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Postural Orthostatic Tachycardia Syndrome (POTS) & Long-Term Disability Insurance

Postural orthostatic tachycardia syndrome (POTS) may not be a name that’s familiar to the average American. However, this blood circulation disorder is more common than many people think; the Neurological Institute at the Cleveland Clinic estimates that POTS currently affects around half a million people in the United States.

The condition varies in severity from one patient to the next, but can frequently be debilitating enough to render its sufferers disabled. If POTS is preventing you from doing the essential duties associated with your full- or part-time occupation, you may be entitled to monthly benefits from an individually purchased or employer-sponsored group short- or long-term disability insurance policy.

What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

POTS is a member of a family of conditions called dysautonomia. Dysautonomia refers to a disorder of the autonomic nervous system that causes issues with digestion, blood pressure, circulation, and regulation of heartrate. The best-known symptom of POTS is an increase in heartrate when a patient goes from lying down to standing up.

The name of the condition relates to its causes and symptoms. “Postural” and “orthostatic” refer to an upright posture, “tachycardia” is the medical name given to an increased heartrate, and “syndrome” is a condition involving a group of symptoms.

POTS frequently arises alongside other conditions, including chronic fatigue syndrome (CFS) and Ehlers-Danlos Syndrome (EDS).

Symptoms of POTS

As noted above, the main symptom of POTS is a spike in heartrate after an individual stands up. This is caused by poor circulation to your extremities, which forces your heart to beat faster to maintain an adequate blood flow to these areas. Common secondary symptoms that occur in POTS patients include:

  • Fainting
  • Dizziness
  • Lightheadedness
  • Shakes
  • Excessive sweating
  • Brain fog
  • Memory issues
  • Nausea
  • Chest pain
  • Heart palpitations
  • Breathing issues
  • Inability to sleep properly

Risk Factors for POTS

POTS is more common in females than males, and is particularly prevalent in women and girls between the ages of 15 and 50. Some female POTS patients report that their symptoms get worse during their period.

Assessment of POTS

Physicians test for POTS using a range of different assessments. One well-known example is the tilt table test, during which a physician measures your blood pressure and heartrate while you’re lying at various angles on a special bed. Your doctor may also decide to order blood tests, an echocardiogram, or an electrocardiogram.

When you present with a health issue that looks like POTS, your physician will first have to rule out other potential causes of your symptoms. These include certain medicines, low blood pressure, and anxiety.

Treatment of POTS

There are various kinds of medications your physician may prescribe to deal with ongoing symptoms of POTS. None of these are designed to treat the condition specifically, but they can address the problem by various indirect means. There are also lifestyle interventions your physician may recommend, such as:

  • A reduction in the consumption of caffeine and alcohol
  • Elevating your head with an extra pillow in bed
  • Avoiding standing for long periods
  • Staying hydrated
  • Getting more exercise

In all cases, physicians will decide on a specific course of treatment after assessing you individually.

Long-Term Disability Insurance & POTS

In order for your insurance company to pay out on your disability claim arising from POTS, you’ll need objective medical evidence of the severity of your symptoms. You should also be able to show your inability to perform as required in the workplace.

In order to adequately prove your case, you’ll have to visit your physician. They will have to verify that your condition meets the definition of disability set out in your disability insurance policy. For potential POTS patients, physicians will often use the aforementioned tilt table test if they have a tilt table at their disposal. Your primary care physician may refer you to a cardiologist for a full workup and diagnosis, or they may provide it themselves.

The definition of disability varies from one policy to the next; the two main categories of disability definition are “own occupation” and “any occupation.” “Any occupation” terms are more demanding, as they require you to be unable to carry on any occupation for which you are trained, educated, or suited before you’ll be entitled to monthly benefits. If your policy has a more generous “own occupation” definition, your insurer will regard you as disabled once you can no longer work in the occupation you had immediately prior to your claim.

Your physician should also administer the most appropriate medical treatment for your POTS symptoms before you’ll be able to file a successful claim. Your primary care physician may refer you to various specialists for additional testing and treatment.

It’s worth noting that many of the most prevalent symptoms of POTS are regarded as subjective. It’s important for a physician to definitively say how serious issues like dizziness or headaches are in a given patient. Frequency, severity and intensity of the symptoms are necessary.

You must satisfy for the elimination or waiting period on your long-term disability insurance policy before you can collect on a claim. If yours is an employer-sponsored ERISA disability policy, your waiting period is likely 180 days. Individually purchased policies can have elimination periods that are significantly shorter like 30 days.

In all cases, you should research your policy careful and ideally with the assistance of your long-term disability attorney to discern its precise benefits and limitations.

When to Call a Long-Term Disability Insurance Lawyer

At DarrasLaw, we’ve helped long-term disability insurance claimants suffering from a wide range of conditions. While your insurer may claim to be on your side, the truth is that the business model of disability insurance involves wrongfully denying valid claims using any available loophole. To give yourself the best possible chance of emerging from your claim with the monthly benefits to which you’re entitled, you need a professional New York City ERISA attorney on your side.

Request your free consultation today. If you’ve received an initial claim denial on an employer-sponsored group disability insurance policy, it’s vital that you start the administrative appeals process without delay. Filing a timely and comprehensive appeal is crucial, and your long-term disability attorney will be able to ensure you get everything right prior to submission.

DarrasLaw is Americas' most honored and decorated disability litigation firm in the country. Mr. Darras has seen more, evaluated more, litigated more, and resolved more individual and group long term disability and long-term care cases than any other lawyer in the United States.

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