Our firm specializes in representing individuals who have been denied short or long term disability insurance (STDI or LTDI) benefits. Some of these individuals have physical injuries that are readily observable and may be objectively documented through MRIs, CT-scans, x-rays, and the like. Other individuals with chronic pain disorders – including osteoarthritis, fibromyalgia (see footnote) and complex regional pain syndrome (CRPS) – have illnesses that are not as easy to observe or document.
If you are unable to work due to a chronic pain disorder, your long-term disability claim will probably have two primary aspects:
1) Chronic pain limits your ability to perform the physical aspects of your job; and
2) The side-effects of your pain medications – including drowsiness, impaired cognitive functioning or foggy-thinking – limits your ability to perform the mental aspects of your job.
This blog post provides information for individuals who cannot work, in part, due to the side-effects of their prescription pain medication regimen.
Insurance Companies Must Give Consideration To The Effects Of Pain Medication On Your Ability To Work
An insurance company evaluating a claim for LTDI benefits must give fair consideration to the fact that heavy pain medication use can create real problems in the work environment. See, e.g., Holmstrom v. Metro. Life Ins. Co., 615 F.3d 758, 773 (7th Cir. 2010). In other words, if your disability claim has been denied, the insurance company’s failure to consider the impact of medication on your ability to work will bolster an argument that the denial of benefits was unreasonable. This is particularly true if your treating physician has opined that the side-effects of your medication would greatly impede or perhaps eliminate your ability to work.
If your disability claim has been denied, review the denial letter carefully to see if the insurance company performed a meaningful analysis of the extent to which your use of pain medication impairs your ability to perform job duties. If the denial letter lacks a meaningful analysis of this aspect of your disability, be sure to emphasize this fact on appeal.
Support From Your Prescribing Physician Is Essential
Next, whether you are preparing an appeal of a denial of benefits or an initial application, it will be important for you to demonstrate:
1) that the side-effects of your pain medication are a contributing factor to your disability; and
2) the extent to which your pain medication use affects your cognitive functioning.
To corroborate your statements regarding medication side-effects, ask your prescribing physician to prepare a written statement for the insurance company that comments on your symptoms, medication dosages and side-effects, and his or her objective observations of those side-effects.
Neuropsychological Testing May Be Used To Provide Objective Evidence Of The Extent To Which Your Pain Medications Affect Your Cognitive Functioning
Additionally, consider contacting a neuropsychologist to discuss whether neuropsychological testing may be an effective means of demonstrating the extent of your cognitive impairment. This kind of testing may be used to identify decreased ability in a number of areas, including memory, attention/concentration, and executive functioning. Neuropsychological testing is particularly helpful because it provides objective evidence of impairment.
Despite the unique challenges for individuals suffering from subjective symptoms such as chronic pain, the disability attorneys at Hawks Quindel have successfully appealed and reinstated LTDI benefits for clients with chronic pain disorders. Contact one of our experienced long term disability attorneys for a free case evaluation to discuss your benefits claim.
Footnote: Earlier this year, Attorney Danielle Schroder wrote a blog post for individuals who can no longer work due to fibromyalgia. Attorney Schroder’s post provides several helpful ideas for gathering the evidence needed to make a strong claim for long-term disability benefits where fibromyalgia is the underlying medical condition.
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