Ménière's Disease (also called endolymphatic hydrops) is a serious vestibular disorder that can significantly impact balance and hearing. Individuals with Ménière's Disease may experience episodic vertigo, balance issues, headaches, dizziness, tinnitus, and hearing loss. The symptoms can be exhausting and disorienting, often resulting in long term disability. Unfortunately, there is no known cure. Here’s what you need to know before filing your long term disability claim for Ménière's Disease.
Disabling Symptoms of Ménière's Disease
Ménière's Disease can cause an array of chronic and serious physical symptoms that can result in long term disability. The symptoms of Ménière's Disease can be extremely limiting and distressing, which can cause cognitive problems and secondary emotional issues, such as depression and anxiety. The insurance company will need to know all of your symptoms so it can understand why they prevent you from working.
Physical symptoms of Ménière's Disease may vary in severity and fluctuate over time, with some days or weeks being much worse than others. Physical symptoms include:
- Balance problems
- Tinnitus(ringing in the ears)
- Feeling of pressure or “fullness” in the ears
- Hearing loss
- Dizziness and “spinning” sensations
- Difficulty sleeping
- Cognitive problems (i.e., impaired concentration, inability to follow conversations, and poor memory)
Secondary emotional symptoms that that may develop due to an Ménière's Disease include:
- Social anxiety and social isolation
- Panic disorders
- Decreased mental acuity
- Decreased tolerance for stress
Proof of Diagnosis for Ménière's Disease
The insurance company will require objective proof of diagnosis for any long term disability. This requirement can be challenging because there is no single diagnostic test for Ménière's Disease. A battery of testing may be necessary before your Ménière's Disease is properly diagnosed.
The insurance company will conduct a broad review of your medical records to assess your diagnosis. The insurance company will specifically look for the following:
- Clinical signs, including impaired balance, unsteadiness, hearing loss, headaches, and tinnitus.
- Diagnostic testing, including hearing tests (audiometry), electrocochleography (ECoG), ENG (electronystagmogram), and other vestibular testing. Other tests, such an as MRI or CT scan of the brain, may be necessary to rule-out a tumor and other possible causes.
Appropriate Treatment for Ménière's Disease
Unfortunately, there is no cure for Ménière's Disease. However, the insurance company will still want to see that you are receiving appropriate treatment. The insurance company can easily use non-compliance and lack of appropriate care as a reason to deny your claim.
To demonstrate appropriate treatment, your doctors should include appropriate specialists, including an otolaryngologist. Treatment options may include:
- Medications. Your doctor may prescribe medications to take during attacks of vertigo. These may include motion sickness and anti-nausea medications.
- Non-invasive therapies and procedures. Your doctor may recommend vestibular rehabilitation, cognitive behavioral therapy, a hearing aid, and a meniette device.
- Injections. Your doctor may inject mediations directly into your ear. These medications may include antibiotics and steroids.
- Surgery. If your vertigo attacks are debilitating, your doctor may even recommend surgery. Procedures include endolymphatic sac procedure (removing small portion of bone over the endolymphatic sac), vestibular nerve resection (cutting the vestibular nerve), and labyrinthectomy (removing a portion of the inner ear associated with balance).
- Lifestyle changes: Your doctor may recommend that you change your diet or reduce your stress to help improve your symptoms.
Your main doctor will probably refer you for additional testing and consultations with other specialists. Make sure to follow-up with your doctor’s recommendations. If you don’t, the insurance company may claim deny your claim.
Inability to Work Due to an Ménière's Disease
Without question, Ménière's Disease can be extremely disabling. However, you should never assume that the insurance company will understand how your symptoms impact your job. To increase your chances of approval, you must explain why each of your symptoms prevents you from performing your job duties.
For example, even mild vestibular and balance issues may make it difficult to commute or safely navigate your work environment. Severe vestibular and balance issues may make it difficult to get a file out of desk drawer or getting up from your chair may be unsafe or exacerbate your symptoms. You may not even be able to lift your head or stand up during a vertigo attack.
Hearing loss and tinnitus may make it very difficult to understand people during conversations or while on the phone. Severe hearing loss and tinnitus may even prevent you from effectively communicating with others at work, particularly when working in groups.
Many people also find it difficult to concentrate and focus at work due to fatigue, tinnitus, dizziness, and chronic headaches. You may even find that you are performing work tasks much slower. This can be particularly troublesome if your job requires rapid responses or higher level cognitive functioning.
Explain how your individual symptoms prevent you from performing your job duties by preparing a written narrative for the insurance company. Make sure that your narrative addresses all of your symptoms by listing them separately first. Since the symptoms of Ménière's Disease tend to be episodic, your narrative should also address the frequency of your symptoms, as well as any factors that trigger or exacerbate your symptoms.
Ménière's Disease is a serious and complicated medical condition that may result in disability. To file a successful long term disability claim, you must support your claim with sufficient medical evidence and proof of appropriate treatment. Knowing how to substantiate your claim will significantly increase your chances of approval.