Getting Long-Term Disability (LTD) Benefits for Hepatitis
A person may begin to feel fatigued at work and find it difficult to concentrate on what they are doing. They may begin to feel abdominal pain that makes them irritable and anxious. Of course, these symptoms could be associated with any number of conditions, but it is possible that the person may be experiencing the early symptoms of a form of the hepatitis virus.
Some forms of the hepatitis virus can become chronic, necessitating the filing of a long-term disability (LTD) claim. Of course, other forms of hepatitis, especially acute forms, can resolve on their own. However, if you suffer from a chronic form of hepatitis — specifically hepatitis B or C — then you may qualify for long-term disability benefits.
Consulting an experienced attorney can help you with your claim. The long-term disability lawyers at Chisholm Chisholm & Kilpatrick understand the stress that comes with filing for such benefits and want to help regardless of where you are in the process. Call us today at (800) 544-9144 for a free case evaluation.
What Is Hepatitis?
Hepatitis is a condition wherein the liver becomes inflamed. While typically caused by a viral infection, there are other potential etiologies. For example, a person may experience “autoimmune hepatitis” or may develop hepatitis because of certain medications or alcohol.
“Viral hepatitis,” however, is the predominant form of this condition, affecting people around the world. There are five types of hepatitis, though only three are common within the United States.
The five types of hepatitis are:
- Hepatitis A: This is a common form of the hepatitis virus and is a short-term illness wherein symptoms usually go away without treatment within two months. It is most common to contract hepatitis A through food and/or contaminated water. There is a vaccine available to prevent infection.
- Hepatitis B: This form of hepatitis is common within the U.S., and it can resolve itself within six months. However, hepatitis B can become chronic and cause liver damage. Hepatitis B is spread through blood and other bodily fluids, dirty needles, and from mother to infant at birth. Moreover, it may be sexually transmitted. There is a vaccine available to prevent infection.
- Hepatitis C: Another of the common forms present in the U.S., many people with hepatitis C do not know they have it. Nevertheless, most people with hepatitis C will get a long-term infection that can lead to cirrhosis of the liver. Hepatitis C is transmitted through blood and from mother to infant at birth. Unfortunately, there is no vaccine available to prevent infection from occurring.
- Hepatitis D: This type only may affect those who also have hepatitis B. About 5 percent of those infected with hepatitis B will also suffer from hepatitis D, which can lead to end-stage liver disease.
- Hepatitis E: A short-term type of hepatitis, it is not common in the United States. Instead, it is mostly found in South America, Africa, and Asia. Nevertheless, most people who contract hepatitis E recover without treatment.
Of the types of hepatitis mentioned above, types B and C will most likely cause a person to need long-term disability benefits. This is because both hepatitis B and C can lead to serious, chronic infections that may damage the liver. The related symptoms may also last for extended periods and make working nearly impossible.
Each type of hepatitis has its own set of symptoms. However, when it comes to long-term disability benefits, it is pertinent to examine the symptoms of hepatitis B and C.
Hepatitis B can be either an “acute” infection or a “chronic” infection. Acute hepatitis B usually clears on its own with no further complications. Chronic hepatitis B, however, can be dangerous. Chronic infection occurs when the infection stays in the blood for longer than six months. This infection can lead to liver damage and increases the risk of liver cancer.
Many who suffer from chronic hepatitis B will be asymptomatic until the disease gets worse. However, it is common for certain subjective symptoms (e.g., fatigue) to occur at any point.
Nevertheless, the symptoms of hepatitis B can include fever, joint pain, fatigue, nausea, abdominal pain, coughing, and swelling. For those with a chronic infection, symptoms of liver failure may be present, such as jaundice and swelling in the legs and feet.
Hepatitis C has three phases. The first stage, or the “prodromal phase,” may include fever, rash, swelling, or joint pain. The second phase, or the “pre-icteric phase,” includes symptoms such as fatigue, muscle pain, nausea, fever, coughing, dark urine, and abdominal pain. The third stage, or the “icteric phase,” may include symptoms such as jaundice, the dissipation of previous symptoms, and the development of irritated skin lesions.
One issue with hepatitis C is that many sufferers will not experience symptoms until their liver is already damaged. Nevertheless, the CDC estimates that “more than 50% of people who get infected with the hepatitis C virus develop a chronic infection.” Moreover, they say that this type of hepatitis is “a leading cause of liver transplants and liver cancer.”
These symptoms — whether for hepatitis B or C — can disrupt your life and make working difficult. You must be able to carry out the material duties of your job, but if you are suffering due to any of the abovementioned symptoms, then you may find it exceedingly difficult to do so.
Diagnosis and Treatment
It is important to receive an official diagnosis of your condition when you are filing for long-term disability benefits. Insurance companies look at objective evidence, such as blood tests, to help guide their decision on your claim. Since many of the symptoms of hepatitis — such as fatigue or pain — are subjective and nonspecific, it is important to visit a doctor who can provide objective evidence.
