The serious symptoms associated with asthma may lead to significant difficulties in daily functioning. Asthma can cause restrictions and limitations making it difficult, if not impossible, to continue working. Before filing for long term disability, you may have questions: Is asthma a disability? What does my insurance company need for me to be approved for disability benefits?
Knowing how to substantiate your asthma long term disability claim will help increase your chances of approval.
Here’s what you need to know before filing your asthma long term disability claim.
Is Asthma A Disability?
Asthma is a chronic illness caused by the narrowing or inflammation of your bronchial tubes. As your airways swell, extra mucus can be produced - making it difficult to breathe. In turn, you may experience shortness of breath, wheezing, coughing, and chest tightness.
Approval of long term disability benefits for asthma will depend on how severe and frequent your symptoms are. Some people with asthma have milder symptoms and can function normally with the aid of an inhaler; others experience much more dire difficulties managing their condition.
When filing for long term disability, your insurance company will want more than just an asthma diagnosis. They will seek to understand the full range of your symptoms and their frequency, and more importantly, how they interfere with your ability to work.
Disabling Symptoms of Asthma
In many cases, asthma is a chronic condition requiring lifelong maintenance. The symptoms can be extremely distressing and make it difficult to engage in normal, everyday activities. During an asthma episode, inhaling and exhaling are restricted due to swelling or inflammation of your airways, increased reactivity and sensitivity of your airways, excess mucus clogging your airways, and/or muscle tightening around your airways.
Disabling Physical Symptoms of Asthma
Disabling symptoms associated with asthma include, without limitation:
- Difficulty breathing which makes it hard to catch your breath; it may feel like you are running out of air to breathe
- Chest pains and tightness, which could be so severe it feels like a weight on your chest
- Shortness of breath
Respiratory Complications of Asthma
Other serious respiratory complications of asthma include a number of serious lung diseases, such as:
- Respiratory failure
- Status asthmaticus
- COPD (i.e. acute bronchitis, emphysema)
Complications from asthma may even result in death, especially when left untreated.
Inability to Work Due to Asthma
Most long term disability insurance policies define disability as a medical condition that prevents you from performing the duties of your occupation. Getting approved for long term disability due to your asthma will require explaining to your insurance company the specific ways that your asthma symptoms prevent you from working.
For example, poorly controlled asthma may result in frequent and unexpected sick days – forcing you to miss an important meeting or causing you to fall behind on your work. Your coughing and constant shortness of breath may keep you up most of the night, resulting in severe fatigue and an inability to concentrate the following day. Or, a stress-induced coughing or wheezing episode may frequently come on at very inopportune times – such as in the middle of a presentation or during a telephone call with a new client.
If your asthma symptoms are induced by physical exertion, traveling to meetings while carrying your heavy briefcase may cause shortness of breath, coughing, wheezing, and chest pains. If you make it to your meeting after experiencing these symptoms, you may not be in the right frame of mind to successfully conduct your business.
Also, your asthma may be triggered by odors or irritants commonly found in the work environment such as dust, perfumes, copier ink, and cleaning agents. While innocuous to most people, your severe sensitivity to small amounts of these odors may cause an asthmatic episode that forces you to leave work early or take an extended break to recover, resulting in decreased productivity.
How Do I Prove My Asthma Is A Disability?
When filing your asthma long term disability claim, your insurance company will require evidence of your diagnosis and symptoms. There are different kinds of evidence you can use to substantiate your claim, such as: proof of your diagnosis, medical records showing appropriate treatment, a supportive report from your doctor, and your own narrative letter and documentation.
Proof of Asthma Diagnosis
Your long term disability insurance company will require proof of your asthma diagnosis for your long term disability claim. The first step is to visit your doctor. Your doctor will likely perform a physical examination before conducting testing to confirm the diagnosis. Your doctor may also refer you to a pulmonologist who specializes in the treatment of respiratory and lung-related disorders.
To rule out other possible conditions – such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will likely perform a physical exam and ask you questions about your signs and symptoms, medical history, and any other underlying health issues.
Lung Function Measurements
If the physical examination does not rule out another condition, your doctor may administer lung (pulmonary) function tests to determine how much air moves in and out as your breathe. These tests may include spirometry or peak flow testing.
