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

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 your benefits.

Appealing a denied LTD claim with the insurance company can be a grueling process, and insurance companies will not concede without a fight.  Such companies have a lot of resources at their disposal, and they often prioritize their own financial interests, which can result in claimants receiving denials of their claims.

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

We can relieve the burden of dealing with the insurance company from you so that you can focus on managing your condition.  Contact us today at 401-331-6300 for a free case evaluation.

Understanding Parkinson’s Disease

About 60,000 people are diagnosed with Parkinson’s disease each year in the United States.  It affects approximately 1 percent of all people over the age of 60.

Parkinson’s disease is a chronic and 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, i.e., they stop working or die.  This degeneration causes neurons in the brain to produce lowered levels of dopamine, which results in symptoms such as the loss of control of movement.

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

Causes of Parkinson’s Disease

Studies show that one may face an increased risk of developing Parkinson’s disease after exposure to pesticides and other chemicals, or after suffering a 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 this condition may result from a combination of genetic and environmental factors.

7 Common Long-Term Disability (LTD) Claim Mistakes (Part 1)

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 age.  As such, the risk of developing it increases dramatically as a person ages, with the average age of diagnosis at 60.  Yet some people receive a diagnosis in their 40s or younger too.

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.  Symptoms can include:

  • Resting Tremor: This is the most noticeable early motor symptom.  It consists of uncontrollable and unwanted movements of a limb when it is at rest.
  • Bradykinesia: This is the slowing or loss of the ability to voluntarily initiate movement in the body.
  • Rigidity: People may experience stiffness in a limb or other body part.
  • Postural instability: This symptom results in a lessened ability to maintain balance and coordination.
  • Reduced facial expression: Those with Parkinson’s disease may find it difficult to move their facial muscles in the way they once did.
  • Walking problems: Otherwise known as “gait problems,” a person suffering from PD may find it difficult to walk even a short distance.
  • Lost sense of smell: Those with Parkinson’s may begin to notice that they can no longer detect certain scents or that their sense of smell is generally weak.
  • Dystonia: Experts estimate that 40 percent of those with Parkinson’s disease will experience dystonia, which is the painful and prolonged contractions of the muscles that causes involuntary repetitive twisting.
  • Digestive issues: Most commonly constipation.  Such digestive symptoms are experienced due to the reduced ability to process food common in PD patients.
  • Mood disorders: Those suffering from Parkinson’s disease are likely to experience mood disorders, such as depression and anxiety.
  • Orthostatic hypotension: This symptom is when low blood pressure fluctuates in a person’s body.
  • Sleep disorders: Such disorders can include insomnia, daytime sleepiness, REM sleep behavior disorder, restless leg syndrome, and obstructive sleep apnea.
  • Mild cognitive impairment (MCI): Such impairments include reduced memory and/or intellectual functionality.  Others may experience difficulty in problem-solving, planning, organizing, multitasking, paying attention, and thought processing.

As is evident, the symptoms mentioned above can make performing the occupational duties of your job impossible.

Advanced Symptoms

Those suffering from more advanced Parkinson’s disease may experience “festination.”  Festination is the involuntary shuffling and/or hastening of individual steps after you begin walking.  Another common motor symptom shown in more advanced stages of PD is “freezing,” or the involuntary cessation of movement while starting to walk or initiate motion.

“Dyskinesia” is a common symptom seen in long-term Parkinson’s disease 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 too.  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.  They may lead to the development of other disorders such as “Parkinson’s-induced Dementia” (PDD).

Lack of balance or mobility alongside involuntary spasms can eventually lead a person suffering from Parkinson’s disease to require a wheelchair.  In the 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 Parkinson’s disease may include:

  • A thorough review of your medical history;
  • A neurological examination;
  • Looking for two or more of the cardinal symptoms of PD, such as resting tremor, bradykinesia, rigidity, or postural instability; and
  • A “DaTscan,” which is a technique that allows doctors to capture detailed images of the dopamine system.

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 Parkinson’s disease, but there are therapies that help manage its associated symptoms.  For example, Levopada is considered a very effective medication to treat the symptoms of Parkinson’s disease.  However, long-term use of this drug often causes dyskinesia.  Dyskinesia symptoms can prove to be just as — if not more — debilitating than the symptoms Levopoda is meant to treat.  Your doctor may be able to combine medications to limit these side effects.

