Huntington’s disease is a serious neurodegenerative, genetic condition. Its symptoms are progressive, presenting both physically and cognitively. The rate at which the disease develops varies from person to person, but typically Huntington’s symptoms appear when a person is middle aged. Once symptoms are present, Huntington’s tends to progress rapidly.
Many people with Huntington’s are eligible for long term disability benefits. Before applying for these benefits, it is important to understand what evidence you will need to get your claim approved by your insurance company.
Below we will outline what you need to get approved for long term disability benefits for Huntington’s disease.
Huntington’s Disease Diagnosis
Huntington’s is a devastating, progressive disease with no cure. Due to its hereditary nature, many people with Huntington’s may suspect their condition before an official diagnosis. Though Huntington’s shares symptoms with many other diseases, a family history of Huntington’s can be a strong indicator for a diagnosis.
In order to get approval for long term disability benefits, your insurance company will require proof of your disabling symptoms as well as a diagnosis. Receiving a diagnosis for Huntington’s can be more complicated than other conditions. Here are the ways in which Huntington’s is usually diagnosed:
- Neurological exam. This is a simple exam in which a neurologist tests your various physical functions, such as motor reflexes, balance, vision and hearing, and general mood.
- Neuropsychological evaluation. A neuropsychological evaluation, conducted by a neurologist, is administered to assess your cognitive deficits, such as memory, mental agility, and spatial reasoning. This evaluation is more in-depth than a simple neurological exam.
- Brain imaging. Brain imaging techniques may be used to check for atrophy of the caudate nuclei. These techniques may include magnetic resonance imaging (“MRI”) and/or computerized tomography (“CT scan”). More recently, functional neuroimaging tests, as fMRI and PET scans, are also being used to test for signs of Huntington’s disease. However, these tests results are not independently reliable for diagnosis.
- Genetic testing. Genetic testing can be performed identify the defective gene for Huntington's disease. It is the only definitive measure to diagnose Huntington’s disease and can be done via a blood draw. However, healthcare providers will require the patient undergo counseling with a genetic counselor before ordering this testing. This way the patient is more emotionally prepared for the results of the testing and the impact a potential diagnosis may have on their life.
While genetic testing is the only certain way to secure a Huntington’s diagnosis, it does not mean you cannot be approved for long term disability benefits otherwise. In fact, your healthcare provider may even advise against a diagnosis through genetic testing. That does not mean you are unable to receive long term disability insurance benefits.
In the eyes of your insurance company, the more important aspect of your disability claim will be evidence of your disabling symptoms.
Huntington’s Disease Symptoms
Huntington’s disease can cause a variety of physical, cognitive, and emotional symptoms. Should your symptoms present severely enough, you may qualify for long term disability insurance benefits.
Before we discuss the disabling symptoms of Huntington’s, let’s explain the definition of “disabled” in the context of long term disability (“LTD”) insurance. That definition will depend on the terms of your LTD policy. Be sure to review it carefully.
Typically, to meet the threshold of “disabled” under your policy you must show you are disabled from your own occupation. Otherwise, your policy may require you be disabled from any occupation, or be a "hybrid" own occupation/any occupation definition. Again, make sure to review your policy carefully to determine which definition of disability you must meet.
Many times when people hear the word “disabled”, they immediately assume your condition must leave you bedridden or with extremely limited mobility. However, under an “own occupation” LTD policy, you only need to prove to your insurance company that you are unable to perform the duties of your own occupation.
If you work in a career field that demands high executive function, such as a CEO, lawyer, investment banker, doctor, etc., even relatively mild cognitive or physical deficits can prevent you from working.
While every case is different, it is not unusual for the earliest Huntington’s symptoms to be cognition related. Many times cognitive symptoms will appear before physical symptoms occur.
Cognitive symptoms may include:
- Inability to pay attention, concentrate, and focus;
- Difficulty organizing thoughts;
- Decreased processing speed;
- Difficulty finding the right word (“word searching”);
- Difficulty processing or learning new information;
- Poor memory;
- Lack of mental flexibility;
- Poor impulse control; and
- Inability to multitask.
As mentioned above, cognitive symptoms alone can prevent you from performing the duties of your occupation. If your line of work requires a high level of focus, sharp memory, multitasking, and/or information recall, it may be difficult—if not impossible—to keep up.
As Huntington’s disease progresses, physical symptoms become more severe.
Some physical symptoms that can manifest from Huntington’s include:
- Problems with balance and gait;
- Abnormal movements and facial expressions;
- Involuntary muscle movements, such as muscle spasms or jerking (chorea);
- Difficulty speaking or swallowing;
- Rigidity or muscle contracture (dystonia); and
- Slow or abnormal eye movements.
Any of these symptoms may impact your ability to work. For example, if your occupation requires you to navigate around an office from your desk to conference rooms, it may become unsafe. Or if you have difficulty with speaking, you may no longer be able to give verbal presentations as necessitated by your job role. Similarly, your muscle weakness and involuntary movements may mean you cannot utilize a computer keyboard, paper files, or other necessary tools.
