When hearing loss impacts your ability to communicate, work, and engage with the world, you may consider seeking short and/or long term disability benefits. However, navigating the complexities of the disability claims process and ensuring your claim is well-documented can be a daunting task requiring careful consideration and strategic preparation. Working with an experienced long term disability attorney can maximize your chances of getting your short or long term disability claim approved.
In this article, we break down the process of obtaining short term and long term disability benefits for hearing loss, from understanding the available benefits to compiling the necessary evidence, and how The Maddox Firm can help prove your hearing loss disability claim.
Can I File for Short or Long Term Disability Due to Hearing Loss?
Yes, if you have disability insurance (most commonly through your employer or via a private policy you have purchased), you can file a short or long term disability claim for hearing loss, provided that your hearing impairment significantly affects your ability to work and perform daily activities. The claims process and eligibility criteria may vary depending on your insurance policy and the severity of your hearing loss.
Hearing loss is typically caused by damage to the structures of the inner ear or the auditory nerve, which are responsible for transmitting sound signals to the brain. Some common conditions and factors that can lead to permanent hearing loss include:
Noise-Induced Hearing Loss (NIHL): Prolonged exposure to loud noises, such as from machinery, concerts, or firearms, can damage the hair cells in the inner ear and lead to permanent hearing loss.
Genetic Factors: Certain genetic mutations can make individuals more susceptible to hearing loss. Some genetic conditions, like Usher syndrome, are characterized by both hearing loss and vision impairment.
Ototoxic Medications: Certain medications, particularly those used in chemotherapy, certain antibiotics (e.g., aminoglycosides), and certain diuretics, can cause damage to the inner ear and lead to permanent hearing loss.
Viral Infections: Viral infections, such as rubella, cytomegalovirus, and certain types of meningitis, can damage the inner ear structures and cause permanent hearing loss.
Head Trauma: Severe head injuries that affect the auditory pathways in the brain or damage the structures of the inner ear can result in permanent hearing loss.
Meniere’s Disease: This disorder of the inner ear causes episodes of vertigo, tinnitus (ringing in the ears), and fluctuating hearing loss. Over time, it can lead to permanent hearing impairment.
Acoustic Neuroma: Also known as vestibular schwannoma, this is a non-cancerous tumor that grows on the auditory nerve. As it grows, it can lead to permanent hearing loss on the affected side.
Tinnitus: Tinnitus is the perception of sound, such as ringing, buzzing, hissing, or clicking, in the ears or head when no external sound source is present. It is often associated with conditions affecting the auditory system, such as hearing loss or exposure to loud noise.
Congenital Conditions: Some individuals are born with structural abnormalities in the inner ear or genetic conditions that lead to congenital hearing loss.
Autoimmune Inner Ear Disease: An autoimmune response that targets the inner ear can result in permanent hearing loss.
Other Medical Conditions: Certain medical conditions, such as cardiovascular diseases, diabetes, and certain autoimmune disorders, can increase your risk of hearing loss.
Understandably, many kinds of hearing loss can make it impossible to continue working. Short term disability (“STD”) insurance provides income replacement for a limited period, typically a few weeks to several months, when you are unable to work due to a covered medical condition, such as hearing loss. STD helps bridge the gap between the onset of your disability and the point at which long term disability (“LTD”) insurance or your return to work becomes applicable.
Your insurance company’s definition of disability can vary depending on the type of insurance coverage and the policy itself. Generally, disability is determined by the extent to which your hearing loss impairs your ability to perform certain job functions. Some policies define disability as being unable to perform the duties of your current occupation (called an “own occupation” definition). This means that if you can’t perform your specific job, you may be considered disabled. Others may use an “any occupation” definition, where disability is determined by the inability to perform any occupation that you could reasonably qualify for based on your skills and qualifications. Oftentimes, “hybrid” policies will start your claim under an “own occupation” definition before eventually transitioning to an “any occupation” definition.
It’s important to carefully review the terms of your insurance policy before filing your claim. A long term disability attorney can help you understand the precise definition of disability in your insurance policy and create a strategy for winning your benefits.
How Does Hearing Loss Cause Disability?
Living with hearing loss can significantly impair your ability to perform your job duties and activities of daily living. Some of the ways hearing loss can contribute to disability include:
Occupational Limitations: Many jobs require effective communication, whether it’s interacting with colleagues, clients, or customers. Hearing loss can hinder your ability to understand instructions, participate in meetings, and communicate clearly. If your job relies heavily on verbal communication and your hearing loss prevents you from effectively performing these tasks, it can be considered a substantial occupational limitation.
