Short and Long Term Disability for Syncope and Vertigo

Syncope and vertigo are debilitating conditions that can significantly interfere with your ability to work.  Whether you experience sudden fainting episodes or debilitating dizziness, these symptoms can make it difficult—if not impossible—to perform everyday tasks, maintain a regular work schedule, or ensure your own safety in the workplace.  If your symptoms are severe enough to impact your job performance, you may be entitled to short or long term disability benefits.

However, obtaining these benefits can be challenging, especially since syncope and vertigo often involve inconsistent and unpredictable symptoms.  In this article, we’ll answer key questions about filing for disability benefits for syncope and vertigo, and explain how you can build a strong disability insurance claim to secure the financial support you need.

How Can Syncope and Vertigo Affect My Ability to Work?

Syncope and vertigo can significantly impact your ability to work, especially if your job requires tasks that depend on balance, focus, or physical coordination.  These conditions often cause sudden episodes of dizziness or fainting, making it difficult to maintain consistent work performance and posing serious safety risks in certain professions.  The unpredictability of these symptoms can affect both your physical and cognitive abilities, limiting your capacity to perform your job safely and effectively.

For example, imagine a nurse who experiences frequent vertigo and syncope.  Her job requires her to be on her feet for long shifts, moving quickly and responding to patient needs.  During a shift, she might experience a sudden bout of dizziness or even faint, putting both herself and her patients at risk.  Despite her best efforts to manage the symptoms, the unpredictability of her condition eventually makes it impossible for her to continue working safely.  This nurse would likely need to seek short term or long term disability benefits due to the severity and frequency of her episodes.

Here are some ways syncope and vertigo can affect your work:

• Frequent episodes may prevent you from maintaining a regular work schedule.

• Sudden fainting spells can pose safety risks if you work in environments that involve machinery, driving, or operating heavy equipment.

• Dizziness and loss of balance can make it difficult to perform tasks that require standing, walking, or climbing stairs.

• Cognitive symptoms such as brain fog, confusion, or difficulty concentrating can impair your ability to focus on tasks, make decisions, or solve problems.

• The unpredictability of symptoms can increase anxiety and stress, leading to decreased job performance and reliability.

In more cognitively demanding roles, the impact can be just as profound.  For example, a software engineer who experiences frequent vertigo may struggle to concentrate on complex coding tasks due to constant dizziness and disorientation, leading to a significant drop in productivity.  Whether your job requires physical exertion, mental clarity, or both, syncope and vertigo can quickly make working impossible.

The debilitating nature of these conditions can severely limit your ability to work.  If your symptoms are frequent and unpredictable, short term or long term disability benefits may be necessary to compensate for your inability to maintain a regular work schedule, perform essential job functions, or ensure workplace safety.

Can I Qualify for Short Term or Long Term Disability Benefits Due to Syncope or Vertigo?

Yes, you can qualify for short term or long term disability benefits due to syncope or vertigo if your symptoms prevent you from performing your job.  Both conditions can significantly impact your ability to work, especially if your episodes are frequent, unpredictable, or accompanied by dizziness, loss of balance, or fainting.  To be eligible, you will need to meet certain common criteria set by disability insurance policies.

Disability policies generally have two types of definitions that impact eligibility:

• Own Occupation: Under the “own occupation” definition, you may qualify for benefits if your syncope or vertigo prevents you from performing the specific duties of your own job.  For example, if you’re a doctor and frequent fainting spells make it impossible to care for patients safely, you could qualify for disability benefits under this definition.

• Any Occupation: The “any occupation” definition is stricter and requires that you be unable to perform any job that you are reasonably qualified for based on your education, training, or experience.  If your syncope or vertigo prevents you from performing not only your current job but any other type of work, you may qualify for benefits under this definition.

To qualify for short or long term disability benefits, you must show that your condition prevents you from fulfilling your job duties.  For short term disability, this typically means a temporary inability to work, whereas long term disability requires evidence that your condition will likely persist for an extended period of time.  Your application must clearly explain how syncope or vertigo impacts your ability to perform work tasks. This could include safety risks (such as fainting while driving or operating machinery), an inability to stand or walk without becoming dizzy, or cognitive issues like difficulty focusing or decision-making.

Eligibility is proven via medical evidence, including your diagnosis of syncope or vertigo, the frequency and severity of your symptoms, and any limitations they cause.  Insurance companies also expect that you are following a prescribed treatment plan to manage your condition.  Your claim should show that you are pursuing appropriate medical treatment, such as medications, physical therapy, or other interventions, and that your symptoms continue despite these efforts.

By meeting these criteria and demonstrating how syncope or vertigo affects your ability to work, you may be eligible for short term or long term disability benefits under your insurance policy.

What Evidence Is Required to Support a Disability Claim for Syncope or Vertigo?

