Arthritis | Long Term Disability Claim Tips

Arthritis is one of the most common conditions leading to long term disability. Many people with arthritis find their range of motion too limited and joint pain too unbearable to continue working. But before filing a long term disability insurance claim, you might have questions: What types of arthritis qualify for disability benefits? How do you document your symptoms for your insurance company? What do you need for them to approve your claim?

Is My Arthritis Serious Enough to be a Disability?

Arthritis can be a disability-- but whether or not your condition qualifies for long term disability benefits will depend on a number of factors.  Mostly importantly, you will have to show how your arthritis prevents you from working.

Arthritis is a broader term covering a scope of different diseases and conditions, all affecting the joints. Typically arthritis is characterized by painful inflammation and stiffness of the joints that in turn causes a decreased range of motion. 

The severity of these disabling symptoms ranges from mild to severe, and can either affect an isolated area or the entire body. Arthritis is generally considered a chronic condition. However, the frequency of flare-ups, the rate of progression, and the severity of the pain depend on the individual.

Types of Arthritis

The two most common types of arthritis are:

• • • Osteoarthritis: A degenerative type of arthritis caused by wear and tear on the joints or an injury. If you tear your ACL, for example, you may wind up with osteoarthritis of the knee.
    • Rheumatoid Arthritis (RA): An inflammatory arthritis occurring due to a haywire immune system response that attacks the membranes surrounding joints. This type of arthritis is generally considered more severe than osteoarthritis, affecting multiple joints and causing greater swelling.

Severe arthritis of any kind causes chronic pain and can make basic daily activities (walking, dressing, personal grooming) difficult or impossible.

Disabling Symptoms of Arthritis

The specific symptoms of your arthritis will depend on what type you have and the areas affected. Disabling symptoms may include:

• • • Joint pain and stiffness
    • Swelling
    • Limited range of motion
    • Weakness in hand grip, lack of finger dexterity
    • Pain while walking, squatting, bending, standing, etc.
    • Difficulty moving after periods of rest

Your insurance company will consider your arthritis a disability if your symptoms are bad enough that you cannot perform your job duties. Before your claim is approved, however, your insurance company will require evidence of your diagnosis and your ongoing symptoms.

How Do I Obtain Long-Term Disability Insurance Benefits for Arthritis?

In order to obtain long term disability insurance benefits based on your arthritis, you must file an application. If your initial application has been denied, an appeal must be submitted. New York long term disability lawyers advise that if you are able to prove that your arthritis prevents you from performing the material functions of your job (or, depending on the language of your insurance policy, of any job), then you will be awarded benefits.

Evidence of Your Arthritis As A Disability

A diagnosis of arthritis alone is not enough to get your claim approved. Your insurance company will want evidence of your symptoms, their severity, and their impact on your ability to work in your occupation.

The more evidence you have, the stronger your claim will be. Here are some steps on gathering evidence to support your arthritis disability claim:

1. Provide the insurance company with all objective medical evidence of your condition. This includes medical records from all your doctors; treatment notes; clinical tests; lab tests; X-rays and other scans.
2. Obtain a narrative report from your doctor. Ask all of your treating doctors to supplement your medical records with a written statement detailing your arthritis and proffering their opinion as to your ability to function in the workplace.
3. Ask your employer for a copy of your personnel file. Is the effect of your arthritis plainly evident in your performance reviews, attendance record, or other notes in the file?
4. Provide evidence of your pain. You may be experiencing chronic, intense, debilitating pain, but the insurance company won’t just take your word for it. Pain is a subjective complaint. One way to bolster your subjective claims of pain is to keep an “Arthritis Diary.” Use your diary to describe your pain on a daily basis. The more detailed your diary entries are, the more powerful your diary will be. Tell the story of each day using specific examples. Be sure to note any trips to the emergency room or urgent care. Also note the negative side effects, if any, of your medications. Regular updates in your Arthritis Diary will paint a vivid picture of your pain over an extended period of time.

5. Obtain statements from third parties. Ask your supervisor and/or co-workers to prepare a statement describing their experiences working with you. What did they observe about the impact of your arthritis on your ability to do your job? Statements from family members, friends or neighbors also may be helpful. Even though these individuals may be biased, their observations will help to complete the picture of your life with arthritis.

A Disability Insurance Attorney Can Help

An experienced New York long term disability insurance lawyer can make all the difference in getting your disability benefits. You can choose to file your application or appeal on your own, but your odds of success are significantly greater when you have a knowledgeable long term disability insurance lawyer on your side. The forms provided by the insurance company are inadequate, and deliberately so. They do not have nearly enough room for you or your doctors to describe your situation completely. If you limit yourself to these pre-printed forms, the insurance company will deny your claim based on a lack of evidence.

Riemer Hess can restore some balance to the process by helping you and your doctors tell your whole story. We know what evidence the insurance company will look for; how to efficiently gather that evidence; and how to package that evidence in a way that will resonate with the insurance company.

Conclusion

If you have been diagnosed with arthritis and your symptoms are making it difficult or impossible for you to work, the New York long term disability lawyers at Riemer Hess can help you navigate the claims process and make your strongest case for benefits.

Riemer Hess can assess your situation, explain your legal rights and options, and answer any questions you have about long term disability insurance. To schedule your free consultation, call Riemer Hess LLC, Attorneys at Law, today at 212-297-0700.