Coping with kidney disease can be physically and emotionally challenging, often requiring significant medical care, lifestyle adjustments, and financial support. If you are dealing with kidney disease, you may be considering your options for short and/or long term disability benefits. However, there are important factors to consider before filing a claim.
Below we’ll share our strategies on filing a kidney disease short and/or long term disability claim, including how insurance companies evaluate these claims, what evidence you may submit to support your claim, and how The Maddox Firm can help.
Can I Get Short and/or Long Term Disability for Kidney Disease?
Yes, it is possible to receive short and/or long term disability for kidney disease, but your eligibility for benefits depends on several factors. These factors include the terms of your insurance policy and the severity of your kidney disease symptoms.
The first step is to review your disability insurance policy. These policies vary widely, and the eligibility criteria for benefits will depend on the specific term language. The policy terms will explain the conditions you must meet to be awarded benefits and the timeline for the claims process. For example, disability insurance policies typically have an elimination period (also known as a waiting period) before benefits kick in. During this period, you are responsible for your own financial support. For short term disability insurance, the elimination period is typically a few weeks. For long term disability insurance, it can be several months. Be aware of the length of this period in your policy.
The severity and duration of your kidney disease will play a crucial role in determining your eligibility for benefits. Insurance providers will assess your medical condition, including your doctor’s recommendations and any limitations or restrictions you may have due to kidney disease. Without sufficient proof of how your kidney disease impacts your ability to work, your claim may be denied.
In the below sections, we’ll discuss how kidney disease causes disability and the evidence you can submit to support your claim.
How Does Kidney Disease Cause Disability?
Kidney disease can lead to long term disability when it significantly impairs your ability to perform daily activities, maintain employment, or engage in typical life functions.
Here are some ways in which kidney disease can cause disability:
Reduced Kidney Function: The primary function of the kidneys is to filter waste and excess fluids from the blood, regulate electrolytes, and maintain overall bodily homeostasis. When kidney disease progresses, the kidneys’ ability to perform these essential functions diminishes. As a result, waste products and fluids can accumulate in the body, leading to a range of complications.
Chronic Fatigue: Many individuals with kidney disease experience chronic fatigue due to the buildup of waste products in their bodies, anemia (common in kidney disease), and the overall strain on their systems. Fatigue can limit a person’s ability to perform daily tasks, including work. Severe fatigue can also cause cognitive impairment and difficulty concentrating, which can affect work performance and daily tasks.
Edema: Kidney disease can lead to fluid retention and swelling, especially in the legs and ankles, referred to as edema. Severe edema can impair mobility and cause discomfort, making it challenging to carry out routine activities.
Hypertension: Kidney disease is often associated with hypertension (the medical term for high blood pressure), which can lead to a range of health problems, including heart disease, stroke, and vision impairment. These conditions can cause disability or limitations in daily life.
Electrolyte Imbalances: Kidney disease can disrupt the balance of electrolytes (e.g., sodium, potassium, calcium) in the body, leading to muscle weakness, muscle cramps, and other neuromuscular issues that can limit physical activity.
Dialysis or Transplant Dependency: In advanced stages of kidney disease, you may require dialysis (a process that mechanically filters waste and excess fluids from the blood) or kidney transplantation. While these treatments can extend life, they also come with physical and lifestyle limitations.
Other Complications: Kidney disease can lead to complications such as anemia, bone disease, neuropathy, and cardiovascular problems, all of which can contribute to disability by limiting mobility, causing pain, or reducing overall well-being.
Mental Health Issues: Coping with the physical and emotional challenges of kidney disease, including the need for dialysis, dietary restrictions, and medication regimens, can lead to secondary mental health issues such as depression and anxiety, which can impact your ability to work.
How Do Insurance Companies Evaluate Kidney Disease Disability Claims?
Insurance companies evaluate kidney disease disability claims to determine if there is sufficient evidence proving that your condition prevents you from performing your occupational duties. Claimants with kidney disease may face specific challenges when filing for Short Term Disability (“STD”) or Long Term Disability (“LTD”) benefits due to the unique nature of their condition.
These challenges can include:
Complex Diagnosis and Documentation: Kidney disease is a complex condition with different stages and potential complications. You may need to provide comprehensive medical documentation that outlines the diagnosis, stage of the disease, treatment plan, and any associated complications. The complexity of the condition can make it more challenging to gather and present the necessary evidence.
Treatment and Side Effects: Kidney disease treatments, such as dialysis or transplantation, can have significant side effects and require adjustments to daily life. Your insurance company may not take this into consideration when evaluating your claim. You may need to demonstrate how their treatment and its side effects affect their ability to work and engage in daily activities.
Fluidity of Kidney Disease Progression: Kidney disease can progress at different rates, and the severity can change over time. Claimants may need to undergo periodic medical evaluations to assess the progression of their condition and determine ongoing eligibility for benefits.
Secondary Mental Health Illnesses: Coping with kidney disease and its treatments can take a toll on your mental health, leading to secondary conditions like depression or anxiety. Your insurance company may be quick to pin your disabling symptoms on a mental health illness instead of your kidney disease, as typically benefits for mental illness can be limited compared to a physical condition disability.
Proving Disability for Non-Physical Limitations: Kidney disease and the side effects from treatment can lead to cognitive impairment, fatigue, and other non-physical limitations that are less visible but equally disabling. You may need to provide documentation and assessments from healthcare providers that address these non-physical limitations.
Coexisting Health Conditions: Many individuals with kidney disease have other health conditions or comorbidities. You may need to navigate the complexities of demonstrating how your kidney disease, along with other health issues, collectively impairs your ability to work.
