Short and Long Term Disability Due to Myasthenia Gravis
- Matthew Maddox
- 14 hours ago
- 10 min read
Filing a short term or long term disability claim for myasthenia gravis can be challenging. Myasthenia gravis is a chronic autoimmune condition that disrupts communication between nerves and muscles, leading to symptoms such as muscle weakness, fatigue, and vision problems. These symptoms can fluctuate and often worsen with activity, making it difficult to maintain consistent work performance. Despite the severity of these limitations, insurance companies may argue that treatment should control your condition or that your symptoms don’t prevent you from working.
This article explains the challenges of proving disability due to myasthenia gravis and the steps you can take to strengthen your claim.
How Can Myasthenia Gravis Affect My Ability to Work?
Myasthenia gravis can significantly impact your ability to work due to its hallmark symptoms of muscle weakness and fatigue. These symptoms can vary in severity and often worsen with activity or as the day progresses, making it difficult to perform the physical or cognitive tasks required by your job.
The specific ways myasthenia gravis might affect your work include:
Weakness in your arms or legs, which can make physical tasks like lifting, carrying, or even standing for extended periods challenging.
Drooping eyelids and vision problems, which can interfere with tasks that require visual focus, such as reading, computer work, or driving.
Difficulty speaking or swallowing, which can impact communication-heavy roles or jobs requiring frequent interaction with clients or coworkers.
General fatigue that worsens throughout the day, reducing your ability to maintain consistent productivity or meet deadlines.
Breathing difficulties in severe cases, which could make any physical exertion or even routine office tasks exhausting.
These symptoms may fluctuate, making it hard to predict when you’ll feel well enough to work. If your job requires sustained focus, physical strength, or reliable stamina, myasthenia gravis can create significant challenges that may necessitate accommodations or utilizing short term or long term disability benefits.
Can I Qualify for Short Term or Long Term Disability Benefits Due to Myasthenia Gravis?
Yes, you can qualify for short term or long term disability benefits due to myasthenia gravis if your symptoms significantly impair your ability to work. While the two types of benefits share some common eligibility criteria, they also have important differences.
For short term disability, you must demonstrate that your symptoms temporarily prevent you from performing the essential duties of your job. Common requirements include:
Medical Evidence: Detailed records from your treating physician, including your diagnosis, treatment plan, and documentation of how your symptoms, such as muscle weakness or fatigue, limit your ability to work.
Active Employment: Most short term disability policies are employer-provided, so you need to be actively employed and meet the specific terms of your plan.
Elimination Period: A short waiting period, usually a few days to a week, before benefits begin.
Benefit Duration: Benefits typically last for three to six months, covering temporary work disruptions.
Long term disability benefits are designed for more extended periods of disability. To qualify, you’ll need to show that your myasthenia gravis causes ongoing functional limitations that prevent you from returning to work. Important distinctions include:
Comprehensive Medical Documentation: This may include neurologist reports, results from functional capacity evaluations, or additional specialist opinions detailing how your condition impacts your ability to work long-term.
Longer Elimination Period: Usually several months, often requiring you to first exhaust short term disability benefits.
Policy Definitions of Disability: Common definitions of disability in long term disability policies are the “own occupation” standard and the “any occupation” standard. Under an “own occupation” definition, you must show that you are unable to perform the duties of your specific job. An “any occupation” definition requires proving that you cannot perform any job for which you are reasonably qualified based on your education, training, or experience.
Both short term and long term disability policies share these common requirements:
Ongoing Medical Certification: You need regular updates from your treating physician about your condition and its impact on your ability to work.
Compliance with Treatment: Insurance companies typically require you to follow prescribed treatments or therapies to maintain eligibility.
Short term disability focuses on temporary disruptions to your work, while long term disability addresses lasting impairments. By meeting the specific criteria for your policy and providing the necessary documentation, you can strengthen your claim and increase your chances of securing benefits for myasthenia gravis.
What Evidence Do I Need to Support Your Disability Claim for Myasthenia Gravis?
To support your short or long term disability claim for myasthenia gravis, you need comprehensive evidence that clearly demonstrates how your condition impacts your ability to work. This includes a combination of medical and vocational documentation. Insurance companies often scrutinize these claims, so gathering thorough and specific evidence is essential.
Medical evidence is the foundation of your claim and should include:
Diagnostic Testing: Results from antibody blood tests, electromyography (“EMG”), and nerve conduction studies that confirm your diagnosis of myasthenia gravis.
