Tinnitus is characterized by noises in the ear(s), such as ringing, buzzing, clicking or hissing. The condition is often accompanied by hearing loss and/or other ear, throat and nose issues. Even with treatment and therapeutic management, tinnitus can cause debilitating limitations. and long term disability.
There are several things you need to know before filing your long term disability claim for tinnitus.
Types of Tinnitus
A long term disability claim for tinnitus will require a diagnosis from your doctor. First, your doctor will determine which type of tinnitus you have.
There are two types of tinnitus - “subjective” (most common) and “objective” (less common). To identify the appropriate type, your doctor will listen for sounds within your ear in a process called auscultation. If your doctor can hear noise in your ear(s) or detect a pulsating motion from the surrounding structure, then she will identify the condition as objective. If your doctor cannot hear the sound, then she will identify the condition as subjective.
The type of tinnitus you have makes a significant difference in how the insurance company will view your claim. Insurance companies typically demand objective proof of a disabling condition, such as abnormal clinical signs upon examination. While claimants with objective tinnitus can meet this burden, those with the more common subjective tinnitus often face more difficulty. Claimants with subjective tinnitus may need other forms of proof, such as cognitive testing results, hearing and/or audiological testing, sleep studies, and supportive statements from physician to satisfy the insurance company.
Claimants with subjective tinnitus should also be aware that their long term disability policy may contain a limitation on benefits payable for a condition based primarily on subjective symptoms. A qualified long term disability attorney will be able to tell you if your policy contains a limiting provision.
Disabling Symptoms of Tinnitus
Severe symptoms of tinnitus can cause impaired concentration, inability to follow conversations, poor memory, poor sleep, extreme fatigue, depression, and anxiety. These symptoms can interfere with your ability to work, and you may find yourself needing to file a long term disability insurance claim as a result.
Physical symptoms of tinnitus may include:
- A ringing sound in the ears;
- Buzzing, roaring, clicking, hissing or humming in the ears;
- Pitches heard (both low and high);
- Hearing loss/impairment;
- Nose and throat pain.
Depending on the type of tinnitus you have, demonstrating objective evidence of these symptoms can be difficult. However, there is testing that can be done to substantiate your tinnitus diagnosis. This testing can include hearing/audiological exams, movement tests to see if facial/bodily movement exacerbates your symptoms, and imaging tests to rule out underlying causes.
The cognitive symptoms secondary to your tinnitus can also be documented to support your claim. For example, as a result of your tinnitus you may experience:
- Difficulty with concentration, focus, and attention span.
When these symptoms exist due to your tinnitus, their evidence adds reasoning to your long term disability insurance claim.
Disability & Inability to Work Due to Tinnitus
Your tinnitus has made it impossible to continue working: Your reduced hearing causes issues communicating with coworkers and clients, and the constant ringing and buzzing in your ears has ruined your ability to concentrate at the high levels required for your work. Your productivity and accuracy suffers as a result. You know this can’t go on.
Hearing Loss vs. Cognitive Impairments
Before filing a long term disability claim for your tinnitus, you must be prepared for the insurance company to focus on your hearing loss (or lack thereof). This is an extremely common problem that most long term disability claimants with tinnitus face.
Time and time again, insurance companies erroneously deny legitimate tinnitus long term disability claims due to lack of substantial hearing loss. Yet, the most disabling cases of tinnitus often have nothing to do with hearing loss. Rather, the most disabling cases are usually due to an inability to concentrate, focus, sleep, or other cognitive difficulties. In some cases, the condition may even be disabling due to secondary depression and/or anxiety.
Records of these cognitive impairments as a result of tinnitus can help explain to your insurance company why you are unable to perform your job duties. They are just as important, if not more so, than your physical symptoms.
Getting Approved For Disability Benefits With Tinnitus
Highlighting Cognitive Impairments
The insurance companies’ tendency to focus on hearing loss is extremely difficult to avoid. A long term disability attorney can highlight your more disabling symptoms to prevent improper focus on hearing loss. If the insurance company persists in questioning your hearing loss (or lack thereof), your attorney may recommend additional neuropsychological testing or elicit a written narrative response from your doctor.
Appropriate Treatment for Tinnitus
Most long term disability insurance policies require proof that: (1) you are receiving medical treatment; and (2) the treatment you are receiving is “appropriate.” However, tinnitus typically presents as a very complicated cluster of symptoms that varies dramatically between different individuals, so it can often be difficult to determine what treatment is “appropriate.”
In some cases, treatment may focus on a known underlying cause or condition, such as blood pressure issues, cardiovascular disease, temporomandibular joint syndrome (TMJ), dysfunctions of the eustachian tube, balance disorders, metabolic dysfunction, vitamin deficiencies, Lyme disease, etc.
However, the underlying cause of tinnitus is often never identified or simply not treatable. For example, it may be useless to treat the underlying cause of tinnitus if it was related to aging, exposure to loud noise over a period of time, traumatic exposure to loud noise, etc. In those circumstances, or where no treatable underlying cause can been identified, doctors typically focus on symptom management. Management of tinnitus symptoms can range from cognitive behavioral therapy, white noise machine therapy, Neuromonic device therapy, avoidance of certain food or substances, annual audiological and hearing testing, physical therapy, vestibular rehabilitation, use of hearing aids, etc.
Compliance with your doctor’s recommended course of treatment and consistent follow-up is key to satisfying the insurance company’s “appropriate treatment” requirement. Typically, the insurance company will want proof that you are following through with all treatment recommended by your doctor, regardless of whether you personally find it helpful.
Ongoing Proof of Treatment
Thankfully, it is possible for tinnitus symptoms to improve with ongoing treatment and care. Even if symptoms don’t improve, it is also possible for patients to adapt to the tinnitus and function better over time. Of course, the insurance companies are aware of this. As a result, they will periodically require proof of an ongoing disability so long as you remain on long term disability benefits.
The frequency of required updates will vary depending on your insurance company and particular facts of your case. You should generally expect a request for updates at least twice per year. Failure to provide the insurance company with timely or sufficient updates is likely to result in benefit termination. An experienced long term disability attorney can help submit supportive and timely updates to protect your benefits.
Tinnitus can be a difficult condition to get approved for on a long term disability insurance claim. Unlike some other conditions, there is often less objective evidence to support your diagnosis. As a result, insurance companies may be more skeptical of the negative impact your symptoms have on your ability work, regardless of how valid they are.
Having an experienced long term disability attorney can go a long way in getting your benefits approved. A long term disability attorney will know how best to substantiate your claim with evidence of not only hearing loss, but the secondary cognitive impairments your symptoms cause, and how they specifically interfere with your job duties. If you’ve already been approved for benefits due to tinnitus, an attorney can make sure any updates to your insurance company support your continued disabling symptoms.