To support a disability claim for syncope or vertigo, you will need to provide a variety of evidence that demonstrates how your condition prevents you from performing your job duties.  Insurance companies require detailed documentation to assess the severity and impact of your condition.

Here are some types of evidence can help strengthen your claim:

• Diagnostic Information: A formal diagnosis from your doctor, including detailed records of your symptoms, their frequency, and severity. 

• Test Results and Imaging: Results from diagnostic tests such as tilt table tests, MRIs, or electrocardiograms (“ECG”) that confirm syncope or vertigo.

• Medical Records: Medical records include office notes from your physician(s) detailing how your condition limits your ability to work, along with treatment records showing the therapies or medications you’ve tried and any noted improvements or ongoing issues despite treatment.

• Functional Capacity Evaluation (“FCE”): An FCE can help support your short or long term disability claim, which is often conducted by a physical therapist to assess your physical abilities and limitations.  The evaluation measures your strength, endurance, balance, and ability to perform job-related tasks.  It can provide objective evidence that your syncope or vertigo impacts your ability to meet the physical demands of your job.

• Neuropsychological Evaluation: If your condition causes cognitive issues, such as confusion, difficulty concentrating, or memory problems, a neuropsychological evaluation can objectively document these deficits.  This can be particularly useful if your job requires mental focus or problem-solving skills, and your ability to perform these tasks is compromised by your condition.

• Vocational Evidence: This evidence may include your resume, official job descriptions outlining the essential duties of your position, and a vocational assessment from a vocational expert who can explain how your symptoms specifically interfere with your ability to perform your job or transition to another occupation.

• Personal Affidavits: A personal affidavit is your own written statement that describes how your symptoms affect your daily life and ability to work.  This personal testimony can help insurance adjusters understand the real-world impact of syncope or vertigo on your functionality.  It is also an opportunity to elaborate on aspects of your condition and your occupation that the other evidence does not cover.

• Witness Statements from Employers or Co-workers: Statements from your employer or colleagues can be powerful in demonstrating how your condition affects your job performance.  These statements can describe specific instances where your symptoms impacted your ability to work, such as frequent absences, fainting episodes, or difficulty completing tasks safely.

• Witness Statements from Family and Friends: Statements from family members or close friends who have witnessed your symptoms outside of work can further validate your claim.  These individuals can provide insight into how syncope or vertigo affects your daily living activities, mobility, and overall quality of life.

By providing a combination of medical, vocational, and personal evidence, you can build a strong case for why your syncope or vertigo prevents you from working and qualifies you for disability benefits.  Each piece of evidence helps create a more comprehensive picture of how these conditions limit your ability to perform your job, whether physically, cognitively, or both.

How Do Insurance Companies Evaluate Syncope and Vertigo Claims?

Insurance companies evaluate syncope and vertigo disability claims by carefully reviewing your medical, vocational, and functional evidence to determine whether your condition meets the policy’s definition of disability.  Because syncope (fainting) and vertigo (dizziness) can be unpredictable and episodic, insurers will look for thorough documentation that demonstrates the frequency, severity, and impact of your symptoms on your ability to work.

Here are common factors insurance companies consider when evaluating syncope and vertigo claims:

• Medical Records: Insurers will look for a confirmed diagnosis, including diagnostic tests (such as tilt-table tests, MRIs, or EEGs) and detailed treatment records showing ongoing management of your condition.

• Functional Limitations: The insurer will assess how your symptoms impact your ability to perform job tasks, particularly those involving physical coordination, balance, or concentration.

• Vocational Impact: Insurers will evaluate whether you are able to perform the essential duties of your current job under an “own occupation” policy or any reasonable job under an “any occupation” policy.

• Objective Evidence: While syncope and vertigo are often difficult to capture through testing, insurance companies prefer objective evidence like Functional Capacity Evaluations (“FCE”) to assess physical limitations and neuropsychological evaluations to measure cognitive impairments.

• Treatment Compliance: Your claim must demonstrate that you are following the prescribed treatment plan, including medications, therapies, or other interventions, and that your symptoms persist despite these efforts.

Despite providing thorough documentation, you may face challenges such as proving the consistency of your symptoms, as both syncope and vertigo can be episodic in nature.  Insurance companies may also question the severity of your condition if objective evidence is limited.  However, by gathering strong medical evidence, vocational support, and personal statements, you can create a more compelling case to prove that your condition is disabling and warrants approval of your short or long term disability claim.

Can Syncope or Vertigo Be Considered a Long Term Disability If My Symptoms Are Inconsistent?

Yes, syncope or vertigo can be considered a long term disability even if your symptoms are inconsistent, as long as they are severe enough to prevent you from working over an extended period of time.  While insurance companies often scrutinize claims for conditions with intermittent symptoms, such as syncope and vertigo, you can still qualify for long term disability if you provide strong evidence that these episodes significantly impair your ability to work, even if they don’t occur every day.

