Functional Neurological Disorder and Long-Term Disability Insurance Claims

Functional Neurological Disorder (FND), sometimes referred to as Neurological Conversion Disorder, is a complex and often misunderstood condition that affects the nervous system. Unlike structural neurological disorders, such as multiple sclerosis or epilepsy, FND does not present with clear structural abnormalities.

This lack of identifiable physical evidence creates significant challenges for individuals seeking long-term disability (LTD) benefits. In addition, the classification of FND—whether as a mental or physical disorder—can significantly impact the outcome of a disability claim.

This article examines the intersection of FND and disability law, highlighting strategies for claimants to navigate this challenging process.

Understanding Functional Neurological Disorder

FND manifests with symptoms that mimic structural neurological conditions but lack identifiable physical causes. These symptoms are real and often disabling, significantly affecting an individual’s ability to work or perform daily activities. Common symptoms include:

• Weakness, paralysis, tremors, dystonia (involuntary muscle contractions), and difficulty walking.
• Numbness, tingling, or problems with vision and hearing.
• Non-epileptic seizures (psychogenic seizures).
• Difficulty concentrating, memory problems, and brain fog.
• Chronic pain and severe fatigue.

Diagnosing FND requires a combination of clinical assessment and diagnostic testing. Neurologists typically identify FND by ruling out other conditions and by detecting positive clinical signs unique to FND, such as Hoover’s sign or tremor entrainment. However, the absence of structural abnormalities often leads to skepticism from insurers and even some medical professionals.

The Classification Challenge: Mental vs. Physical Disabilities

A major issue in FND claims is the classification of the condition as either a mental or physical condition. Insurance companies often misclassify FND as a “mental and nervous” condition, which often limits LTD benefits to 24 months. This classification ignores the physical symptoms of FND, such as paralysis and seizures, which can be just as disabling as those caused by structural neurological disorders.

Courts have faced similar challenges in cases involving conditions with both physical and mental components. For example, in Watson v. Reliance Standard Life Ins. Co., the court held that the claimant’s physical limitations—not just her mental health—should determine her eligibility for disability benefits. The court emphasized that functional limitations, such as the inability to perform work duties due to physical symptoms, are key to evaluating disability claims.

For FND claimants, this precedent underscores the importance of emphasizing the physical aspects of their condition and countering any attempt by insurers to misclassify FND as a purely mental disorder.

Proving Disability with FND

To qualify for LTD benefits, FND claimants must prove that their condition substantially limits their ability to work. This requires thorough documentation and compelling evidence, including:

1. Medical Records: Detailed descriptions of symptoms, such as motor dysfunction, cognitive impairment, and fatigue, are essential. Records should also include diagnostic findings that confirm the diagnosis of FND and rule out other conditions.
2. Residual Functional Capacity (RFC) Forms: Physicians should complete RFC forms to describe how FND symptoms prevent claimants from performing essential job functions or maintaining a consistent work schedule.
3. Supporting Statements: Testimony from family, friends, or co-workers about the claimant’s functional limitations at home and work can strengthen the case.
4. Employment Records: Evidence of reduced performance, missed days of work, or job accommodations highlights the real-world impact of FND symptoms.

Overcoming Insurance Company Tactics

Insurance companies often deny or limit benefits for FND claimants by:

• Claiming Insufficient Objective Evidence: Insurers may claim that FND lacks definitive tests. To counter this, claimants should provide comprehensive medical records, diagnostic test results, and evaluations that confirm the effects of FND.
• Misclassification of FND as a Mental Condition: Claimants should provide statements from neurologists or other specialists confirming that FND is a recognized neurological disorder with physical symptoms.
• Reliance on Independent Medical Examinations (IMEs): Insurers may use IMEs to minimize the severity of FND. Treating physicians should document the fluctuating and unpredictable nature of FND symptoms to counter this tactic.

Courts have repeatedly criticized insurers for failing to properly evaluate functional capacity in claims involving conditions such as FND. For example, the court in Watson found that an insurer’s focus on mental health diagnoses—to the exclusion of physical symptoms—was inappropriate and did not reflect the claimant’s true limitations.

The Role of Legal Counsel

Navigating the FND claims process can be overwhelming, especially when insurers deny benefits. A skilled long-term disability attorney can:

• Review your policy to identify potential pitfalls.
• Gather strong medical evidence to support your claim.
• Represent you in appeals or litigation.

At the Ortiz Law Firm, we understand the challenges faced by FND claimants. We have extensive experience advocating for individuals with complex conditions like FND and ensuring they receive the benefits they deserve.

Get Help with Your Functional Neurological Disorder Disability Claim

Functional Neurological Disorder is a disabling condition that presents unique challenges in long-term disability claims. By understanding the legal principles surrounding FND and using strong medical evidence, claimants can overcome insurer tactics and secure the benefits they need. If you’re facing challenges with your FND claim, contact us for a free case evaluation. Call (888) 321-8131 today for help with your claim.