Insurance companies generally recognize that symptoms of Parkinson's can vary drastically in nature, severity, and frequency among those afflicted with the disease. Due to the varying and somewhat unpredictable clinical presentation of Parkinson’s disease, a simple diagnosis is usually insufficient for entitlement to long term disability. Instead, the insurance company will look to see how your particular symptoms impact your ability to work.
In reviewing your long term disability claim, the insurance company usually will assess your Parkinson’s by considering the presence and impairment of your motor, cognitive and/or mental functioning as well as your level of fatigue and any other non-motor symptoms.
How Motor Functioning Effects Diagnosing Disability for Parkinson's Disease?
The insurance company will consider how your motor deficits and/or abnormalities impacts your ability to work. The insurance company will review your medical records for documentation of the following motor deficits and abnormalities:
- Difficulty walking
- Abnormal and/or slow and shuffling gait
- Bradykinesia (slowness in initiating body movements)
- Difficulty standing
- Impaired balance
- Dyskinesia (involuntary muscle movements)
- Stiffness and/or muscle rigidity
- Difficulty commuting to work and/or traveling to work
- Episodes of falling
- Postural instability
- Any other motor abnormalities noted by your neurologist
The insurance company will want to see clear evidence substantiating your Parkinson's symptoms, so you may run into problems if your doctor’s notes are incomplete, disorganized, or handwritten. You may need to request that your doctor produce a clear and comprehensive list of your motor deficits and/or abnormalities for the insurance company to review.
The insurance company will also require documentation from your neurologist as to the severity and frequency of your motor deficits and/or abnormalities. For example, if your medical records document tremors, then the insurance company will want your neurologist to specify whether the tremors are minor or severe, and whether they occur constantly or only during exertion.
The insurance company will also want your neurologist’s opinion as to how your your motor symptoms impact your work functions. For example, if your medical records document tremors and you have a desk job, the insurance company will want your neurologist’s opinion as to whether you can type effectively.
How Cognitive and/or Mental Functioning Effects Diagnosing Disability for Parkinson's Disease?
The insurance company will also consider how your Parkinson’s is impacting your cognitive and/or mental functioning. Common deficits and symptoms that the insurance company will look for include:
- Difficulty staying organized
- Poor memory
- Becoming easily distracted
- Difficulty staying on task
- Slowed processing of information
- Becoming fatigued easily upon mental exertion
- Feeling anxious and/or depressed
- Decreased ability to deal with stress
- Difficulty communicating
- Word-searching and/or difficulty articulating thoughts
- Difficulty problem solving
The insurance company will require documentation from your medical providers regarding your cognitive and/or mental deficits. Appropriate providers may include your neurologist, neuropsychologist, psychiatrist, and/or psychologist. In general, documentation and thorough testing from a neuropsychologist is considered the strongest proof.
The insurance company will also want your doctors’ opinions regarding the impact that your cognitive and/or mental symptoms have on your ability to work. For example, your neuropsychologist may indicate that you process information too slowly to perform the complex analytical responsibilities of your job in a productive and efficient manner.
How Level of Fatigue Effects Diagnosing Disability for Parkinson's Disease?
The insurance company will consider whether your Parkinson's causes fatigue that is severe enough to prevent you from working. The insurance company will want to see documentation from your doctors as to how your fatigue impacts your ability to:
- Perform the physical demands of your job on a sustained basis (i.e., typing constantly, traveling for work, sitting or standing for extended periods of time, etc.)
- Perform the cognitive demands of your job on a sustained basis (i.e., paying attention for prolonged periods of time, performing complex analytical thinking, applying technical knowledge accurately and efficiently, etc.)
- Complete a normal workday and/or workweek without an excessive number of rest breaks or absences
It is important to note that the impact of fatigue is often difficult for the insurance companies to understand. Thus, the input of your medical providers will be key.
For example, you may be able to perform complex analytical thinking for short spans of time without difficulty. However, you may require a long rest break after a half hour due to fatigue. If your job requires you to consistently perform complex analytical thinking throughout the day, then your doctor will need to specify that you are disabled because you can only perform complex analytical thinking for short periods of time followed by long rest breaks as needed.
How Non-motor Physical Symptoms Effects Diagnosing Disability for Parkinson's Disease
The insurance company will also consider the impact of any non-motor physical symptoms that you experience. Many people with Parkinson's experience significant autonomic nervous system problems, visual symptoms, or other complications that can be independently disabling. These often include:
- Blurred vision
- Double vision
- Frequent urination or urinary incontinence
- Orthostatic hypotension
- Excessive salivation
- Difficulty sleeping
- Side-effects of medications
Sufficient documentation as to the frequency, severity, and impact of these non-motor physical symptoms will be key. For example, if you need to urinate very frequently, your doctor may need to specify that you require constant access to a restroom and that you will spend enough time in the restroom to interfere with your work productivity.
If you are experiencing any of these non-motor physical symptoms, the insurance company may also want to see evidence from an appropriate medical provider, which may not necessarily be your neurologist. For example, if you allege disability due to severely blurred vision, the insurance company may want to review visual acuity testing results from a qualified eye specialist.