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Getting Long-Term Disability (LTD) Benefits for Parkinson’s Disease

The process for getting your long-term disability (LTD) benefits for Parkinson’s Disease (PD) can be daunting if your claim gets denied. Coping with the symptoms of PD can be difficult enough without also having to fight the insurance company for benefits you are rightfully owed.

Appealing a denied LTD claim with the insurance company can be a grueling process, and insurance companies will not concede without a fight; they have a lot of resources at their disposal, and can be motivated by their own financial interests.

At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys know how to handle ERISA and non-ERISA LTD appeals to help you win the long-term disability benefits you deserve. We have experience helping those living with Parkinson’s Disease achieve favorable outcomes when appealing to the insurance company.

We can relieve the burden of dealing with the insurance company from you, so that you can focus on living your life to the fullest. Contact us now at 401-331-6300 for a free consultation.

Understanding Parkinson’s Disease:

In the U.S., about 60,000 people are diagnosed with PD each year. PD affects approximately 1% of all people over the age of 60.

Parkinson’s Disease (PD) is a chronic, degenerative neurological disorder that is often characterized by a loss of coordination and movement. PD is a progressive disorder that occurs when dopamine-producing neurons found in a section of the midbrain, the “substantia nigra,” undergo degeneration, meaning they stop working or die. This degeneration causes neurons in the brain to produce lowered levels of dopamine, resulting in PD symptoms such as loss of control of movement.[1][2]

Dopamine is a neurotransmitter chemical “messenger” in the brain that helps coordinate movement and initiate activity.[3]

Causes of Parkinson’s Disease:

Studies show that one may face an increased risk of developing PD after exposure to pesticides and other chemicals, or suffering head injury.  Certain genetic mutations have also been linked to the development of PD, but the majority of cases studied are not directly related to genetics as we currently understand them. Presently, the common belief held by scientists is that PD may result from a combination of genetic and environmental factors.

The reason why the dopamine-producing neurons in the brain die in people with Parkinson’s Disease is not yet fully understood. The only definitive risk factor for developing PD is increased age. The risk of developing PD increases dramatically as a person ages, with the average age of diagnosis at 60, but some are diagnosed in their 40s or younger.[4]

Symptoms of Parkinson’s Disease:

The effects of Parkinson’s Disease can inhibit multiple functional systems in the body; symptoms can manifest in motor, non-motor, and cognitive deficiencies.

  • Resting Tremor is the most noticeable early motor symptom of PD, defined as uncontrollable and unwanted movement of a limb when it is at rest.
  • Bradykinesia refers to the slowing or loss of ability to voluntarily initiate movement.
  • Rigidity, or stiffness in a limb or other body part
  • Postural Instability resulting in a lessened ability to maintain balance and coordination
  • Reduced facial expression
  • Gait (walking) problems
  • Lost sense of smell
  • Dystonia, or painful and prolonged muscle contractions causing involuntary repetitive twisting; experts estimate that 40% of those with PD will experience symptoms of dystonia[5]
  • Digestive problems, most commonly constipation, are experienced by PD patients due to the reduced ability to process food.
  • Mood disorders such as depression and anxiety[6][7]
  • Orthostatic hypotension, or fluctuating low blood pressure[8]
  • Sleep Disorders such as insomnia, daytime sleepiness, REM sleep behavior disorder, restless leg syndrome, and obstructive sleep apnea[9]
  • Mild Cognitive impairment (MCI) such as reduced memory and/or intellectual functionality. Others may experience difficulty in: problem solving, planning and organizing, multitasking, paying attention, and thought processing.[10]

Advanced Symptoms

Those suffering from more advanced Parkinson’s Disease may experience festination, or shuffling, of involuntary, hastening of steps after beginning to walk. Another common motor symptom shown in more advanced stages of PD is referred to as ‘freezing’, or the involuntary cessation of movement while starting to walk or initiate motion.[3]

Dyskinesia is a common symptom seen in long-term PD patients. Dyskinesia is an uncontrolled, abnormal, and involuntary movement that can affect any part of the body. This condition is indicative of a side effect of long-term use of a commonly prescribed MS drug, Levopoda.

