Scleroderma

Do I Qualify For Disability Insurance Benefits If I Have Scleroderma?

The word “scleroderma” comes from the Greek, “sclero,” meaning hard, “derma,” meaning skin. Hardening of the skin is one of the most visible manifestations of scleroderma.

Not everyone with scleroderma is entitled to disability benefits, and disability insurance companies don’t always make it easy for policyholders who are disabled because of scleroderma to get the disability benefits they deserve.

What Is Scleroderma?
A chronic connective tissue disease, scleroderma is classified as one of the many autoimmune rheumatic diseases.

Because scleroderma symptoms are much like other autoimmune diseases, the diagnosis can be difficult to make. You may have to see an arthritis and skin specialist and undergo numerous tests, depending on the organs involved.

The two types of scleroderma are localized and systemic. With localized scleroderma, changes are found only in a few places on the skin and muscles. It rarely spreads and generally is not disabling.

With systemic scleroderma, the involved tissue and organs become hard and fibrous. They function less efficiently. Systemic scleroderma can involve the skin, esophagus, stomach, bowels, lungs, kidney and heart, and it can affect blood vessels, muscles, and joints.

How Disability Carriers Handle Scleroderma Claims

Disability carriers are notorious for denying and terminating many scleroderma claims. Carriers often argue:

– Coverage is excluded by the pre-existing condition clause of your disability policy.

– Benefits are limited under the subjective limitation clause. Pain and fatigue can be your most disabling symptoms, but carriers routinely dispute their impact.

– You’ve had scleroderma for years and have not been disabled before now. You will have to overcome the carrier’s argument that you have been working with these problems for years and nothing has changed. It is crucial that your medical records develop the progression of your symptoms.

– Your symptoms are in remission and just flare-up temporarily, so you can work.

Many disability claims are denied. Other reasons carriers deny claims:

1. There is no objective basis of the scleroderma diagnosis,
2. There is no objective basis for the restrictions and limitations assigned by your physician, or
3. There is no causal relationship between your scleroderma diagnosis and/or your restrictions and limitations, and your inability to do your own or any occupation,
4. There is no reason you can’t work in a sedentary capacity, or
5. There is no reason you can’t work with accommodation.

Why You Need Nancy Cavey

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many scleroderma policyholders. She overcomes a claims denial by working closely with you and your physician. She obtains, as needed, a Functional Capacity Evaluation to objectively document your physical limitations. She even hires a Vocational Evaluator to explain why your symptoms prevent you from doing your occupation or any occupation.

Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

How Do I Get The Disability Insurance Benefits I Deserve?

Scleroderma can interfere not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for disability benefits, you should take steps before you apply:

1. Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove and if there are limitations in your coverage. Your policy might limit conditions that are based on subjective complaints without objective evidence of a diagnosis.
2. Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
3. Obtain a copy of your personnel file to see if your scleroderma has affected your work performance.
4. Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
5. Provide your doctor with the occupational description. Ask your doctor to prepare

a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.

6. Prepare a diary that explains and gives examples of how your scleroderma symptoms interfere with your ability to do things on a daily basis and the side effects of your medication. Document the flare-ups and your dysfunction even when you are not flared.
7. Take pictures of any physical manifestation of the scleroderma.
8. Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
9. Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.

Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live

Scleroderma can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits.  Call today for a free consultation at 727-477-3263.