Epilepsy is the most commonly diagnosed brain disorder in the world, categorized by those who suffer recurring seizures. While the severity of epilepsy varies depending on type, for some the serious symptoms can interfere greatly with daily living and the ability to function in a work environment.
If you need to file for long term disability because of epilepsy, it’s important to know beforehand how best to corroborate your claim (e.g. through medical evidence, proof of treatment, etc.). That way you’ll have the best chance of approval with your insurance company.
Here’s what you need to know before filing your epilepsy long term disability claim.
Is Epilepsy A Long Term Disability?
Whether your insurance company will consider your epilepsy a disability will depend on a few factors. They will want to understand the symptoms you experience due to your epilepsy, both physical and cognitive. To get approved for long term disability, your symptoms must prevent with enough severity and frequency to prevent you from working in your occupation. This means not only must your claim include all of your symptoms – it should also describe the demands of your occupation.
An epilepsy diagnosis alone will not be enough for your insurance company. After all, some people with milder forms of epilepsy, such as Idiopathic Generalized, are able to function without issue. However, other types—such as the most commonly diagnosed form, Symptomatic Partial—can make it difficult to perform daily activities, including work.
In order to receive disability benefits for your epilepsy, your insurance company will need a full accounting of your symptoms and the ways they prevent you from working.
Disabling Symptoms of Epilepsy
The main symptom of epilepsy is repeated seizures. However, epilepsy affects each person differently, with a wide range of symptoms can include:
- A convulsion with no fever
- Uncontrollable repetitive movements or jerking of the arms, legs, or body
- Short blackout spells or confused memory
- Strong headaches
- Intermittent fainting spells, during which bowel or bladder control is lost
- Extreme fatigue
- Poor balance and disorientation
- Feelings of intense panic, fear, depression, and/or irrational anger
When preparing your disability claim, don’t limit yourself only to the physical symptoms of epilepsy – make sure any cognitive impairments are represented as well. These can be just as disabling as any physical limitations.
Studies have also shown a strong link between epilepsy and psychological disorders like depression and anxiety, as some of the brain areas responsible for certain types of seizures also affect emotional stability and mood. These secondary emotional symptoms can be disabling as well.
Inability to Work Due to Epilepsy
Your insurance company may not fully understand the impact your epilepsy has on your job performance. Never assume they will connect the dots on their own. You must explain it.
Think of how your condition prevents you from working in specific ways. With epilepsy, seizures can come at any time – for example, in the middle of an important business presentation or during a telephone call with a new client. Uncontrollable jerking of the limbs might make it impossible to perform your job duties, whether it’s typing on a computer, handling tools, or interpersonal meetings. Extreme fatigue and headaches might cause you to frequently use sick days.
Your epilepsy may be exacerbated by your work environment. Stress can trigger epileptic seizures, so a demanding job may worsen your condition significantly. Sleep deprivation is another very common trigger - if you work long hours that require late nights and early mornings, it could be very detrimental to your health and cause you to experience more seizures than you would otherwise.
Your epilepsy may also directly cause you to experience severe emotional problems, such as depression or anxiety, that leave you unable to perform your job as needed.
Proving Epilepsy As A Disability
To get approved for long term disability, your insurance company will require proof of your condition, symptoms, and impact on your job performance. This evidence can come in a few forms: proof of diagnosis; additional testing; proof of appropriate treatment; and personal documentation.
Proof of Epilepsy Diagnosis
Your long term disability insurance company will require proof of your epilepsy diagnosis for your long term disability claim.
Testing used to diagnose epilepsy and determine the cause of seizures may include:
- A Neurological Exam. Your doctor may test your behavior, motor abilities, mental function, and other areas to diagnose your condition and determine the type of Epilepsy you may have.
- Blood Tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions, or other conditions that may be associated with seizures.
- Electroencephalogram (EEG). This is the most common test used to diagnose Epilepsy. In this test, doctors attach electrodes to you scalp to record the electrical activity of your brain. If you have Epilepsy, it’s common to have changes in your normal pattern of brain waves, even when you’re not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep to record any seizures you experience.
Additional Testing to Detect Brain Abnormalities
Your doctor may recommend additional testing to narrow down what type of epilepsy you have, as well as rule out other conditions that may be causing your symptoms, such as tumors or cysts. Your insurance company will want the findings of these tests included with your claim.
Additional epilepsy tests include:
- High-density EEG. High-density EEG testing may help you doctor more precisely determine which areas of your brain are affected by seizures.
- Computerized Tomography (CT) Scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities іn your brain that might be causing your seizures, such as tumors, bleeding, and cysts.
- Magnetic Resonance Imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Yоur doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures.
- Positron Emission Tomography (PET). PET scans use a small amount оf low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities.
- Single-Photon Emission Computerized Tomography (SPECT). This type of test is used primarily іf you've had an MRI and EEG that didn't pinpoint the location іn you brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that is injected into a vein to create a detailed, 3-D map of the blood flow activity іn your brain during seizures.
- Neuropsychological Tests. In these tests, doctors assess your thinking, memory, and speech skills. The test results help doctors determine which areas of your brain are affected.
Accurate diagnosis of your seizure type and its severity level gives you the best chance for long term disability approval.
Your Doctor's Support is Key
The most important thing you can do is submit a supportive opinion from your doctor(s). 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.
Appropriate Treatment for Epilepsy
When evaluating a disability claim due to epilepsy, the insurance company will want to see you’re receiving appropriate treatment. Should the insurance company believe you are not seeking appropriate or frequent enough care, they can use that as an excuse to deny your claim.
Since there is no cure for epilepsy, the purpose of treatment is to prevent seizures and effectively control any other symptoms through the use of pharmaceuticals. Some people have a type of epilepsy that is resistant to anti-seizure drug therapy; in these cases, surgical intervention may be an option, though surgery comes with many serious risks, such as memory problems, sight loss, and stroke.
Personal Documentation of Your Epilepsy Disability
While objective medical evidence will hold the most weight with your insurance company, medical records do not always give the full picture of your symptoms, your occupation, or how your condition impairs you from performing your job duties.
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 working. Make sure your narrative addresses each of your symptoms by listing them separately. Also cite your specific job duties, and exactly how your symptoms interfere with performing them.
It also may be helpful to keep a symptom journal or diary to provide to your insurance company. Your journal can include the exact date and time of your epilepsy episodes; your other physical and cognitive symptoms; what, if anything triggers your symptoms; and the effects of your symptoms. Your symptom journal or diary can help your insurance company understand the frequency and severity of your epilepsy episodes – making it easier to prove your long term disability.
These supportive pieces of evidence can go a long way in helping to prove your epilepsy long term disability claim.
A Long Term Disability Attorney Can Help
For epilepsy disability claim, it is advised you consult with a disability attorney. An experienced long term disability insurance attorney can help. They will understand how best to substantiate your epilepsy claim with evidence your insurance company is looking for and significantly increase your chances of approval.
If you suffer from epilepsy and are seeking to file for disability, talk to the New York disability lawyers at Riemer Hess about filing a claim for long term disability insurance. We know what evidence LTD insurance companies find persuasive and are prepared to help you make the most convincing claim possible. To arrange for a consultation with lawyers at Riemer Hess, call us at 212-297-0700.