Inconsistent symptoms can pose challenges in proving the extent of your disability, but there are ways to strengthen your claim:

• Medical Documentation: You’ll need thorough medical records showing your diagnosis, the frequency and severity of your episodes, and how they impact your ability to perform job duties.

• Functional Capacity Evaluations (“FCE”): These evaluations measure your ability to perform physical tasks and can provide objective proof of your limitations, even if your symptoms vary.

• Neuropsychological Evaluations: If syncope or vertigo affects your cognitive abilities, such as concentration or memory, a neuropsychological evaluation can demonstrate how these issues impact your job performance.

• Symptom Diary: Keeping a detailed symptom diary can be one of the most effective ways to track the frequency, duration, and severity of your episodes.  This allows you to document your symptoms on both “good” and “bad” days, giving the insurance company a clearer picture of how unpredictable and disabling your condition can be.

• Witness Statements: Statements from family, friends, or coworkers can corroborate the impact of your condition, especially if they’ve observed how your symptoms affect your ability to function.

Even if your symptoms are inconsistent, providing comprehensive evidence can help demonstrate that the overall unpredictability and severity of your condition make it impossible for you to maintain employment.  A symptom diary, along with medical and vocational evidence, can be particularly useful in showing how your condition fluctuates and how it affects your day-to-day life, ultimately supporting your long term disability claim.

What Can I Do If My Short or Long Term Disability Claim for Syncope or Vertigo is Denied?

If your short or long term disability claim for syncope or vertigo is denied, it can be frustrating, but you still have options to challenge the decision.  Denials are not uncommon, especially for conditions like syncope and vertigo, which may have inconsistent symptoms or be difficult to document through standard medical tests.  However, you can take important steps to strengthen your case and improve your chances of getting the benefits you deserve.

Here are actions you can take if your claim is denied:

• Carefully Review the Denial Letter: Review your insurance company’s denial letter carefully to understand the specific reasons for the denial.  This will help you and your attorney identify what additional evidence is needed to strengthen your claim.

• Consult a Disability Insurance Attorney: One of the most important steps you can take is to consult with a disability insurance attorney, particularly one experienced with ERISA (“Employee Retirement Income Security Act”) claims.  ERISA governs most group disability policies, and the process for appealing a denial under ERISA is complex.  An experienced attorney can help navigate this process, identify missing evidence, and build a stronger appeal on your behalf.

• Gather Additional Evidence: You may need to submit more comprehensive medical documentation, such as updated medical records, more detailed diagnostic tests, or evaluations like a Functional Capacity Evaluation (“FCE”) or neuropsychological assessment.  A symptom diary can also help provide detailed evidence of your condition’s impact over time.  Your attorney can be instrumental in coordinating additional testing and other evidence needed to perfect your appeal.

• Obtain Witness Statements: If you haven’t already, gather statements from family, friends, coworkers, or supervisors who can describe how your syncope or vertigo impacts your daily activities and ability to work.  These personal testimonies can strengthen your claim by providing first-hand accounts of your condition’s effects.

An attorney experienced in disability law can guide you through the appeals process, ensuring that your claim is presented with the strongest possible evidence.  They will understand the specific requirements of your insurance policy and the legal standards involved, increasing your chances of success in overturning the denial.  Avoid handling the appeal on your own, as disability claims, especially those involving ERISA policies, require expert knowledge to navigate effectively.

How Can The Maddox Firm Prove My Short or Long Term Disability Claim?

The Maddox Firm is committed to helping you secure the short or long term disability benefits you deserve for your syncope or vertigo claim.  We understand the challenges that come with proving conditions that have unpredictable or inconsistent symptoms, and our team is here to guide you through every step of the process.  Here’s how we can help:

• We Examine Your Policy and Assess Your Claim: Our team thoroughly reviews your disability insurance policy to understand the specific terms, definitions of disability, and any exclusions that might apply.  We assess your claim to ensure it aligns with your policy’s requirements, helping you understand what is needed to demonstrate that your condition qualifies for benefits.

• We Handle All Communications with Your Insurance Company: Dealing with insurance companies can be overwhelming, but The Maddox Firm manages all interactions on your behalf.  We ensure that all necessary information is communicated clearly and in a timely manner, protecting you from common tactics insurers use to delay or deny claims.

• We Help You Obtain Evidence to Support Your Claim: We work with you to gather strong medical evidence, including diagnostic tests, physician reports, Functional Capacity Evaluations (“FCE”s), and neuropsychological evaluations.  Additionally, we help you collect personal affidavits and witness statements from coworkers, employers, family, or friends to further support your case.

• We Handle Appeals and Litigation: If your claim is denied, we are fully prepared to file an appeal and handle any litigation if necessary.  The Maddox Firm understands the best strategies for navigating the complexities of ERISA regulations and other legal processes, ensuring that your appeal is handled with precision and a comprehensive legal strategy.

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.

Contact us to help you file your claim, appeal, or litigation the right way.