Lung function tests often are done before and after taking a medication called a brоnсhоdіlаtоr, such as аlbutеrоl, to open your airways. If your lung function improves with use of a bronchodilator, your doctor is likely to diagnose asthma.
In addition to the above testing, other tests to diagnose asthma include:
- Mеthасhоlіnе challenge
- Nitric oxide test
- Imaging tests
- Allergy testing
- Sputum еоѕіnорhіlѕ
- Provocative testing for exercise and cold-induced asthma
If the spirometry and peak flow tests suggest asthma, these additional tests can help confirm the diagnosis and/or determine the severity of your asthma.
Classification and Types Asthma
When filing your asthma long term disability claim, it may also be beneficial to explain the classification and type of asthma you have. Having this information could help your insurance company assess the severity and limiting nature of your asthma.
Doctors generally use four basic classifications to determine the severity of asthma, include:
- Severe persistent: Meaning you experience symptoms throughout the day on most days and frequently at night.
- Moderate persistent: Meaning you experience symptoms once a day and more than one night a week.
- Mild persistent: Meaning you experience symptoms more than twice a week, but no more than once in a single day.
- Mild intermittent: Meaning you experience symptoms up to two days a week and up to two nights a month.
A Supportive Doctor Goes A Long Way
It is almost always helpful to submit a supportive opinion from your doctor(s). Your doctor’s support is one of the most important factors you’re your insurance company is deciding your disability claim. In fact, your insurance company will likely require an opinion report from your doctor.
Your doctor's report should focus on the frequency and severity of your symptoms, positive physical examination findings, direct observations of you during office visits, and the specific restrictions and limitations that prevent you from working.
Document Your Asthma Symptoms in Your Own Words
Objective medical evidence will hold the most weight with your insurance company, but it doesn’t always provide a complete overview of your occupation and how exactly your asthma interferes with your ability to work. To increase your chances of approval, you can explain how and why each of your symptoms prevents you from performing your job duties.
Write A Personal Narrative
It can be helpful to prepare a written, detailed narrative for the insurance company that explains how your individual symptoms prevent you from performing your job.
Make sure your narrative addresses each of your symptoms by listing them separately. Be specific and detailed when explaining your job duties and how your symptoms affect your ability to perform them.
Keep A Symptom Diary
It also may be helpful to keep a symptom journal or diary to provide to the insurer. Your journal can include the exact date and time of your asthma episodes, your symptoms, what (if anything) triggered your symptoms, and the effects of your symptoms.
The symptom journal or diary can help your insurance company understand the frequency and severity of your asthma episodes - making it easier to prove your long term disability.
Appropriate Treatment for Asthma
When evaluating an asthma disability claim, your insurance company will want to see you’re receiving appropriate treatment. If they do not feel you are seeking appropriate treatment or exercising a good faith effort to manage your condition, they can easily use noncompliance and lack of appropriate care as a reason to deny your asthma long term disability claim.
The purpose of asthma treatment is to curb symptoms and effectively control asthma attacks. Treatment may include oral medications, inhalers, and avoidance of whatever elements are known to trigger your asthma attacks.
Oral medications and inhalers used for asthma treatment include, without limitation:
- Long-term control medications
- Inhaled corticosteroids
- Rescue inhalers that include short-acting beta-agonists such as Albuterol, Levalbuterol, or Pirbuterol
- Ipratropium, which is a bronchodilator
- Oral and intravenous corticosteroids, which decrease inflammation in the airway
A qualified physician should always be consulted to guide your treatment and manage your medications. Make sure to follow the recommendations of your doctor(s) and check in with them regularly to chart the severity, frequency, and management of your symptoms.
Even after approval for disability, you should continue to treat with your doctor(s) on a regular basis. Your insurance company can use infrequent care as a reason to terminate your benefits.
A Long Term Disability Attorney Can Help
Getting approved for long term disability for asthma can be challenging. Your insurance company may be skeptical of the severity of your symptoms, or not understand the ways your symptoms impair you from working.
Having an experienced long term disability attorney can go a long way in getting your benefits approved. A long term disability attorney will know how best to substantiate your asthma disability claim with the evidence your insurance company seeks.
Avoid fatal mistakes and get it right the first time by calling Riemer Hess LLC, Attorneys at Law, to arrange a consultation: 212-297-0700.