To overcome these challenges, it’s always recommended you speak with a long term disability insurance attorney. Understanding the specific terms and requirements of your insurance policy, as well as what to expect during the claims process, is essential for claimants with kidney disease seeking STD or LTD benefits. An experienced long term disability lawyer can provide invaluable guidance and increase your chances of winning your claim.
What Evidence Can I Use to Support My Kidney Disease Disability Claim?
When filing a disability claim for kidney disease, it’s crucial to provide comprehensive evidence to support your case. The strength of your claim often depends on the quality and completeness of the medical documentation you submit. Objective medical evidence, meaning test results, imaging studies, or anything quantifiable, will always hold the most weight with your insurance company. However, there are many kinds of evidence you may use to support your claim.
Examples of evidence you may submit include:
Medical Records: Gathering your complete medical records from your treating doctors related to kidney disease is essential. This should include records of diagnoses, treatment plans, and the progression of your condition over time. Ensure that your records are up-to-date and accurately reflect the status of your kidney disease.
Diagnostic Test Results: Include results of relevant diagnostic tests, such as blood tests (e.g., creatinine levels, glomerular filtration rate), urine tests (e.g., proteinuria, hematuria), imaging studies (e.g., ultrasound, CT scans), and kidney biopsies, if applicable. These tests provide objective evidence of your kidney function and the severity of your condition.
Physician Reports: Obtain reports from your treating physicians, nephrologists, or specialists who have been managing your kidney disease. Sometimes these reports will need to be completed on an Attending Physician Statement or "APS" provided by the disability insurance company. These reports should outline your diagnosis, treatment plan, and any limitations or restrictions on your ability to work or perform daily activities.
Medication and Treatment Records: Provide documentation of the medications you are prescribed, including dosage and any side effects. This can help demonstrate the medical necessity of your treatment and any side effects (such as drowsiness, nausea, etc.) that further contribute to your disabling condition.
Hospitalization Records: If you have been hospitalized due to complications of kidney disease, submit records of your hospital stays, including discharge summaries, surgical reports, and any other relevant documents.
Treatment History: Your insurance company will require proof that you have been compliant with treatment recommendations from your doctors. Provide medical records of any procedures or treatments you’ve undergone related to kidney disease, such as dialysis sessions, transplant surgery, or other medical interventions.
Functional Capacity Evaluation: A Functional Capacity Evaluation (“FCE”) can be instrumental in supporting a kidney disease disability claim by providing objective evidence of your physical limitations and functional capacity. The FCE is an evaluation conducted by a medical professional which assesses your ability to perform essential job-related tasks, helping to establish the extent to which kidney disease affects your capacity to work.
Neuropsychological Evaluation: If your kidney disease causes cognitive impairment, a neuropsychological evaluation can help your kidney disease disability claim. This evaluation can identify any cognitive deficits, mood disorders, or cognitive fatigue that may impair your ability to perform your occupational duties. By providing objective evidence of these cognitive limitations, a neuropsychological evaluation adds a vital layer of support to your claim.
Specialist Opinions: Obtain opinions from specialists, such as your nephrologist. These specialists can provide expert opinions on your patient history, symptoms, disease progression, and how your kidney disease affects your ability to work.
Personal Statements: Write a personal statement describing how kidney disease has affected your life, including details about your symptoms, pain, fatigue, and limitations in daily activities and work. Be honest and specific in your description.
Statements from Witnesses: If appropriate, consider obtaining statements from family members, friends, or coworkers who can attest to the impact of your kidney disease on your daily life and work performance.
Remember that the quality and completeness of your medical evidence are crucial for a successful disability claim. It’s essential to work closely with your healthcare providers to ensure that your medical records accurately reflect the impact of kidney disease on your life.
Additionally, consulting with an attorney experienced in disability claims can help you navigate the process and improve your chances of approval.
How Can The Maddox Firm Help Me With My Kidney Disease Disability Claim?
The Maddox Firm has helped hundreds of individuals successfully file, appeal, or litigate their short or long term disability claims, including those with kidney disease. Kidney disease is a complicated condition that can cause a wide variety of symptoms that are difficult to prove to your insurance company. Our experienced team understands the complexity of kidney disease disability claims and what documentation your insurance company requires to approve your benefits.
Here are a few ways The Maddox Firm can help you with your kidney disease short and/or long term disability claim:
Examining your disability insurance policies. The Maddox Firm will review your employer’s disability policies and any private insurance policies you may have to understand what benefits are available to you and the eligibility requirements for benefits.
Gathering all medical and vocational evidence on your behalf. The Maddox Firm will communicate with your providers to obtain all medical records on your behalf. We also handle communications with your employer for any necessary paperwork. With all documentation in hand, we can assess any gaps or weaknesses in your evidence and formulate a personalized strategy to file your kidney disease disability claim.
Obtaining any needed additional evidence. The Maddox Firm will coordinate with your nephrologist to obtain a supplemental letter elaborating on your kidney disease symptoms and how they impact on your ability to work. For a more in-depth assessment of your physical functioning, The Maddox Firm can refer you to undergo a Functional Capacity Evaluation, or if your symptoms affect your cognitive abilities, we can refer you for a neuropsychological evaluation. These assessments provide your insurance company comprehensive objective evidence of your limitations.
Handling all communications with your insurance company. The Maddox Firm will immediately take over all correspondence with your insurance company to ensure all paperwork is received and any questions or requests go through us. We make sure they receive what they need while protecting your rights.
Filing an appeal or litigation on your behalf. If your kidney disease disability claim has already been denied, or your benefits are terminated, The Maddox Firm can handle your appeal or litigation with your insurance company.
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 kidney disease 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 kidney disease short and/or long term disability claim.