People with PD may experience cognitive changes as well. The disease affects chemicals in the brain such as acetylcholine, dopamine, serotonin and norepinephrine.  Over time these cognitive changes can, but do not always, worsen, and may lead to the development of other disorders such as Parkinson’s-induced Dementia (PDD).[5]

Lack of balance or mobility alongside involuntary spasms can eventually lead a person suffering from PD to require a wheelchair. In advanced stages of PD, one may require aid from another person to carry out everyday activities.

How is Parkinson’s Disease Diagnosed?

A doctor’s diagnostic process for PD may include:

  • Thorough review of medical history
  • Neurological examination
  • Looking for two or more of the cardinal symptoms of PD such as resting tremor, bradykinesia, rigidity, and postural instability
  • DaTscan, a technique that allows doctors to capture detailed images of the dopamine system[1]

Parkinson’s Disease shares the symptoms of many other disorders. Since none of the above methods can definitively diagnose a person with Parkinson’s, PD’s misdiagnosis rate is fairly high.[1]

How is Parkinson’s Disease Treated?

There is no cure for PD, but there are therapies to manage PD symptoms.  For example, Levopoda is considered a very effective and frequently prescribed medication used to treat the symptoms of PD; however long-term use of this drug often causes a side effect known as dyskinesia. Dyskinesia symptoms can prove to be just as, if not more, debilitating than the Parkinson’s symptoms Levopoda is prescribed to treat.[5] Your doctor may be able to combine medications in order to limit side effects.[11]

If your doctor deems it appropriate to your situation, surgery may be a viable option in easing your PD symptoms. The most frequently performed surgical procedure is referred to as Deep Brain Stimulation (DBS). DBS is conducted by placing electrodes in specific areas of the brain. These electrodes are connected to a neurostimulator (similar to a pacemaker), to continuously deliver electrical impulses in order to reduce PD symptoms.[12]

Since there is no standard trajectory or progression of severity of Parkinson’s Disease, each person experiences their own set of symptoms and treatment regimens must be personalized.[13] PD is highly individualistic: which symptoms you develop, when they manifest, and their severity is unpredictable and unique to you.

Experts encourage patients to maintain a healthy lifestyle by eating a balanced diet, participating in regular exercise, and avoiding stress as much as possible; stress is thought to worsen every symptom of Parkinson’s Disease.[1] You should always consult your treating physician when selecting a regimen for managing your Parkinson’s symptoms.

What is the Impact On Daily Life for a Person with Parkinson’s?

The effect of Parkinson’s Disease on one’s ability to work varies from case to case. Some people may experience rapid progression of symptoms, while others experience a slower progression.  Some jobs may be more physically or mentally demanding than others. Individuals experiencing the cognitive symptoms of PD who work in fast-paced jobs may find it challenging to concentrate or manage multiple projects.[14]

Your PD symptoms are unique to your disease’s course.  You and your doctor can determine if your symptoms and/or side effects from medication inhibit your ability to continue working.[14]

CCK Understands Parkinson’s Disability Claims

We understand the effects that Parkinson’s Disease can have on you over time, both physically and cognitively. The cognitive symptoms of PD may make it difficult for you to concentrate or juggle multiple responsibilities at once. Physical symptoms can impede your ability to perform everyday tasks, such as getting dressed, physically attending work reliably and traveling.[15]

Your insurer may not fully comprehend the strain you face by remaining in the workforce. They may not understand how you have worked with PD in the past, but are now rendered unable to do so due to the disease’s progression.  At CCK, we have experience helping professionals who have pushed through their symptoms for years, but simply can no longer perform at the capacity required to remain in the workforce.

How can CCK Help You With Your Long-Term Disability appeal?

Chisholm Chisholm & Kilpatrick LTD helps level the playing field for you against powerful insurance companies.

Finding insurance company errors

We gather and analyze all documentation surrounding your case such as: your denial letter, the insurance company’s claim file, your policy documents, and any other plan-governing documents. There are certain rules that your insurance company must follow. We will incorporate our knowledge of ERISA, the U.S. Department of Labor, and insurance policies into your arsenal in order to identify errors made by the insurance company.

Communication with doctors during the appeal process

Obtaining professional, detailed, and thoughtfully written reports from your treating physician and specialists is an important step in defending your insurance claim. Often times, doctors want to help but are too busy in their day-to-day duties to most effectively do so. We facilitate the flow of information between your doctor and insurer in order to ease the burden on your doctor.

We advise our clients on how to effectively communicate with their doctors in order to encourage documentation of all findings that may be helpful in supporting your case.

