Getting Long-Term Disability (LTD) Benefits for Ulcerative Colitis
Ulcerative colitis is one of the two most common forms of inflammatory bowel disease (IBD) in the United States. According to the CDC, about 1.3 percent of people in the U.S. have been diagnosed with a form of IBD. Moreover, ulcerative colitis alone affects around 600,000 to 900,000 people.
When a person suffers from ulcerative colitis, they may find it impossible to work. Long-term disability (LTD) benefits are meant to protect a person’s income when they cannot work due to a medical condition. Typically, these benefits can cover between 60 and 80 percent of a person’s pre-disability earnings. This is significant when having to manage a chronic condition.
What Is Ulcerative Colitis?
Ulcerative colitis is a form of inflammatory bowel disease. These types of diseases are debilitating as they cause chronic inflammation of the digestive tract. Moreover, IBDs cause many symptoms that can make it impossible to work and necessitate long-term disability benefits.
While inflammatory bowel disease is an umbrella term for several conditions, the two most common are Crohn’s disease and ulcerative colitis. Ulcerative colitis specifically affects the colon. This condition usually develops between the ages of 15 and 30, but it can occur at any time. Some people may even experience the condition beginning after the age of sixty.
Nevertheless, ulcerative colitis can be categorized into four distinct types:
- Left-sided colitis: This type affects the rectum up to the splenic flexure.
- Pancolitis: This type affects the entire colon.
- Proctosigmoiditis: A person who suffers from this type will have inflammation of the rectum and the sigmoid colon.
- Ulcerative proctitis: This is the mildest form of ulcerative colitis since it only affects the rectum.
The distinct types affect different parts of the colon and can vary in severity. It is important to visit a doctor when something does not feel right.
Causes and Symptoms
Unfortunately, there is no known cause of this condition. However, researchers have pinpointed three potential causes that are worth recognizing. First, environmental factors may play a role in the development of ulcerative colitis. These environmental factors include day-to-day living and health habits.
Second, this condition may be genetic. If a person has a family member who suffers from this condition, they are more likely to develop it themselves. Finally, and perhaps most importantly, the immune system may initiate a defense response against inflammation in the digestive tract when there is no inflammation to protect against. This error in the immune system can then — potentially — cause ulcerative colitis to develop.
As mentioned earlier, there are myriad symptoms that can accompany ulcerative colitis. These symptoms can go into remission. These periods can last from a few months to a few years before the symptoms return. Therefore, managing the symptoms is crucial, even when in remission. Symptoms may include:
- Diarrhea (sometimes with blood and/or pus);
- Abdominal pains and cramps;
- Rectal pains and rectal bleeding;
- The inability to defecate even if you feel the urge to do so;
- A constant urgency to go to the bathroom;
- Nausea;
- Fever;
- Fatigue;
- Weight loss;
- Loss of appetite;
- Swollen joints;
- Skin rashes and sores; and
- Vomiting.
This is not an exhaustive list, but it exemplifies the severity of the condition. Moreover, it is evident how these symptoms can sideline a person. Such symptoms can make working nearly impossible.
Complications
Ulcerative colitis can lead to other complications. Some of these complications can be severe and require immediate medical assistance. For example, if someone suffers from this condition, they are more likely to develop anemia, osteoporosis, kidney stones, blood clots, and colorectal cancer.
Moreover, some of the more severe complications include fulminant ulcerative colitis, which has extreme symptoms; perforation, which is a hole in the wall of the large intestine that may require emergency surgery; and toxic megacolon, which is when the inflammation spreads deep within the tissue layers of the large intestine and can cause them to stop working.
Diagnosis and Treatment
It is important to receive a diagnosis of your condition when you are looking to file for long-term disability benefits. The deadline to file for such benefits is contingent upon when the symptoms first began. Therefore, it is important to visit a doctor when symptoms first occur. Moreover, an official diagnosis is a good piece of evidence to include with a claim.
Nevertheless, to receive a diagnosis, a person suffering from ulcerative colitis must visit their doctor and undergo a physical exam. However, an official diagnosis can only come from an endoscopic procedure with a tissue biopsy. Endoscopic procedures include colonoscopies and flexible sigmoidoscopies.
Other tests, however, can help rule out other conditions. Imaging procedures, for example, can include X-rays and CT scans. The doctor may take blood samples to check for anemia, and they may take stool samples to check for white blood cells, which can be a sign of ulcerative colitis.