Job Performance: If hearing loss affects your job performance, such as missing critical information during meetings, misinterpreting instructions, or not being able to communicate with coworkers or customers, it can result in decreased productivity and effectiveness in the workplace.
Accommodation Challenges: While accommodations such as hearing aids or assistive listening devices can help mitigate the impact of hearing loss, they might not completely eliminate the limitations it imposes. Some work environments may not be conducive to accommodating hearing-impaired individuals, further limiting your ability to perform your job duties.
Safety Concerns: Certain jobs have safety requirements that rely on hearing, such as detecting warning signals or alarms. If hearing loss puts you or your coworkers at risk due to an inability to hear critical auditory cues, it can be grounds for disability consideration.
Activities of Daily Living: In addition to work-related limitations, hearing loss can also impact an your ability to perform everyday activities, such as communicating with family and friends, running errands, and participating in social events.
Ultimately, whether your hearing loss qualifies as a disability for the purposes of short or long term disability benefits depends on your specific circumstances, the severity of your hearing loss, and the nature of your work. Consulting with an attorney experienced in disability claims can help you determine if you are eligible to receive short or long term disability benefits for your hearing loss.
How Do Insurance Companies Evaluate Disability Claims for Hearing Loss?
Your insurance company will evaluate your hearing loss disability claim to determine if you have provided sufficient evidence establishing your hearing loss diagnosis, severity, and its impact on your ability to perform your occupational duties.
As discussed above, the exact “definition of disability” you must meet will depend on the terms of your specific policy. While it’s not inherently more difficult to get approved for hearing loss compared to other disabilities, there are some challenges to consider:
Subjective Nature of Hearing Loss: Hearing loss is a subjective experience, and its impact can be difficult to quantify objectively. Your insurance company will require thorough documentation to establish the severity of your hearing impairment and how it affects your ability to work.
Varied Impact: The impact of hearing loss can differ greatly among individuals, depending on factors such as the degree of hearing loss you experience, the nature of the work you perform, and your job’s communication environment.
Interaction with Other Factors: If your hearing loss is exacerbated by other medical conditions or if you have other disabilities, the evaluation becomes more complex.
Insurance Policy Specifics: The terms of your insurance policy, including definitions of disability, occupational requirements, and waiting periods, can influence the ease of approval.
Evaluation Challenges: Since hearing loss is often invisible, insurers might find it challenging to understand the full extent of your limitations and the impact on your work and daily life.
Subjective Evidence: Relying on subjective evidence, like your own descriptions of communication difficulties, can be harder to validate compared to objective medical tests. That said, keeping a symptom diary can be among the most helpful types of subjective evidence.
While these challenges exist, many individuals with significant hearing loss successfully obtain LTD benefits by providing thorough documentation that highlights the impact on their work and daily life. Working with an attorney who specializes in disability claims can help you navigate the process effectively and present a compelling case for claim approval.
What Should I Submit with My Hearing Loss Disability Claim?
To approve your disability claim, your insurance company will demand substantial documentation of your hearing loss diagnosis, the severity of your hearing loss, and the required duties and functions of your job role. They will want to see that you are both medically disabled due to hearing loss and proof that you cannot work in your occupation due to your hearing loss.
Below we’ll discuss different types of evidence you may obtain to prove your medical disability and your inability to work.
Proving Medical Disability Due to Your Hearing Loss
When filing a disability claim based on hearing loss, providing thorough and relevant medical evidence is crucial for the success of your claim. Your insurance company will weigh any objective medical evidence above all else, though you should still submit any “subjective” evidence as well. Under ERISA regulations, insurance companies are not allowed to reject subjective symptom reports out of hand and must consider it fairly.
Here are some types of medical evidence that can be used to support a hearing loss disability claim:
Audiograms: Audiograms are comprehensive hearing tests conducted by audiologists. They provide a detailed assessment of your hearing abilities, including the degree and type of hearing loss. Audiograms measure your ability to hear different pitches and volumes of sound.
Vestibular Testing: Vestibular testing assesses the balance and spatial orientation of the inner ear, which is closely connected to hearing and can impact your ability to perform daily activities, including work-related tasks. If your vestibular testing identifies significant impairments that compound the challenges posed by your hearing loss, it can strengthen your claim by providing a more comprehensive picture of your overall condition and its impact on your ability to work and engage in daily life.
Medical Records: Medical records from otolaryngologists (ENT specialists) or other relevant specialists can document your hearing loss diagnosis, its underlying causes, and the progression of your condition.
