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Heart Conditions | Long Term Disability Claim Tips

Disability Wiki.

Man with heart pain. Contact our New York disability AttorneysIf symptoms of heart disease are making it difficult or impossible for you to do your job, your employer-provided long term disability policy may provide benefits. Heart disease can be a debilitating ailment and is a common reason for disability claims. The New York disability attorneys at Riemer Hess have helped many clients with heart conditions obtain benefits.

Below you’ll find tips on filing your long term disability claim for heart disease conditions.

Heart Disease and Long Term Disability

Whether you qualify for long term disability due to heart disease will depend on the nature of your condition and symptoms. When evaluating whether to file a long term disability claim, review your policy carefully. Long term disability insurance policies typically define disability as a condition that prevents you from performing the duties of your occupation (or, in some cases, the duties of any occupation).

Types of Heart Disease

Many heart conditions cause severe restrictions and limitations that prevent you from working. The most common types of heart disease include:

  • Ischemic heart disease. Also known as coronary artery disease or atherosclerosis, this condition is characterized by build-up of materials within arteries. The result is that the flow of blood to the heart is restricted. High blood pressure is characteristic of this condition in early stages.
  • Arteriosclerosis. This disease causes the artery walls to thicken and become rigid due to fat and/or calcium deposits. When combined with ischemic heart disease, this condition often leads to heart attack.
  • Congestive Heart Failure. This condition occurs as the heart weakens and cannot pump a sufficient amount of blood to feed oxygen-starved organs.

Disabling Symptoms of Heart Disease

Getting approved for long term disability due to heart disease conditions hinges on explaining your symptoms, their severity and frequency. A diagnosis alone will not be enough for benefit approval. Your insurance company will want to fully understand the range of your symptoms and how they prevent you from working.

The disabling physical effects produced by heart disease differ depending on the condition, but common symptoms may include:

      • Fatigue;
      • Weakness;
      • Chest pain;
      • Shortness of breath;
      • Dizziness;
      • Fainting;
      • Swelling and pain in the hands and feet.

Beyond the symptoms your heart disease directly causes, you can take into account the side effects caused by any medications taken for treatment.

Proving Long Term Disability from Heart Disease

There are two possible approaches to proving that a person is disabled because of heart disease. The first is to show that your symptoms render you physically unable to work. For instance, even sedentary jobs require a worker to be able to walk for up to an hour during a workday. A person with heart disease may not be able to walk for that long without experiencing symptoms. For executives and professionals with demanding jobs, persistent fatigue and shortness of breath can rob of them of the stamina needed for long days and frequent travel.

The second approach is to show that simply performing the job exposes the claimant to significant risk of harm. This situation often occurs when a claimant with a bad heart condition works in a high stress occupation. Even if the claimant could physically perform the duties of the job, they should not because it puts them at significant risk of a heart attack. However, risk of harm disabilities can be difficult to prove because the treating doctor may find it difficult to quantify the risk of a person returning to a high stress job.

Importance of Medical Evidence

medical evidenceMedical evidence supporting a claim of disability because of heart disease is crucial. While other kinds of proof can help your chances, your insurance company will weigh objective medical evidence most heavily when evaluating your claim.

Medical evidence may include:

      • Proof of diagnosis. Your doctor’s notes and any diagnostic testing results that substantiate your diagnosis should be submitted in your claim.
      • Test results and findings. Examples of cardiovascular testing include echocardiograms, stress tests, and cardiac magnetic resonance imaging (MRI).
      • An opinion letter from your doctor. Your doctor’s opinion is key to your insurance company. Request that your doctor write a report outlining your condition, your symptoms, and the way your heart disease impairs you from working.
      • Treatment notes. Your insurance company will require proof of appropriate treatment in order to approve your claim. Make sure when submitting your claim to include medications you’re taking and records of regular follow-up visits with your treating doctor(s). If your insurance company believes you are noncompliant or ignoring your doctor’s recommendations for treatment, they may deny your claim or terminate existing benefits.

A Long Term Disability Attorney Can Help

At Riemer Hess, our New York disability attorneys believe that the best approach is to combine the two strategies.

We work closely with each client and their employer to develop a detailed description of the duties of the client’s occupation so that we can explain exactly what it is the client can no longer do and why they can no longer do it. We also contact the client’s treating doctors to collect supporting medical evidence.

Our disability insurance attorneys will compile the client’s entire medical history, including the doctor’s treatment notes and objective test results. In addition, our attorneys obtain a detailed written report from the treating doctor that includes the client’s symptoms; medical signs and laboratory findings; medications and side effects; the doctor’s opinion about the client’s ability to sit, stand, walk, reach, twist and bend in a competitive working environment; and the doctor’s opinion about whether the client can perform the duties of their occupation.

Whether you're thinking about making a claim for disability insurance, your claim has been denied, or your insurance company is terminating your benefits, the New York disability attorneys at Riemer Hess can assist you. Call Riemer Hess LLC, Attorneys at Law, at 212-297-0700.

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