If you believe you are suffering from hepatitis — or exhibit any of the abovementioned symptoms — you should visit your doctor. To receive a diagnosis of hepatitis B or C, you must:
- Undergo a physical examination that may reveal a swollen liver;
- Get blood tests to check for elevated liver enzymes that occur when there is damage present;
- Receive blood tests to check for the hepatitis virus; and
- Get an ultrasound of the liver.
Your doctor may also order a liver biopsy, which can confirm the inflammation of the liver. A biopsy is usually ordered when other tests are unclear. A liver biopsy may also determine the severity of any liver damage that may be present.
When you receive a hepatitis B or C diagnosis, your doctor will create a treatment plan for you. Typically, these forms of hepatitis are treated with antiviral medications. When a person suffers from hepatitis C, they may need a combination of antiviral medications to treat the infection. Over time, these medications can become costly, especially since treatments may last several months to several years.
Moreover, those who have hepatitis C may develop cirrhosis or liver disease, which may necessitate a liver transplant.
Additionally, those who suffer from hepatitis B or C must also regularly visit their doctor during treatment. Their doctor must monitor their progress and check whether the infection is responding to the treatment.
Long-Term Disability Benefits for Hepatitis
Long-term disability benefits help protect your income when you become unable to work due to a medical condition or injury. Typically, these benefits can protect a percentage — usually 60 to 80 percent — of your pre-disability earnings. However, to receive these benefits, you must first file a claim with your insurer who must then approve it. This is not always a straightforward process.
Your LTD policy will have either an “own occupation” definition of disability or an “any occupation” definition of disability. These definitions are crucial in obtaining benefits because they dictate how disabled you must be to receive an approval. For example, if you have an “own occupation” definition, then you must prove your condition only prevents you from performing the duties of your specific job. However, if you have an “any occupation” definition, you must prove your condition prevents you from working the duties of any job whatsoever.
Therefore, to qualify for long-term disability benefits, you must prove that your hepatitis prevents you from working the duties of either your “own” job or “any” job at all, per your policy.
When you file an LTD claim, you must submit evidence. For someone suffering from hepatitis, this can include medical records; blood tests; ultrasound results; biopsy results; witness statements; specialized reports from your doctor; and vocational assessments. Not all claimants must submit supplemental evidence, but it may be necessary.
Yet many long-term disability policies are difficult to understand, and you may not know what evidence you should submit. Consulting with an experienced LTD attorney is beneficial. CCK has over three decades of collective experience handling such claims, and we can help you make sense of your policy. We can collect the best evidence to support your claim and submit it on your behalf.
Additionally, the Social Security Administration (SSA) does consider hepatitis B and C to be disabling conditions, but you should not rely solely on this designation to determine if you will receive approval for your claim. Long-term disability policies are different than Social Security Disability Insurance (SSDI), so what may be considered “disabled” under one policy may not be under the other — and vice versa.
How ERISA May Impact Your LTD Claim for Hepatitis
If you have your long-term disability claim through your employer (i.e., a group policy), then it is likely governed by ERISA. ERISA is a federal law that governs such policies. It can impact claims because, while it is supposed to protect the claimant, it often benefits the insurance company. For example, you may not submit evidence after the administrative appeal, so, if your claim were to go to litigation, you could not submit new evidence, nor would you be entitled to a jury trial.
ERISA also has its own deadlines of which you must be aware. This can impact a hepatitis claim. The main issue is that many claimants will not experience symptoms initially and, when they do, may not think anything of them. They may even push off filing for benefits because they think they will get better. This can be a mistake.
When you file your initial claim, the deadline is contingent on when your disability began. If you hold off, you may miss this window. If you miss this initial deadline, you may lose your right to your benefits entirely. An ERISA attorney can help you navigate this often-complex governing law.
What If the Insurance Company Denies a Hepatitis Long-Term Disability Claim?
Despite your best efforts to avoid mistakes, it is always possible that your insurance company will deny your long-term disability claim. This can be disheartening and may seem like an impossible obstacle to overcome. However, you do have the right to appeal. Some policies may allow several rounds of appeals too.
When you receive a denial, your insurer will send you a denial letter. It is important to thoroughly review this letter because it will help form the basis of your appeal. You should address any reasons your insurer gives for their denial in your appeal. It is important to remember to include objective evidence with your appeal if they cite a lack of sufficient evidence.
A long-term disability insurance attorney understands how difficult it can be to obtain these benefits. CCK can take care of your appeal for you.
When you are suffering from a medical condition that necessitates LTD benefits, you must manage your condition. However, this can be difficult when you are also worrying about filing an appeal with your insurance company. We can help alleviate this stress by collecting and submitting a comprehensive appeal package to your insurer demonstrating your need for benefits.
Call CCK Today for a Free Case Evaluation
As mentioned, we understand how stressful it can be when you are suffering from a medical condition and must file for LTD benefits. CCK has over 20 years of experience helping LTD claimants receive the disability benefits they require, and we may be able to help you too. We can alleviate the stress that comes with filing and/or appealing a claim so that you can focus on what matters most: your well-being.
Call us today at (800) 544-9144 for a free case evaluation with a member of our team. We will analyze your case and determine if we can assist.
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