Documentation of Treatment: Your insurance policy likely requires that you are seeking “appropriate treatment” for your condition. Records of treatments you’ve undergone for your hearing loss, such as hearing aid prescriptions, cochlear implant surgeries, or other medical interventions, can demonstrate the efforts you’ve made to manage your condition. These records should also document how these treatment efforts have not improved your hearing loss to the degree you can continue working.
Speech-Language Pathologist (SLP) Reports: If you’ve undergone speech therapy to improve communication skills affected by your hearing loss, reports from speech-language pathologists can provide insight into the functional impact of your condition on communication.
Medical Opinions: Letters or reports from medical professionals, including audiologists, otolaryngologists, or specialists, that outline the severity of your hearing loss, its impact on your ability to work and perform daily tasks, and your prognosis can strengthen your claim. We always recommend having a specialist who treats hearing loss write the opinion letter, as it will hold the most weight with your insurance company.
Objective Testing: Some insurance companies may require objective testing beyond audiograms, such as word recognition tests or speech-in-noise tests, to further assess your hearing capabilities in real-life situations.
Other Treatment and Medication Records: If your hearing loss is related to a separate medical condition or medication, documentation of that condition and its treatment can be relevant.
When submitting medical evidence, make sure it’s well-organized, clear, and relevant to your claim. A long term disability attorney can help you gather and present the appropriate medical documentation effectively to strengthen your hearing loss disability claim.
Proving Inability to Work Due to Your Hearing Loss
The second component of your claim is proving you cannot perform your job duties due to your hearing loss. Vocational evidence can demonstrate to your insurance company the scope of your occupational demands and how your hearing loss prevents you from meeting these demands.
Examples of vocational evidence to support your hearing loss claim may include:
Job Description: An official job description of your current occupation from your employer should outline your major occupational functions and responsibilities. This can show your insurance company what your role entails, including tasks that your hearing loss would prevent you from performing.
Personal Affidavit: We often recommend our clients write a personal affidavit to supplement other vocational evidence. Your affidavit should explain your education, background, job duties, the onset of your hearing loss, and how your hearing loss interferes with your ability to work (i.e., inability to participate in meetings or phone calls, communication struggles, etc.).
Statements from Your Employer/Co-Worker(s)/Family/Friends: Statements from your employer, supervisors, colleagues, family members, and/or friends can be submitted to support your claim. These witness statements should detail your communication struggles at work, social situations, and in your daily life. The statements can provide third-party evidence of the impact of your hearing loss on your ability to perform work.
Vocational Assessment: An occupational analysis can be performed by a vocational expert to evaluate the physical and cognitive demands of your work. The analysis will examine the essential functions of your job and determine if your cardiological condition prevents you from performing those functions. The vocational expert can evaluate your medical and vocational documentation to provide an informed opinion on whether your hearing loss disables you from working.
How Can The Maddox Firm Prove My Hearing Loss Disability Claim?
Proving disability due to hearing loss can be a time-consuming, stressful, and complex process. An knowledgeable disability insurance attorney can ensure that your claim is well-supported with as much evidence as possible. The experienced team at The Maddox Firm has successfully obtained short and long term disability benefits for many clients due to hearing loss.
Here are a few ways The Maddox Firm can prove your short or long term disability hearing loss claim:
We Examine Your Policy: The Maddox Firm will review your disability insurance policy and offer you advice regarding the specific criteria set by your insurance company. This encompasses covered and excluded conditions, the requisite definition of disability, the waiting period, and the benefit amount. In analyzing your policy, The Maddox Firm will pinpoint any potential concerns that might arise during your claim, such as limitations or exclusions that might impact your eligibility for benefits.
We Gather and Organize Your Medical Evidence: Presenting medical evidence that substantiates your hearing loss disability is a critical component of the claims process. The Maddox Firm will help you obtain and organize your medical records, guaranteeing your insurance company receives all relevant medical documentation. We’ll also coordinate with your treating physicians to secure additional supporting statements for your claim and meticulously review any questionnaires your doctor fills out for your insurance company, ensuring they are accurate and supportive.
We Help You Obtain Additional Evidence: The Maddox Firm can recommend you for additional testing if needed, such as vestibular testing. We can also refer you to trusted vocational experts to conduct a vocational assessment that may be used to further support your claim.
We Can Represent You in Appeals and Litigation: If your short or long term disability claim is denied or terminated, The Maddox Firm can represent you in the appeals process and, if necessary, litigation. We can prepare a strong appeal letter that addresses the reasons for the denial and presents new evidence that supports your claim. In litigation, The Maddox Firm can file a lawsuit against your insurer and represent you in court.
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 you secure benefits for your hearing loss. The team at The Maddox Firm will look over 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.