Surgery may be a viable option to ease your Parkinson’s disease symptoms if your doctor deems it appropriate.  “Deep brain stimulation” (DBS) is the most frequently performed surgical procedure.  DBS is conducted by placing electrodes within specific areas of the brain.  These electrodes are connected to a neurostimulator (similar to a pacemaker) to continuously deliver electrical impulses to reduce PD symptoms.

There is no standard trajectory or progression of the severity of Parkinson’s disease.  As such, each person experiences their own set of symptoms, and, subsequently, treatment regimens must be personalized.  PD is highly individualistic; the specific symptoms you develop, when they manifest, and their severity is unpredictable and unique to each patient.

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.  You should always consult your treating physician when selecting a treatment regimen for managing your condition.

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

The effect Parkinson’s disease has on a person’s ability to work will vary from person to person.  Some people may experience a rapid progression of symptoms.  Yet others may experience a slower progression of their symptoms.  Likewise, 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.

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.

How Do I Determine If I Have Long-Term Disability Coverage?

If you receive a diagnosis of Parkinson’s disease, then you should determine whether you have long-term disability 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 – a family member, a close friend, or your LTD attorney.

How ERISA Impacts Long-Term Disability Claims

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 a long-term disability insurance company, then you may request a copy of your policy from them directly.  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 supersede the SPD if there is a discrepancy.  Also, more than one document may govern your coverage.  You can request a complete copy of your plan-governing documents in writing from the plan administrator, which is usually your 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.

Chisholm Chisholm & Kilpatrick Understands Disability Claims for Parkinson’s Disease

Our long-term disability team here at Chisholm Chisholm & Kilpatrick understands the effects that Parkinson’s disease can have on you — both physically and cognitively.  The cognitive symptoms of PD may make it difficult for you to concentrate or multitask responsibilities.  Physical symptoms can impede your ability to perform typical day-to-day tasks, such as getting dressed, physically attending work on a reliable basis, and traveling.

The insurance company often does not fully comprehend the strain claimants face by remaining in the workforce when they suffer from a debilitating medical condition.  For example, your insurer may not understand how you have worked with Parkinson’s disease in the past but are now rendered unable to do so due to PD’s progressive nature.

At CCK, we have over 30 years of combined experience handling long-term disability claims.  We have helped professionals who have attempted to work through their symptoms for years but simply can no longer perform their job at the capacity required to remain in the workforce.  When you become unable to work due to your condition, and you have the proper coverage, you must consider filing a claim for long-term disability benefits.

Yet insurance companies routinely deny LTD claims.  Unfortunately, numerous disability claims receive denials every year across the United States for one reason or another.  If your insurer denies your claim, they will send you a denial letter in the mail.  This letter will cite their reasons for their decision.  This may be disheartening to receive, but you have the right to appeal this decision.

How Can CCK Help With My Long-Term Disability Appeal?

The administrative appeal is a critical time for your long-term disability claim, especially if you have an ERISA-governed policy.  The long-term disability lawyers at Chisholm Chisholm & Kilpatrick understand this and want to help.

Definition of Disability in Long-Term Disability Policies Explained

We can alleviate the stress associated with filing an LTD appeal while also leveling the playing field for you against the powerful, big-name insurance company that likely administers your claim.  We help our clients fight for their benefits in various ways.

Finding Insurance Company Errors

Our team can gather and analyze all documentation surrounding your case to identify any errors your insurance may have made.  Documentation we analyze can include:

  • The denial letter
  • The insurance company’s claim file
  • Your long-term disability policy
  • All 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 appeal to help us identify these potential errors that insurers sometimes make.

Communicating with Your Doctors

Obtaining professional, detailed, and thoughtfully written reports from your treating physician and specialists is an essential step in defending your insurance claim.

Often, doctors want to help but are too busy with their day-to-day duties to most effectively do so.  We facilitate the flow of information between your doctor and insurer 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 their case.

Gathering Evidence and Writing the Appeal

Properly handling a long-term disability 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 to managing your appeal.  We gather all evidence that you will need in court and submit it with your appeal.  This evidence might include:

  • Test results
  • Medical records
  • Reports from your treating physicians
  • Expert opinions, such as vocational evaluations
  • 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 long-term disability appeals.  In ERISA cases, the administrative appeal stage is the final opportunity a claimant has to submit substantive evidence to the record.

One major source of adversity that ERISA long-term disability 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.

Call Chisholm Chisholm & Kilpatrick Today

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 receive a diagnosis.  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.  CCK understands this and wants to help.  This is not a process you must do on your own.

Call CCK today at (800) 544-9144 for a free case evaluation with a member of our team.  We will analyze your LTD claim for Parkinson’s disease and determine if we can assist you.