Once a person receives a diagnosis, they can begin treatment. Doctors usually prescribe medication to help treat the inflammation, such as aminosalicylates, corticosteroids, and immunosuppressants. Further, a doctor may also prescribe over-the-counter medications to treat certain symptoms, such as diarrhea and pain.
Additionally, surgery may be an option for some. Surgery will remove the condition entirely by removing the colon and rectum. The two most common surgeries for this condition are ileoanal reservoir surgery and an ileostomy.
Ulcerative Colitis Can Prevent You from Working
When you suffer from ulcerative colitis, you may find it impossible to work. The symptoms of this condition are debilitating. It can affect your ability to sit or stand for extended periods, and it can affect your mood and ability to concentrate on important tasks.
When you are at work, you may have to make frequent, urgent trips to the bathroom. This can keep you away from your work, but it can also be embarrassing, especially if you work in an office setting. Moreover, the abdominal pains associated with this condition can become severe and make it impossible to do anything productive.
You may also experience fatigue, which can bring down your motivation to complete your work and can lead to mistakes. Additionally, if you are losing sleep due to your condition, you may oversleep or find it difficult to stay awake and alert at work.
In short, if you suffer from this condition, your work output will suffer. Ulcerative colitis is a chronic condition and requires time to treat properly. Thus, long-term disability benefits are crucial.
Filing for Long-Term Disability Benefits When Suffering from Ulcerative Colitis
It is important to monitor your symptoms so that you know when you must file your LTD claim. There are deadlines located within your long-term disability policy that will explain when you must file.
Talking with your doctor, and regularly meeting with them, is important too. Many LTD policies require that you are receiving treatment for your condition to qualify for benefits.
Evidence is key when filing for long-term disability benefits. You must submit evidence to prove that your condition disables you per the definition of disability within your policy. This definition — either an “own occupation” or an “any occupation” definition — forms the basis for what you must prove to win your claim.
When you have ulcerative colitis, you will receive objective evidence when you undergo imaging and endoscopic procedures. It is vital to collect these tests and submit them as part of your claim as they will show the presence of your condition.
Moreover, having your doctor submit a specialized report can be beneficial. Your doctor can expound upon how your condition impairs you and how it affects you at work. Therefore, having open communication with them is so important.
It is also important to be cognizant of your policy’s waiting period. The waiting period is typically 90 to 180 days. This means you must meet your policy’s definition of disability for this length of time before the benefits begin. Therefore, you may receive approval of your claim but may not receive benefits immediately. It is important to understand this so that you can plan accordingly. Short-term disability benefits may be necessary to bridge this period.
What Happens if My Insurance Company Denies My Ulcerative Colitis Claim?
It is possible that you may receive a denial of your claim. This can be disheartening and may seem impossible to overcome. However, you have the right to appeal your insurer’s decision. Your LTD policy will have information about how to appeal, including any deadlines you must meet.
If you have a policy through your employer, then you must be cognizant of ERISA. ERISA is a federal law that governs such policies. If you file an appeal, you must be aware of the appeal deadlines too. If you miss this deadline, and the insurance company denies your appeal, you may lose your right to sue in federal court. Moreover, the administrative appeal is the last time in which you may submit new evidence.
Your insurer will send you a denial letter. It is important to read this letter and make note of the specific reasons they cite for their decision. In your appeal, you should directly address these issues. A long-term disability insurance attorney can help you with your appeal to help avoid common mistakes.
Chisholm Chisholm & Kilpatrick Can Help You with Your Claim
Suffering from a debilitating medical condition that prevents you from working is stressful. It is not easy and coping with the prospect of not working can be troubling. Some claimants may feel that they should handle these claims on their own. While this is possible, it is not always the best option. These claims often get complex, and long-term disability policies are typically hard to understand.
Consulting with a long-term disability attorney is always beneficial. The LTD lawyers at Chisholm Chisholm & Kilpatrick have over three decades of collective experience dealing with insurance companies and know how they operate. We know what they expect and what to include with your claim. In short, we will work to help you obtain your benefits.
Moreover, we can track all deadlines; collect and submit evidence on your behalf; and represent you in court, if necessary. We can assist you at any stage of the process. If you are suffering from ulcerative colitis, you may feel lost trying to file your claim or appeal. Call CCK today at (800) 544-9144 for a free case evaluation. We will analyze your case and see if we can help.
Share this Graphic