Imaging: Chest imaging, such as CT scans or MRIs, to rule out or identify a thymoma, which is sometimes associated with myasthenia gravis.
Functional Capacity Evaluation (“FCE”): A detailed assessment of your physical limitations, such as weakness in your arms or legs, fatigue, and difficulty performing routine tasks.
Neuropsychological Evaluation: If you experience cognitive symptoms, such as brain fog or difficulty concentrating, this evaluation can provide evidence of how these issues affect your job performance.
Treatment Records: Documentation of your treatments, such as medications (e.g., corticosteroids or anticholinesterase agents), plasmapheresis, or IVIG, and any side effects that further impair your ability to work.
Vocational evidence helps connect your medical limitations to your job requirements. This includes:
Job Description: A detailed outline of your job’s physical, cognitive, and functional demands, showing how your symptoms prevent you from meeting those requirements.
Vocational Assessment: An assessment from a vocational expert that analyzes your ability to perform your current role or other jobs, considering your symptoms, education, and work history.
Employer and Co-Worker Statements: Witness statements from your employer or coworkers about observed changes in your work performance or your inability to meet workplace expectations.
Together, this evidence paints a clear picture of how myasthenia gravis affects your ability to work, helping you meet the requirements for short term or long term disability benefits. Providing thorough documentation and expert evaluations strengthens your claim and addresses any potential challenges from the insurance company.
How Can Fatigue and Muscle Weakness Associated with Myasthenia Gravis Be Documented?
Fatigue and muscle weakness are common symptoms of myasthenia gravis, and documenting them effectively is crucial for supporting your short or long term disability claim. These symptoms can fluctuate, so it’s important to provide evidence that captures both their severity and their impact on your ability to work.
Here are ways you can document these symptoms:
Medical Records: Your doctor’s treatment notes should include a detailed description of your fatigue and muscle weakness, including their frequency, severity, and how they interfere with daily activities or work tasks.
Diagnostic Tests: Tests such as electromyography (“EMG”) and nerve conduction studies can objectively show muscle weakness, particularly when weakness increases with repetitive activity.
Functional Capacity Evaluation (“FCE”): An FCE measures your physical abilities, such as lifting, gripping, or maintaining posture, and can reveal how quickly muscle fatigue sets in during tasks.
Neuropsychological Evaluation: If fatigue contributes to concentration or memory problems, a neuropsychological evaluation can help establish how these issues compound your functional limitations.
Symptom Diary: Keeping a detailed diary of your symptoms, including when they occur, what triggers them, and how long they last, provides valuable insight into the variability and persistence of fatigue and weakness.
Specialist Opinions: Reports from your neurologist explaining how fatigue and muscle weakness are characteristic of myasthenia gravis and how these symptoms limit your capacity to work can be particularly persuasive.
By combining objective testing with detailed personal and professional observations, you can create a comprehensive record that demonstrates how fatigue and muscle weakness prevent you from performing the essential duties of your job. This evidence is essential for convincing your insurance company of the validity of your claim.
Can Treatments for Myasthenia Gravis Impact My Short or Long Term Disability Claim?
Yes, treatments for myasthenia gravis can significantly impact your disability claim. Insurance companies often consider the effectiveness of your treatments when evaluating whether you are disabled under the terms of your policy. It’s essential to document your treatment history and any limitations or side effects associated with the therapies you receive.
Insurance companies may examine:
Response to Treatment: If your treatments, such as corticosteroids, anticholinesterase medications, or immunosuppressants, effectively manage your symptoms, your insurance company may argue that you can return to work. However, if you still experience significant fatigue, muscle weakness, or other disabling symptoms despite treatment, this supports your claim.
Side Effects: Medications for myasthenia gravis often have side effects such as insomnia, mood changes, or gastrointestinal issues, which can further impair your ability to work. Documenting these side effects with your physician is crucial, as side effects can also lead to disability.
Surgical Interventions: If you’ve had a thymectomy to address a thymoma, the insurer may want to see records of your recovery and whether your symptoms have improved. Delayed or incomplete recovery can bolster your claim.
Consistency with Treatment: Insurance companies typically expect you to follow prescribed treatments unless you have a valid reason for not doing so, such as intolerable side effects. Refusing recommended treatments without justification could result in a claim denial.
Impact of Treatments on Work Schedule: Some treatments, such as IVIG or plasmapheresis, require frequent hospital visits or prolonged recovery periods, making regular work attendance challenging. Providing records of these treatments highlights how they disrupt your ability to maintain consistent employment.
