Knowing how to substantiate your Macular Degeneration long term disability claim will significantly increase your chances of approval. To get your Macular Degeneration claim approved, it should be supported with medical evidence and proof of treatment. It is also essential to provide a detailed explanation of how your symptoms prevent you from performing your job duties.
What is Macular Degeneration?
Macular Degeneration is a common, progressive disease of the eyes that can lead to disability. It is the leading cause of vision loss in the United States. The disease affects your macula, which is the central area of your retina responsible for controlling visual acuity (i.e., to see fine detail in your direct line of sight). Macular Degeneration can adversely affect your ability to read, drive, watch television, use a computer, recognize people, and perform normal, everyday visual tasks. As the condition progresses, you may find it increasingly difficult to perform work tasks.
Knowing how to substantiate your long term disability claim (e.g., through medical evidence, proof of treatment, etc.) will help increase your chances of approval. Here’s what you need to know before filing your long term disability claim for Macular Degeneration.
Disabling Signs and Symptoms for Macular Degeneration
The changes that result frоm Macular Degeneration are gradual. Most people don’t recognize the changes until the later stages, when vision loss starts to occur. The main symptom of Macular Degeneration is blurring of the person's central vision (peripheral or outer vision is not affected), which cannot be corrected by wearing glasses. Other symptoms include:
Gradual loss of ability to see objects clearly
When the macula is compromised, you lose the sharpness or clarity that you are accustomed to seeing. A normal macula enables you to see your clearest, if this important part of the retina is damaged in any way, your vision drops in a proportionate manner.
Distortion of the shape of objects; straight lines look wavy or crooked
The macula is extremely sensitive and delicate. Damage to the macula can result in wavy vision because of stretching of the nerve cells within the macula. Juѕt like a folded picture, folds or creasing of the macula will cause a corresponding defect іn your vision.
Impaired depth perception
To provide normal depth perception, both eyes must work together. If your vision is compromised because of macular problems, your ability to gauge depth may also become impaired. Fine motor activities, such as judging distance when driving a car, may become impaired by reduced depth perception.
Loss of clear color vision
The macula is responsible for your color perception. Damage to the macula from degeneration, swelling, scar tissue, or by virtually any process will compromise your color perception. Color perception becomes increasingly difficult as macular problems progress.
Blind Spots - dark or empty areas in the center of vision
Small areas in the central (i.e., straight ahead) portion of your vision become faded, eventually leading to a blind spot. These blind spots are known as scotomas. Words or images in the field of vision that focus on the blind spot suddenly disappear from view. This change in your vision can become distressing and debilitating.
Excessive sensitivity to light is known as photophobia. Individuals with macular problems are often more sensitive to light than other people.
Changes when light conditions change
Individuals with Macular Degeneration are very sensitive to changes in lighting. Sunlight tends to stress your macula so that it becomes difficult to see properly from shifting from a bright environment to a dark environment.
Visual hallucinations without an apparent cause may be due to Macular Degeneration. Some experts believe that changes in the macula stimulate cells in the retina that in turn stimulates the visual cortex. This phenomenon is also known as the Charles Bonnet Syndrome. The result can be very distressing.
When the central part оf your vision is impaired, you begin to rely on your side vision to be able to see. As a result, you may turn your head slightly away to be able to see something of concern – something generally known as eccentric fixation.