Huntington’s affects the brain, and as such can cause emotional psychiatric symptoms along with the cognitive and physical ones. Separately, a Huntington’s diagnosis itself can understandably cause anxiety and depression.
Emotional symptoms of Huntington’s disease may include:
- Depression (malaise, apathetic mood, fatigue, lack of motivation, appetite changes, etc.);
- Anxiety (uncontrollable worrying, obsessive behavior/over-thinking, lack of sleep, difficulty with attention span, etc.); and
- Mood swings (high levels of irritability, uncontrollable anger, extreme emotional behavior, etc.)
It is important to understand whether your emotional symptoms are tied to your Huntington’s disease. In most cases, your long term disability insurance policy will have a limit of how long they will pay benefits for mental illness disabilities. This means your insurance company may be eager to write your symptoms off as related to a mental illness rather than a physical disability.
However, many times people with Huntington’s suffer from mental illnesses that are secondary to their disease. Your emotional symptoms may be the product of the disease or even just a consequence of your diagnosis. In these cases, your insurance company may not limit your disability benefits to the mental illness limitation.
Below we will discuss what evidence you can provide to show your insurance company that your mental illness symptoms are secondary to your Huntington’s disease.
What You Need For Your Huntington’s Disease Disability Claim
Your insurance company will wonder why you could work one day, but not the next. To answer this question, your insurance company will look at the progression of your symptoms. Because Huntington’s disease causes a wide range of symptoms, every symptom must be well-documented to demonstrate the progression of your condition.
It may be helpful to create a timeline of your symptoms and disability to document the progression of your Huntington's disease. This timeline can be helpful when describing the progression of your Huntington’s disease to your insurance company.
In order for your disability claim to be approved, your insurance company will require medical evidence of your diagnosis and symptoms, as well as proof of treatment.
While genetic testing is not the only form of diagnosis your insurance company will accept, it is vital that you show proof you have treated with a doctor for your condition. A specialist, such as a neurologist, who can evaluate your symptoms and give their opinion on your diagnosis is especially helpful. The diagnosis can come from your family history, a neurological exam, and documentation of your symptoms.
Treatment for Huntington’s disease is usually very extensive. The type of treatment that your doctors recommend depends on the particular symptoms that you experience. Treatment typically includes medications and various therapies. Provide your insurance company a list of any medications you are taking and your daily dosage.
Medical records such as office visit notes, test results, or examination findings from your regularly treating physicians (such as your neurologist, speech therapist, physical therapist, etc.) should all be included with your disability claim.
Opinions From Your Treating Doctor(s)
Having your doctor write a supportive letter to your insurance company is recommended. This letter should outline your treatment history, diagnosis, symptoms, and whether they feel you can perform the duties of your occupation. As your treating doctor, they will be most familiar with your restrictions and limitations.
Above we discussed the complexities of emotional symptoms, Huntington’s disease, and long term disability claims. If you are treating with a mental health professional for your emotional symptoms, request that they also provide a letter to your insurance company. As with your treating physician, the letter from your mental health professional should explain your treatment history and symptoms. Additionally, they should make it clear that your emotional symptoms are secondary (and directly resulting from) your Huntington’s disease.
Compliance with Treatment Is Necessary
There is no cure for Huntington’s disease and the condition is progressive. Yet, the insurance company will still require you to comply with your doctor’s treatment plan. If you stop taking certain medications due to intolerable side effects and/or ineffectiveness, your insurance company may claim that you are noncompliant. Your doctor may ultimately need to describe the intolerable side-effects and ineffectiveness of treatment, as well as an alternative treatment plan.
The Required Ongoing Proof
After your claim is approved, your insurance company will still require proof of an ongoing disability. In fact, insurance companies have even demanded updates from residential treatment facilities and hospice centers. Therefore it is very important to stay in treatment after your insurance company approves your claim.
Insurance companies often set deadlines to submit updated evidence. These deadlines are usually very strict. If you fail to submit evidence by the deadline, the insurance company will likely terminate benefits. Should your insurance company ask you for updates on your condition, make sure to provide them the requested information by their deadlines.
How Riemer Hess Can Help
Dealing with a Huntington’s disease diagnosis and long term disability can be overwhelming. While it may seem obvious you are unable to work, your insurance company will still require you to jump through various hoops before they approve your claim.
Whether you are preparing to leave work, filing a claim, need help appealing a wrongful denial by your insurance company, or would like professionals to monitor your ongoing benefits, the experienced long term disability ERISA attorneys at Riemer Hess can help. We have decades of experience in fighting on behalf of clients like you to win long term disability claims, appeals, and litigations.
If you are suffering from any of the symptoms above or if you have already been denied disability benefits but have Huntington's, our New York long term disability lawyers can assist you. Call Riemer Hess LLC at (212) 297-0700 or click the button below for a consultation on your disability case.