By thoroughly documenting how treatments impact your symptoms, daily functioning, and work capacity, you can address potential challenges from your insurance company and strengthen your short or long term disability claim. This evidence demonstrates that you are doing everything possible to manage your condition while still facing limitations that prevent you from working.
Is It Difficult to Get Short or Long Term Disability for Myasthenia Gravis?
It can be challenging to get short or long term disability benefits for myasthenia gravis due to the fluctuating nature of the condition and the scrutiny often applied by insurance companies. While myasthenia gravis is a recognized disabling condition, insurers may question the severity of your symptoms or argue that treatments should allow you to continue working. This is where a disability insurance attorney with experience in ERISA can be invaluable in helping you navigate the process and secure your benefits.
The difficulty lies in providing sufficient evidence to show that your symptoms—such as fatigue, muscle weakness, or vision problems—consistently prevent you from performing the essential duties of your job. Since these symptoms can vary in intensity from day to day, insurers may claim that you are still capable of working during periods when your symptoms are less severe. Additionally, insurers might argue that with proper treatment, such as medications, surgery, or therapy, you should be able to manage your condition well enough to work.
A disability insurance attorney can help address these challenges by:
Gathering Comprehensive Medical Documentation: An experienced attorney knows how to work with your doctors to obtain detailed records of your diagnosis, treatments, and how your symptoms affect your daily functioning.
Securing Objective Evidence: Attorneys can help you organize and present diagnostic tests, functional capacity evaluations, and reports from specialists that demonstrate the physical limitations caused by myasthenia gravis.
Handling Insurer Communications: Insurers often try to exploit inconsistencies or gaps in medical records. An attorney can manage all communication with the insurer, ensuring your case is presented clearly and accurately.
Providing Vocational Evidence: An attorney can assist in connecting your symptoms to specific job duties by gathering employer statements, vocational assessments, or detailed job descriptions.
Challenging Denials: If your claim is denied, an attorney experienced in ERISA can appeal the decision, leveraging their knowledge of the procedural requirements and legal standards to strengthen your case.
While obtaining disability benefits for myasthenia gravis may be complex, working with a knowledgeable disability insurance attorney significantly increases your chances of success. They can help you build a strong case, address challenges from the insurance company, and fight for the benefits you deserve under your policy.
How Can The Maddox Firm Prove Your Short Term or Long Term Disability Claim for Myasthenia Gravis?
Proving a short or long term disability claim for myasthenia gravis can be a complex process due to the condition’s fluctuating symptoms and the high level of scrutiny applied by insurance companies. The Maddox Firm has the experience and expertise to guide you through this process, ensuring that your claim is supported with the strongest possible evidence and handled in compliance with your policy’s requirements.
Here are a few ways The Maddox Firm can prove your short or long term disability claim:
We Examine Your Policy and Assess Your Claim: We carefully review your disability insurance policy to determine how terms like “own occupation” or “any occupation” apply to your situation. For myasthenia gravis claimants, we pay particular attention to how your symptoms—such as fatigue, muscle weakness, or vision problems—impact your ability to perform the physical and cognitive requirements of your job. We also assess whether your policy has exclusions or limitations, such as for pre-existing conditions, that could affect your claim.
We Handle All Communications with Your Insurance Company: Insurance companies often attempt to downplay the severity of fluctuating conditions like myasthenia gravis. We take over all correspondence to ensure your claim is presented accurately and that your insurance company doesn’t mischaracterize your symptoms. If your insurance company requests additional information, we ensure it is provided in a way that strengthens your case, and we push back against unreasonable delays or demands.
We Help You Obtain Evidence to Support Your Claim: Myasthenia gravis claims require robust evidence to demonstrate how your condition prevents you from working. We collaborate with your medical team to gather diagnostic test results, treatment records, and reports from neurologists and other specialists. We also arrange for functional capacity evaluations to document muscle weakness or fatigue and neuropsychological testing if cognitive issues are involved. If your treatments have side effects or fail to manage your symptoms effectively, we highlight this to show how your disability persists despite medical intervention.
We Handle Appeals and Litigation: If your claim is denied, we act swiftly to challenge the decision through the appeals process. For claimants with myasthenia gravis, this often means addressing the insurer’s arguments about treatment effectiveness or symptom variability with detailed evidence and expert opinions. If necessary, we will take your case to court, fighting to secure the benefits you deserve.
A short term disability or long term disability claim 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.