Classification and Types of Macular Degeneration
When filing your Macular Degeneration long term disability claim, it may be beneficial to explain the classification or type of Macular Degeneration you have. This information could help the insurer assess the severity and limiting nature of your condition. There are generally three main classifications of Macular Degeneration:
Dry Age-Related Macular Degeneration
This is the most common type of Macular Degeneration. Symptoms of dry age-related Macular Degeneration may not appear for up to 10 years or longer after onset of the disease. Dry age-related Macular Degeneration occurs when the macula atrophies, or gets progressively thinner, resulting in decreased function over time. When symptoms do appear, they may include:
- Visual distortions
- Reduced central vision
- The need for a brighter light when reading
- Increased blurriness
- Slow recovery of visual function after exposure to bright light
- Colors seeming less vibrant than they used to
- Increasing difficulty recognizing people's faces
- Hazier, less defined vision
Wet Age-Related Macular Degeneration
This type of Macular Degeneration is typically caused by the growth of abnormal blood vessels that leak fluid or blood into the macula, distorting your central vision. Wet age-related Macular Degeneration symptoms can appear suddenly, and progress more rapidly than with dry age-related Macular Degeneration. While you may experience any of the above symptoms, the most common symptoms of wet age-related Macular Degeneration include:
- Metamorphopsia, in which straight lines appear crooked or wavy
- A blind spot in the central vision that will get bigger without treatment - the blind spot may appear grey, red, or black
Juvenile Macular Degeneration
Also known as Juvenile Macular Dystrophy, this type of Macular Degeneration affects children and young adults usually between the ages of 6 tо 20. Juvenile Macular Degeneration is a rare inherited form of Macular Degeneration also affecting central vision. Symptoms include:
- Gaps or dark spots in vision
- Objects may change shape, size, or color
- Colors can fade
- Problems dealing with bright lights and moving from dark to light environments
- Words may disappear when reading
- Straight lines may appear bent or distorted
All three types of Macular Degeneration may result in long term disability, particularly as vision loss begins to occur. Knowing the kind of Macular Degeneration you have will help the insurer understand your symptoms and the nature of your disability.
How is Macular Degeneration Diagnosed?
Your long term disability insurance company will require proof of your Macular Degeneration diagnosis for your long term disability claim. The first step is to visit an eye doctor, such as an ophthalmologist or optometrist.
Your ophthalmologist or optometrist will likely dilate your eyes, which will allow for examіnation of the back of your eyes, where the retina and macula are located. Your doctor will look for a mottled appearance caused by yellow deposits that form under the retina.
Your doctor also may conduct a series of tests to help with the diagnosis. These tests may include:
Thе patient looks at a special grid, which consists of vertical and horizontal lines. If Macular Degeneration is present, some of the lines on the grid may seem distorted, broken, or faded. The result will give a better idea of how much damage has occurred. Most people with detectable symptoms find the lines nearest the center of the grid seem distorted, faded, or broken.
Thіs test confirms the type of Macular Degeneration. It is usually carried out if the specialist suspects wet Macular Degeneration. The doctor will inject a special dye into the patient's eye then look into their eyes with a magnifying device. They will take a series of pictures of the eye. The pictures wіll indicate whether the blood vessels behind the macula are leaking. For example, with wet age-related Macular Degeneration, the blood vessels leak behind the macula.
Indocyanine green angiography
This test also uses an injected dye to confirm the findings of a fluorescein angiography or to help identify specific types of Macular Degeneration.
Optical coherence tomography
Special light rays scan the retina and take an image оf іt. The image gives the specialist more data about the macula. If the macula has become thicker, thinner, or changes in any way, the image may reveal evidence of Macular Degeneration.
Your chances of long term disability claim approval will increase with clear, objective documentation of your Macular Degeneration diagnosis. Without documented medical proof of your diagnosis, such as appropriate testing results, your insurance company may question the reliability of your diagnosis and deny your long term disability claim.
Appropriate Treatment for Macular Degeneration
When evaluating a Macular Degeneration long term disability claim, the insurance company will want to see you’re receiving appropriate treatment. The insurance company can easily use non-compliance and lack of appropriate care as a reason to deny your Macular Degeneration long term disability claim. So, you should try to follow your doctors’ instructions and comply with treatment.
Treatment for Dry Age-Related Macular Degeneration
Unfortunately, treatment cannot completely restore your vision, but it can help to slow vision loss. Therefore, regular eye check-ups are recommended to detect Macular Degeneration before vision loss begins. However, once you are diagnosed with dry age-related Macular Degeneration, some treatment options include:
Low vision rehabilitation
You can work with a low vision rehabilitation specialist, occupational therapist, and/or your eye doctor to help find ways to adapt to your changing vision.
Used for dry age-related Macular Degeneration, this treatment involves the implantation of a telescopic lens in one eye. The telescopic lens contains lenses that magnify your field of vision, which may improve both close-up and distance vision. However, the field if vision wіll be reduced, and you may still have problems driving, for example.
