maddox Firm will manage all communication with your insurance company. This ensures that they do not impede on your rights or ask inappropriate questions.
Preparing and Submitting the Claim: The Maddox Firm will prepare a thorough and well-documented disability claim with as much evidence as possible. We’ll also make sure that all required forms are completed accurately, comprehensively, and submitted on time.
Appealing Denied Claims: If your epilepsy disability claim has been denied, The Maddox Firm can help you navigate the appeals process. We can review the denial letter, identify the reasons for the denial, and develop a strategy to strengthen your appeal.
Suing Your Insurance Company: In the event that litigation becomes necessary, The Maddox Firm can represent you in court and fight for your rights to obtain the disability benefits you deserve.
Whether you are looking for assistance in navigating the claims process, appealing a claim denial, or litigating a final adverse decision, The Maddox Firm can help with your epilepsy disability claim. 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 epilepsy short and/or long term disability claim.
Contact us to help you file your claim, appeal, or litigation the right way.