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Does Long-Term Disability Insurance Cover Autoimmune Disorders?

Many autoimmune disorders, defined as a class of illnesses in which the body’s immune system malfunctions, are genetic or age-related conditions. This isn’t to say you won’t qualify for long-term disability benefits if you’re disabled due to an autoimmune disease. However, individual and group long-term disability insurers routinely, wrongfully delay, deny, or terminate benefits for autoimmune disorders. They may use the pretext these conditions are “pre-existing” or “age-related” non-disabling conditions.

Individual long-term disability insurance typically costs about 2 percent of your annual income. This is about $1,000 per year for the average American worker. Employer-sponsored or group long-term disability insurance may cost less if covered by an employee benefits program. Accordingly, during 10 years, you may pay close to $10,000 in long-term individual disability premiums.

These premiums will typically provide you income protection for an injury or illness at about 60 percent of your monthly income. This means a disabling illness or injury, such as an autoimmune disorder, can qualify the average American worker for $40,000 per year in individual or group long-term disability benefits.

The math doesn’t add up, especially considering that insurance is a business. How can a disability insurer stay in business if you only paid $1,000 per year, but it’s paying you $40,000?

This is one common reason for the bad-faith denial of individual or group long-term disability benefits. Your individual or group long-term disability insurer conducts a risk-benefit analysis to determine whether it will profit from providing coverage. Your chronic autoimmune disorder may offset this balance. Don’t be surprised if you are suddenly wrongfully denied individual or group long-term disability benefits.

Autoimmune disorders are often debilitating diseases. The award-winning long-term individual disability lawyers and top-rated group ERISA attorneys at DarrasLaw know how to fight for your legal right to long-term disability benefits. Our founding partner, Frank N. Darras, and his firms have recovered nearly $1 billion in insurance benefits worldwide.

You may qualify for long-term disability benefits due to an autoimmune condition. To schedule your completely free disability policy analysis and free claim consultation, contact our nationally renowned individual disability lawyers and prominent group ERISA attorneys today at 800-898-7299 or online.

What Are Autoimmune Disorders?

What comes to mind when you think of an injury or illness? Most people think of the flu you caught from your coworker or a broken leg suffered in a fall.

Few people probably think of an internal disorder caused when the body attacks itself. This is an autoimmune disorder.

Your immune system contains the soldiers of your body. Your white blood cells are designed to sense and attack foreign cells, such as viruses and bacteria. A condition is considered an autoimmune disorder when the immune system malfunctions and begins to attack healthy cells.

Autoimmune disorders cover a broad category of diseases ranging from psoriasis and ear infections to multiple sclerosis and lupus. They commonly manifest with:

  • Swollen glands, such as the lymph nodes that store your immune cells
  • Skin irritation and sores
  • Fevers
  • Joint pain
  • Swelling, especially in your joints
  • Fatigue
  • Abdominal pain
  • Digestive distress

There’s no simple test to diagnose many autoimmune disorders. There aren’t any “foreign” bodies in your blood. Your treating doctors need to look at your white blood cell count and perform special exams to determine if you have an autoimmune condition.

Many people with autoimmune disorders initially receive a misdiagnosis, and it’s often difficult to treat your immune system. You can’t simply destroy immune cells because some are malfunctioning.

Understanding the risk factors associated with an autoimmune disorder can ensure you get proper medical care. These risk factors include:

  • Weight – Reports indicate that excess weight and fat tissue puts pressure on your joints and encourages inflammation. This can lead to the development or acceleration of autoimmune conditions such as rheumatoid arthritis.
  • Genetics – You have a greater risk of developing some autoimmune conditions if a blood relative has one as well. Conditions such as multiple sclerosis are sometimes genetic.
  • Medications – Surprisingly, certain common medications such as blood pressure pills and antibiotics can trigger mild autoimmune disorders such as myopathy.
  • Smoking – Tobacco use increases the risk of autoimmune disorders like arthritis, lupus, multiple sclerosis, and thyroid conditions.

Don’t accept a wrongful delay, denial, or termination of benefits simply because your individual or group long-term disability insurer miscategorizes your autoimmune disorder. Not every variation of these disorders is “pre-existing” or non-disabling “age-related problems” despite your individual or group long-term disability insurer’s claims.

Common Disabling Autoimmune Disorders

You’d be surprised how common autoimmune disorders actually are. Examples include:

  • Inflammatory bowel disease (IBS) – IBS occurs when your immune system attacks the lining of your intestines, causing diarrhea, bleeding, loss of bowel control, fever, pain, and weight loss. Serious forms of IBS may include Crohn’s disease. If not managed properly, IBS and Crohn’s can render you unable to perform the important duties of your occupation.
  • Type 1 diabetes – This occurs when your immune system attacks insulin-producing cells in your pancreas. Insulin helps regulate your blood sugar. If you do not properly manage Type 1 diabetes, it could prove fatal. Luckily, medicines can replace insulin. Type 1 diabetes can lead to certain disabling conditions like nerve damage, heart disease, pregnancy complications, kidney damage, and amputations.
  • Guillain-Barre syndrome – This rare condition occurs when your immune system attacks the nerves that control the muscles in your arms and legs. Guillain-Barre results in weakness and difficulty moving. It can prevent you from performing the important duties of your occupation. Treating this condition requires blood filtration, which can cause fatigue and take time out of your work schedule.
  • Multiple sclerosis (MS) – This debilitating, degenerative condition is caused when the immune system attacks your central nervous system. MS can lead to pain, the inability to walk, blindness, weakness, and severe muscle spasms. Some treatments are available for this condition, but nerve cells do not regenerate. Accordingly, it is hard to recover your ability to perform the important duties of many occupations once MS damages the cells.
  • Rheumatoid arthritis – Next to IBS, this is one of the most common autoimmune disorders. It occurs when your immune system essentially attacks the lining of your joints. This causes inflammation, pain, and stiffness. It eventually results in permanent joint damage, and the only treatment is to suppress your immune system.
  • Lupus – This disease is hard to diagnose because it’s categorized as an autoimmune attack against your entire body. Your immune system can attack your lungs, kidneys, blood cells, nerves, and joints. There is no cure for this condition. Most patients must suppress their immune systems with a powerful steroid called prednisone. The treatment itself causes disabling symptoms such as confusion, mood swings, restlessness, nausea, weakness, weight gain, high blood pressure, and headaches.
  • Alopecia – This condition occurs when the immune system attacks your hair follicles. You won’t always qualify for individual or group disability benefits for this condition, but the loss of all bodily hair can cause stress, depression, and suicidal thoughts. You may qualify for individual or group long-term disability benefits for the mental health disorders that developed as the result of alopecia.
  • Polymyalgia rheumatica – This chronic condition is characterized by inflammation, pain, and stiffness in the shoulders. It commonly occurs with a disorder called giant cell arteritis. Your treating doctor can diagnose it when the immune system attacks your arteries. This can cause vision problems, headaches, and jaw pain.
  • Addison’s disease – This condition occurs when your immune system attacks your adrenal glands. They control hormones that affect how your body uses carbohydrates. Addison’s disease is a hard condition to diagnose. It typically presents with unexplained weakness, fatigue, and low blood sugar.
  • Graves’s disease – This is similar to Addison’s disease, except it occurs when your immune system attacks your thyroid. Your thyroid produces the hormones that control your metabolism and energy. An attack on your thyroid causes your body to produce too many hormones, causing a rapid heartbeat, weight loss, heat intolerance, and nervousness.

Treating doctors often rule out all other illnesses and injuries before diagnosing you with an autoimmune disorder. All of the necessary objective medical testing is essential however. Your long-term disability insurers will require compelling medical evidence and proof that your autoimmune condition renders you disabled.

Diagnosing and Treating Autoimmune Disorders

There is no single test used to diagnose an autoimmune disorder, but treating doctors typically perform an antinuclear antibody test (ANA) if they suspect one. Your antibodies scan your body for the foreign germs they’re specifically designed to attack. You may have antibodies to certain strains of the flu or the chicken pox. Antibodies that go rogue and attack the nucleus, or the heart of healthy cells, are called antinuclear antibodies. An ANA test can detect the presence of these antibodies and provide objective evidence and proof of some autoimmune disorders.

You need your immune system to survive, so unlike a cancerous tumor, you can’t simply destroy or remove your immune system. Instead, you have to suppress it. Over-the-counter medications such as Advil can help if you suffer from mild symptoms. More serious autoimmune conditions require more powerful, and more dangerous, immunosuppressant drugs. These drugs, like prednisone, suppress your immune system so it can’t attack and destroy healthy cells.

The danger with immunosuppressants is that they may work too well, preventing your immune system from doing its intended job. This can result in a reduced ability to fight common infections. A common cold can quickly result in a hospitalization for a patient on immunosuppressants. You may file a valid claim for individual or group long-term disability benefits for conditions related to your autoimmune disorder if illnesses develop and prevent you from performing the important duties of your occupation.

Individual or Group Long-Term Disability Coverage and Autoimmune Disorders

You can qualify for long-term individual or group disability benefits for an autoimmune disorder if the disease prevents you from performing the important duties of your occupation. For example, a bad case of IBS may result in an inability to work as a pilot or as a police officer.

Many autoimmune conditions are misdiagnosed as “age-related” problems. Pain in your joints can result from overuse or an attack on the tissues surrounding the joint itself.

While you may not qualify for individual or group long-term disability benefits due to normal age-related degeneration, you may qualify with an autoimmune disorder.

Don’t accept a wrongful delay, denial, or termination of individual or group long-term disability benefits for an autoimmune condition. Instead, consult the experienced long-term individual disability lawyers and seasoned group ERISA attorneys at DarrasLaw. You may qualify for individual or group disability benefits due to:

  • Your disabling symptoms
  • Your need for inpatient infusions and treatments
  • Medication side-effects
  • Related conditions caused by an autoimmune disorder
  • Illnesses contracted as the result of your suppressed immune system
  • Reduced immune system functioning, necessitating seclusion

Call America’s Top-Rated Individual Long-Term Disability Lawyers and Award-Winning Group ERISA Attorneys for a Free, Confidential Consultation

Led by the nation’s top-rated long-term disability lawyer, Frank N. Darras, we’re here if you are disabled from an autoimmune condition. If you experienced a wrongful delay, denial, or termination of your individual or group long-term disability benefits, call DarrasLaw’s stellar long-term individual disability attorneys and skilled group ERISA attorneys. Contact us at 800-898-7299 or online without delay to schedule your free disability policy analysis and free claim consultation.

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