Treatment for Wet Age-Related Macular Degeneration
Some treatments can stop the progression of wet age-related Macular Degeneration, but treatment must be immediate for it to be effective. Once any eyesight lost, it is very hаrd tо regain. Some treatment options for wet age-related Macular Degeneration include:
Medications to stop the growth of abnormal blood vessels: This is generally the first line of treatment for wet age-related Macular Degeneration. The medications block the chemicals that contribute to the formation of new blood vessels in the eyes of people with wet age-related Macular Degeneration. Examples of these drugs include Bevacizumab (Avastin); Ranibizumab (Lucentis), and Aflibercept (Eylea).
These medications are injected into the eye with a very fine needle. The effects of the medications are not permanent, and repeat treatment is needed every few weeks. The medications generally do not have many side effects, but pain, swelling, redness, and blurred vision typically occur after the injections. In very rare cases, treatment can lead to complications, such as damage to the retina, damage to the lens of the eye, and infection.
A light medication is injected into the vein in your arm. It attaches itself to the proteins in the veins and can detect abnormal blood vessels in the macula.
During the treatment, your doctor shines a focused laser through the eye to the abnormal blood vessels, which activates the medication and causes the abnormal blood vessels to close and stop leaking. This can help prevent further damage to the macula. Some patients need photodynamic therapy every few months. Whether this type of treatment is given depends on where the target blood vessels are located and how badly they have affected the macula.
During this treatment, your doctor wіll use a high-energy lаѕеr tо treat and seal the abnormal blood vessels in the macula, preventing further leakage. Unfortunately, the laser can cause scarring that can create a blind spot, but this treatment is still used as it can minimize further damage to the macula.
Other Treatments for Both Dry and Wet Age-Related Macular Degeneration
In addition to the medical treatments discussed above, your doctor may also recommend some lifestyle changes and home remedies. These can include:
Make sure you eat healthy: Foods high in antioxidant vitamins, zinc, and unsaturated fats are known to contribute to eye health.
- Quit Smoking
- Manage your other medical conditions
- Maintain a healthy weight and exercise regularly
- Take vitamin supplements: While not a cure for Macular Degeneration, vitamin supplements can help reduce the risk of vision loss and/or slow the disease progression, especially during the intermediate or late stages of Macular Degeneration. Vitamin supplements include:
- Vіtаmіn C (500 mg)
- Vіtаmіn E (400 IU)
- Zіnс oxide (80 mg)
- Copper оxіdе (cupric oxide 2 mg)
- Lutein (10 mg)
- Zеаxаnthіn (2 mg)
Disability and Inability to Work Due to Macular Degeneration
Macular Degeneration can be an extremely distressing and frightening condition. It not only disrupts your ability to perform your normal activities but can lead to long term disability from work. However, your insurance company may not understand the significance of your symptoms or the impact on your job. To increase your chances of approval, you can explain how and why each of your symptoms prevents you from performing your job duties.
For example, your decreased visual acuity and the blurry vision associated with Macular Degeneration may make it extremely difficult to read. It may take you much longer to read a document – regardless of whether it is on paper or the computer screen. This can result in missed deadlines or a delayed response to a client’s time-sensitive question. Worse yet, blind spots and empty areas in your center of vision may cause you to miss an important word(s) while reading leading you to misinterpret the meaning of documents and make mistakes.
The blurriness resulting from Macular Degeneration can cause difficulty recognizing people’s faces, and your lack of depth perception may cause you to “overshoot” a handshake. This can make for an uncomfortable or embarrassing situation at an important business meeting. The symptoms of Macular Degeneration can also prevent you from following a visually intensive presentation during a business meeting or at a seminar.
Also, if you must travel or drive for work, your decreased central vision, impaired depth perception, light sensitivity, and the distorted shape of objects may make it impossible to drive and/or make it difficult to negotiate airports. For instance, the symptoms of Macular Degeneration can cause problems seeing road signs, traffic, and people crossing the street. Moreover, your symptoms can make it difficult to read signs at airports causing you to miss your connecting flight.
As such, 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.
When determining whether your Macular Degeneration is disabling, your insurance company will also want the opinions of your treating doctor(s). Your doctor’s support is key. Your doctor’s reports should detail the severity of your problems, any positive examination findings, any objective tests documenting your vision deficiencies, their direct observations of you during office visits, and the specific restrictions and limitation that prevent you from working.
Your narrative and your doctor’s support will go a long way to help prove your Macular Degeneration long term disability claim.
Don’t assume the insurance company will connect the dots – you must thoroughly explain your disability due to Macular Degeneration.