Patients with Guillain-Barre syndrome may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their Guillain-Barre syndrome may qualify for long-term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
What is Guillain-Barre Syndrome?
Guillain-Barre syndrome is a rare autoimmune disorder where the immune system attacks the nerves. Symptoms can start with weakness and tingling, which then progresses into severe weakness, pain, and paralysis. People with Guillain-Barre syndrome may experience incontinence, difficulty breathing, and the inability to speak. Severe weakness usually sets in about two weeks after the first symptoms appear.
Some people recover fully from their symptoms. For others, their symptoms may improve but never entirely disappear. Children are more likely to recover than adults, and early intervention treatments give the patient a better chance at a full recovery. Lingering muscle weakness and difficulty breathing are the most lasting symptoms.
While a definitive cause has not been discovered, Guillain-Barre syndrome usually occurs shortly after an infection or surgical procedure. It can happen in any demographic, but most commonly affects men and young adults.
Diagnosing Guillain-Barre Syndrome
Diagnosis can be difficult when Guillain-Barre syndrome is still in the early stages. A clinical exam that includes a patient medical history can determine symptoms and risk factors. Further diagnostic testing may be needed, including:
- Spinal tap;
- Electromyography; and
- Nerve conduction studies.
These tests measure nerve health and the spinal fluid changes that can occur in people that have Guillain-Barre syndrome.
Treating Guillain-Barre Syndrome
Hospitalization is urgent, as Guillain-Barre syndrome can rapidly progress into life-threatening symptoms. Guillain-Barre syndrome has no cure, but treatments can help relieve symptoms. Two treatments that can reduce the severity of symptoms are plasmapheresis and immunoglobulin therapy. These can block the antibodies that attack the nervous system. Other treatments include physical therapy, mobility aids, and medication to treat pain and prevent blood clots.
Most people with Guillain-Barre syndrome recover from their symptoms within a year. Some people do not fully recover from their Guillain-Barre syndrome and may qualify for disability benefits if they cannot return to work.
Disability Evaluation of Guillain-Barre Syndrome
Definition of Disability
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to work in almost any job after that. Each LTD plan has a different definition of “disability,” so look over your plan policy to see how your plan determines “disabled.”
Evaluating Disability for People with Guillain-Barre Syndrome
To be considered disabled, you will have to prove that your Guillain-Barre syndrome keeps you from doing your old job (or – depending on the language of the long-term disability insurance policy – prevents you from working at any other job). Your insurance company looks at your symptoms as well as any other disorders that may affect your ability to work.
The insurance company will look at the Residual Functional Capacity (RFC) form to determine the extent of your symptoms and how they may keep you from working. If you have trouble walking, many active jobs will be impossible. Limited use of hands can prevent someone from working even sedentary jobs. The unpredictable nature of Guillain-Barre syndrome and the need for hospitalization may cause someone with severe symptoms to qualify for disability benefits.
Even if your Guillain-Barre syndrome is not considered disabling, you may still be awarded benefits based on your other conditions.
What the Insurance Company Needs From You and Your Medical Providers
You should tell the insurance company about any doctors you may have seen for your Guillain-Barre syndrome. The insurance company will need to obtain all relevant medical records to get the full picture of your health. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself. Vital records to include are:
- Physician notes;
- Diagnostic test results;
- Physical therapy records; and
- Hospitalization records.
You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform.
Working with a Disability Attorney
Working with an experienced disability attorney will put you in the best position to get the benefits you deserve for your Guillain-Barre syndrome. Even if you have been denied disability benefits before, that does not mean you are out of options. It is not unusual to be denied the first time you apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be intimidating, your disability attorney is an expert on the process. You can seek help without worrying about upfront costs or unexpected bills because they are paid out of any awarded funds.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to one of our experienced disability lawyers about your Guillain-Barre syndrome and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the appeal process.