Connective Tissue Disorders And Long-Term Disability Insurance Claims

Are you or a loved one struggling with a connective tissue disorder that is impacting your ability to work and maintain financial stability? Long-term disability may be an option worth exploring to alleviate some of the burdens that come with managing a chronic condition. In this post, we dive into connective tissue disorders and long-term disability claims.

Can I Get Long-Term Disability for a Connective Tissue Disorder?

Patients with connective tissue disorder may be unable to work because of their disorder and its related complications. Patients who find themselves unable to work because of their connective tissue disorder 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. While the process can be daunting, your experienced disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.

Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your connective tissue disorder. Even if you have been denied benefits, that does not mean your fight is over. Many people are denied benefits the first time they 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.

What Are Connective Tissue Disorders?

In patients with connective tissue disease, it is common for collagen and elastin to become injured due to inflammation. Many connective tissue diseases feature abnormal immune system activity demonstrated by tissue inflammation due to an immune system directed against one’s body tissues (this is why it is called an “autoimmune” disorder). Another name for connective tissue disease is collagen vascular disease.

Hundreds of diseases impact the body’s connective tissue. Some connective tissue disorders result from an infection, such as cellulitis, while environmental factors may cause others. Injuries or scarring after trauma can also cause connective tissue disorders. Others, such as Ehlers-Danlos syndrome and Marfan syndrome, are genetic. Still, others have no known cause, like scleroderma. Each disorder has its own symptoms and needs different treatment.

Autoimmune Connective Tissue Disorders

Many connective tissue diseases are autoimmune disorders, including:

• Systemic Lupus Erythematosus (SLE): An inflammation of the connective tissues, SLE can afflict every organ system. It is up to nine times more common in women than men and strikes black women three times as often as white women. The condition is aggravated by sunlight.
• Rheumatoid Arthritis (RA): Rheumatoid arthritis is a systemic disorder in which immune cells attack and inflame the membrane around joints. It also can affect the heart, lungs, and eyes. Of the estimated 2.1 million Americans with rheumatoid arthritis, approximately 1.5 million (71 percent) are women.
• Scleroderma: an activation of immune cells that produces scar tissue in the skin, internal organs, and small blood vessels. It affects women three times more often than men overall but increases to a rate 15 times greater for women during the childbearing years and appears to be more common among black women.
• Granulomatosis with Polyangiitis (GPA, previously known as Wegener’s): A type of vasculitis that causes inflammation in the blood vessels, impacting the nose, lungs, kidneys, and other organs.
• Churg-Strauss Syndrome: Inflammation that affects cells in the blood vessels of the lungs, gastrointestinal system, skin, and nerves.
• Microscopic Polyangiitis (MPA): A rare autoimmune disease affecting cells in the body’s blood vessels.
• Polymyositis/dermatomyositis: Characterized by muscle inflammation and degeneration. When it also affects the skin, it’s referred to as dermatomyositis.

Hereditary Connective Tissue Disorders

More than 200 conditions are considered genetic connective tissue disorders. These disorders result from gene mutations and thus are called “heritable.” All of these diseases are directly related to mutations in genes that are responsible for building tissues. Alterations in these genes may change the structure and development of skin, bones, joints, the heart, blood vessels, lungs, eyes, and ears. Some heritable connective tissue disorders include:

• Marfan syndrome – a genetic disease causing abnormal fibrillin;
• Ehlers-Danlos syndrome – a defect in the synthesis of collagen (Type I or III) causes progressive deterioration of collagens, with different EDS types affecting different sites in the body, such as joints, heart valves, organ walls, arterial walls;
• Osteogenesis imperfecta (brittle bone disease) – caused by insufficient production of normal collagen (primarily type I) to produce healthy, strong bones;
• Stickler syndrome – affects collagen (primarily type II and XI) and may result in a distinctive facial appearance, eye abnormalities, hearing loss, and joint problems;
• Loeys Dietz syndrome – Discovered in 2005, the disorder is marked by aneurysms in the aorta, often in children. Symptoms appear to be like Marfan Syndrome and EDS. This is caused by a mutation in the gene TGFBR on either chromosome 3 or 9, depending on the type.

Mixed and Unspecified Connective Tissue Disorders

Some individuals may experience an unspecified or mixed connective tissue disorder:

• Mixed connective tissue disease (MCTD): Mixed connective tissue disease is an autoimmune disorder in which features of various connective-tissue diseases (CTDs) such as systemic lupus erythematosus (SLE), systemic sclerosis, dermatomyositis, polymyositis, anti-synthetase syndrome, and, occasionally, Sjögren syndrome can coexist and overlap. In most cases, MCTD is considered an intermediate stage of a disease that eventually becomes either SLE or scleroderma.
• Undifferentiated connective tissue disease(s): Conditions with characteristics resembling connective tissue diseases but not meeting specific guidelines at a given time. Some individuals with these conditions may later develop a particular type of connective tissue disease, while most will not.

Connective Tissue Disorder Limitations in Long-Term Disability Policies

A connective tissue disorder limitation in a long-term disability policy is a restriction or limitation on the benefits an insured can receive for a connective tissue disorder. Here is an example of one such limitation from a real disability insurance policy:

“Payment of long-term disability benefits is limited to 24 months during your entire lifetime for a Disability caused or contributed to by musculoskeletal or connective tissue disorders including, but not limited to:

1. Any disease or disorder of the cervical, thoracic, or lumbosacral back and its surrounding soft tissue.
2. Sprains or strains of joints or muscles.
3. Carpal tunnel or repetitive motion syndrome.
4. Fibromyalgia.
5. Temporomandibular joint or craniomandibular joint disorder
6. Myofascial pain.
7. Arthritis.

This limitation will not apply to:

1. Herniated discs with neurological abnormalities that are documented by electromyogram and computerized tomography or magnetic resonance imaging.
2. Scoliosis.
3. Tumors, malignancies, or vascular malformations.
4. Radiculopathies that are documented by electromyogram.
5. Spondylolisthesis, grade II or higher.
6. Myelopathies and myelitis.
7. Traumatic spinal cord necrosis.
8. Osteopathies.
9. Rheumatoid or psoriatic arthritis.
10. Lupus.”

Understanding potential limitations and roadblocks can better equip you to manage your claim. Document your condition thoroughly, engage with your medical providers, consider obtaining legal advice, and don’t give up if you initially receive a denial. You have the right to appeal a denial.

A National Disability Law Firm Can Help You Appeal a Long-Term Disability Denial

The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to an experienced disability lawyer about your connective tissue disorder and its impact on your ability to work, call us at (888) 321-8131. Long-term disability attorney Nick Ortiz would be happy to evaluate your case and discuss how he can help you through the appeal process.