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Scleroderma And Long-Term Disability Insurance Claims

Individuals diagnosed with scleroderma may encounter challenges that prevent them from maintaining regular employment due to the debilitating nature of the disease and its associated complications. Those whose ability to work is adversely affected by scleroderma could potentially be eligible for long-term disability (LTD) benefits. To assess their eligibility, the insurance company will examine their claim to ensure it aligns with the stipulations of the insurance plan.

What is Scleroderma?

Scleroderma is a connective tissue disease that can cause the skin to become thick and stiff, resulting in scar tissue build-up or damage to the tissue and organs. This autoimmune condition affects the body on either a localized or systemic basis. When scleroderma is localized, a person may notice random hardening of the skin or muscles, but it is generally not severe and does not cause disability. Systemic scleroderma, however, can cause severe and life-threatening symptoms, which may be disabling depending on their severity. In the case of systemic scleroderma, the tissues of the body and the organs in the body can become hard and fibrous, causing them to function less efficiently or not at all.

Common areas affected by systemic scleroderma include:

  • Skin;
  • Esophagus;
  • Stomach;
  • Lungs;
  • Kidney;
  • Heart;
  • Blood Vessels;
  • Muscles; and
  • Joints.

What Are the Symptoms of Scleroderma?

The symptoms of scleroderma tend to vary from patient to patient, depending on which area of the body is most affected by the disease. In general, common symptoms of scleroderma include:

  • Hardening and tightening of the skin that often occurs in patches throughout the body;
  • Restricted movement in areas where the skin is stiff or tight;
  • Raynaud’s Syndrome, which causes the limbs to develop an exaggerated response to cold temperatures and may result in numbness, pain, or changes of color in the fingers and toes. In severe cases, gangrene may develop in the extremities, and amputation may be necessary;
  • Digestion difficulties, including reflux and problems absorbing nutrients if damage occurs to the esophagus or the muscles used to aid in digestion;
  • Scarring in the lungs can result in decreased lung function, an inability to breathe, and/or exercise intolerance. A person may also develop pulmonary hypotension in the lungs;
  • Scarring of the heart may result in arrhythmias, pericarditis (inflammation in the membranous sac surrounding the heart), and congestive heart failure;
  • Blood pressure may suddenly increase in the kidneys, resulting in renal crisis and possibly failure; and
  • Some patients experience severe dental problems, as scleroderma can cause dry mouth and reduced saliva, leading to rapid decay. In addition, tightening of the skin around the face can cause the mouth to become smaller or narrower and make it difficult for the patient to brush his or her teeth or have them professionally cleaned.

How is Scleroderma Treated?

While there is no cure for scleroderma, there are treatment options that can help delay the progression of the disease, limit symptoms, and prevent future complications. Such treatment options include:

  • The use of blood pressure medicine to help dilate and open the blood vessels to keep heart and lung problems at bay while reducing the occurrence of Raynaud’s Disease; and
  • Immunosuppressants can help to stop the progression of scleroderma. Commonly prescribed drugs include methotrexate, cyclosporine, anti-thymocyte globulin, mycophenolate mofetil, and cyclophosphamide;
  • Steroids and anti-inflammatory drugs may be used to reduce inflammation and reduce pain; and
  • Surgery, including amputations or organ transplants, may be necessary in advanced cases of scleroderma.

How to Qualify for Long-Term Disability Benefits When You Have Scleroderma

A diagnosis of scleroderma alone is not enough to qualify for long-term disability benefits.   And, like most autoimmune diseases, proving the extent of your disability from scleroderma can be tricky. It is important to work with a qualified long-term disability attorney to ensure that you are putting together a strong claim that clearly shows you cannot work in any capacity.

It’s important to note that most autoimmune diseases like scleroderma tend to have periods of flares and remissions. Some cases of scleroderma are also manageable with medication. Your long-term disability insurance provider will be tasked with examining whether the pattern and severity of your flares and your ability to respond to treatment while living with scleroderma still prevent you from maintaining employment. This may indeed be the case for someone who flares often and would miss a significant amount of work as a result.

Likewise, your experienced long-term disability attorney will help you gather appropriate medical records, physician reports, and tests with the goal of establishing a clear connection between your scleroderma diagnosis and your restrictions and/or limitations in the workforce.

In general, a person who suffers from “limited systemic sclerosis,” meaning that their heart, kidneys, or lungs have not yet been affected by this condition, will have a more difficult time providing the disabling nature of their condition. But, this in no way means that the patient does not have a case; in fact, even patients with limited systemic sclerosis or even localized scleroderma can still experience severe pain, fatigue, complications (such as problems stemming from Raynaud’s Disease), and skin hardening in places that make it difficult to function in any capacity (such as an inability to swallow due to hardening in the throat). Again, working with a qualified attorney will be paramount in helping you draw this connection.

Work with a Disability Attorney to Improve Your Chances of Being Put On Claim

You can maximize the chances that your long-term disability claim will be approved by working with an attorney who is well-versed in disability insurance claims and has experience handling scleroderma-related claims. They will gather all the necessary evidence and guide you through the administrative appeal process. There are no fees or costs unless we recover your benefits. 

If your LTD claim has been unfairly denied or discontinued and you wish to discuss it with an experienced LTD insurance lawyer, call us at (888) 321-8131 to schedule a free case evaluation. We can help you evaluate your claim to determine how we can strengthen it and how to proceed with the process.

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