Gathering Evidence and writing the appeal

Properly handling an LTD appeal is much more complicated than just completing some paperwork. Although a doctor’s note proclaiming your inability to remain in the workforce helps your case, it may not be enough for the insurance company to approve your LTD claim. At CCK, we take a comprehensive approach in managing your appeal. We gather all evidence that you will need in court and submit it with your appeal in order to provide the strongest evidence record possible. This evidence might include:

  • Test results
  • Medical records
  • Reports from your treating physicians
  • Expert opinions
  • Witness statements from you, your family, friends, or co-workers

Preparing a strong and complete evidence record to file with your LTD appeal is especially important with ERISA-governed LTD appeals; this is because in ERISA cases, the administrative appeal stage is the final opportunity a claimant has to submit substantive evidence into the record. One major source of adversity that ERISA LTD claimants face is the lack of flexibility in submitting new evidence to the administrative record in court. We gather all evidence and write the appeal using this information. In our appeal, we thoughtfully explain why you meet your policy’s definition of disability and other conditions for coverage. Our arguments are based on, and supported by, evidence.

The best time to identify and understand your disability coverage is before you need it.  Many with Parkinson’s disease continue to work long after they are diagnosed.  Depending on your job and your symptoms, you might continue working without accommodation.  However, at some point, you might need to reduce or change how you work, or you might need to stop working altogether.  If you have disability insurance coverage and you suffer lost income because of your Parkinson’s disease, you may qualify for benefits.  However, you risk losing your benefits if you do not understand your rights and obligations.

If you have been diagnosed with Parkinson’s disease, you should determine whether you have LTD insurance coverage.  You may have purchased disability coverage, or earned it as an employment benefit from work.  It is a good idea to involve someone you trust – family member, close friend, or your LTD attorney.  For some, Parkinson’s disease can impair cognitive function and impact focus, memory, planning and organization.  Even if the outward effects are subtle, cognitive impairment could cause you to make a mistake that could result in a benefit denial.

If you purchased an individual disability policy, you have probably paid premiums for coverage on an ongoing basis – monthly, quarterly, or annually.  Review your financial records and checking accounts for evidence of these payments.  If you find payments to an LTD insurance company, you might request a copy of your policy from the insurance company.  If you have an insurance agent, you can also ask your agent to help you get a copy of your policy.

Ask your employer for information on your employment benefits.  If you earned your disability insurance coverage as an employment benefit, or purchased it through your employer, you can ask your human resource contact or supervisor for a copy of the Summary Plan Description (SPD) for each benefit plan and pension plan, in which you participate.  Some employers allow you to access these documents online.  The SPD should contain basic information about your coverage.  However, there can be other documents that superseded the SPD if there is a discrepancy.  Also, your coverage may be governed by more than one document.  You can request a complete copy of your plan governing documents in writing from the plan administrator, which is usually the employer.

If you have coverage, you should review it carefully to learn about your benefits and how to access them.  Organize your insurance information and store it in a safe place that you and your trusted person can access if needed.  This will provide you with peace of mind if you need help accessing your benefits down the road.

Call Chisholm Chisholm & Kilpatrick Today

Let Chisholm Chisholm & Kilpatrick help you in your LTD claim for Parkinson’s Disease. Our consultations are always free. Find out if we can help you: 401-331-6300.

References

  1. https://www.michaeljfox.org/parkinsons-101
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181806/
  3. https://www.michaeljfox.org/glossary-terms
  4. https://www.michaeljfox.org/causes
  5. https://www.michaeljfox.org/news/dyskinesia?dyskinesia=&navid=dyskinesia
  6. https://www.michaeljfox.org/symptoms
  7. http://www.parkinsons.org/parkinsons-symptoms.html
  8. https://www.michaeljfox.org/podcast/blood-pressure-and-parkinsons
  9. https://files.michaeljfox.org/031416_MJFF_SLEEP_GUIDE_SM.pdf
  10. https://www.michaeljfox.org/news/memory-thinking-changes
  11. https://www.michaeljfox.org/news/medications-motor-symptoms
  12. https://www.michaeljfox.org/news/deep-brain-stimulation
  13. https://www.michaeljfox.org/news/watch-our-latest-video-what-parkinsons-disease
  14. https://www.michaeljfox.org/news/memory-thinking-problems
  15. https://www.michaeljfox.org/news/workplace-challenges
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3367543/