Bartolic Law has helped people fighting Muscular Dystrophy get their long-term disability insurance claims paid. Like many other chronic and progressive conditions, the biggest hurdle is often getting the initial approval of the claim, as insurers know people do not improve while battling such progressive conditions. The insurers often deny the claims, asserting you have not become disabled yet, but you have already stopped working and would otherwise lose coverage under the policy if you do not succeed.
In one client’s case, the client worked in a sedentary occupation, but the Muscular Dystrophy advanced to the point the client had to stop working. The insurer contended the client should not be disabled yet because the illness did not impair the client’s ability to sit. But even sedentary work requires standing and walking occasionally. More importantly, the symptoms prevented the client from effectively transferring from sitting to standing or walking. Through showing the difficulty the client had with changing postural positions, we were able to persuade the insurer to pay the claim.
Muscular dystrophy is a combination of hereditary diseases that gradually destroy and weaken the body’s muscles. Protein deficiency is to blame for tissue damage from this disease since our bones and muscles need protein to function well. Thus, any acute shortage can adversely affect how you swallow, coordinate muscles, and walk. This medical condition affects men and women across all age groups. However, its Duchenne variant mostly affects small boys. Patients with a genetic history are also at higher risk of developing muscular dystrophy. The available treatment options also depend on a patient’s symptoms.
The most common treatments include corticosteroid drugs that assist in strengthening muscles and slowing muscle deterioration, assisted ventilation when respiratory muscles are damaged and drugs for heart challenges. A patient may need surgery for correcting muscle shortening, repairing cataracts and treating scoliosis or cardiac challenges. However, the disease can still cause severe complications that might make one lose their ability to work. For instance, a patient might develop walking problems requiring wheelchair use. A patient might also be unable to use their arms to perform regular duties. Severe breathing problems necessitating ventilators might also occur.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)
Developing disabilities that force you from employment should also give you the right to file a disability insurance claim. Talk to a disability insurance claims attorney from Bartolic Law today to assess your case. Contact us for a free consultation.