Getting Long-Term Disability For Stiff Person Syndrome

Living with stiff person syndrome can present unique challenges that profoundly affect daily life. It is characterized by muscle stiffness and spasms that often cause significant pain and mobility limitations for those affected. People with severe Stiff Person Syndrome may require help with walking and moving around, which can significantly affect their ability to perform daily activities and maintain employment.

Understanding Stiff Person Syndrome

Stiff Person Syndrome (SPS) is a rare, incurable autoimmune disorder that causes muscle stiffness and painful spasms. While muscle stiffness is the primary symptom, some people may experience an unsteady gait, double vision, or slurred speech.

SPS primarily affects the nervous system, disrupting communication between the brain and muscles. This disruption leads to abnormal signaling, resulting in muscle stiffness and spasms. The lack of proper communication within the nervous system can impair motor function and coordination, making simple tasks difficult for people with Stiff Person Syndrome.

SPS typically develops in people between the ages of 40 and 50. Rarely, however, it can occur in children and older adults. Experts estimate that SPS affects one to two people per million. While the exact cause of Stiff Person Syndrome is not fully understood, research suggests that autoimmune factors and genetic predisposition play a role in its development.

Stiff Person Syndrome is often associated with other autoimmune diseases, such as type 1 diabetes, thyroid problems, and pernicious anemia. Cancer, most commonly breast or lung cancer, is associated with SPS in less than 5% of cases. When cancer is associated with SPS, it is known as paraneoplastic SPS.

Symptoms of Stiff Person Syndrome

The most common symptom of Stiff Person Syndrome is painful muscle contractions and spasms that usually begin in the back and legs. The spasms may also affect the abdomen, upper body, arms, neck, and face.

These spasms can occur suddenly and are often triggered when someone with SPS is surprised, startled, or moves abruptly. Cold temperatures and emotional stress can also trigger muscle spasms. For some people, certain types of exercise or touch can trigger the spasms.

The muscle contractions can make affected areas feel stiff. Depending on which part of the body is affected, you might experience:

• Trouble walking, needing to widen your stance for better balance.
• Feeling rigid because of ongoing spasms in your back or trunk.
• Being unsteady or falling due to sudden spasms, which can result in injuries.
• Difficulty breathing when SPS affects your chest muscles.
• Dealing with chronic pain.
• Developing excessive lower back curvature (hyperlordosis) over time because of muscle tightness and spinal cord compression (myelopathy) caused by changes in spinal alignment.
• Feeling anxious or developing agoraphobia due to falls triggered by spasms.

Less common symptoms include issues with eye movement leading to double vision, speech difficulties, and lack of coordination.

A person’s specific symptoms are related to their SPS type. Here’s a breakdown of the major types:

• Classic SPS: Most individuals with Classic SPS display the typical symptoms, such as stiffness and spasms, mainly in the lower back and leg muscles. They might also experience these issues in the abdomen. People with this form often deal with frequent muscle spasms, move with a rigid gait, and endure pain consistently throughout the day.
• Partial SPS: In contrast, Partial SPS, also called stiff limb syndrome, stiff leg syndrome, or stiff trunk syndrome, is less common. In this variation, symptoms are localized to a specific area, typically affecting just one leg. While most individuals with Partial SPS experience spasms and contractions without impacting the trunk, in some instances, these symptoms can affect part of the chest or abdomen.
• SPS Plus: Another less prevalent type is SPS Plus, which blends the classic symptoms of spasms and rigidity with indications of brainstem and/or cerebellar dysfunction. Those with SPS Plus may endure muscle spasms, stiffness, a lack of coordination, double vision, slurred speech, and additional symptoms.
• Other Types of SPS: Experts recognize other less common SPS conditions within the spectrum of disorders, such as Progressive Encephalomyelitis with Rigidity and Myoclonus (PERM), Predominant/Pure Cerebellar Ataxia, and Overlapping Syndromes. These types often exhibit symptoms consistent with dysfunction in the brainstem, cerebellum, spinal cord, and/or cerebrum.

Navigating the Long-Term Disability Claim Process for Stiff Person Syndrome

As individuals with Stiff Person Syndrome navigate the disability claim process, it is critical to gather and submit comprehensive documentation to support their case and prove that they meet the eligibility requirements is crucial. Providing a thorough case supported by medical evidence increases the likelihood of a successful disability claim.

Meeting Eligibility Criteria

Individuals with Stiff Person Syndrome must meet specific eligibility criteria to qualify for long-term disability benefits. This includes demonstrating the severity of symptoms that significantly impair mobility and daily activities. Functional limitations that prevent the individual from engaging in substantial gainful activity are also key factors in determining eligibility for disability benefits.

Proving Disability

Detailed medical documentation from healthcare providers supporting the inability to work because of the condition strengthens the case for receiving long-term disability benefits. This includes medical records, test results, and a detailed account of how the condition affects daily functioning. Detailed statements from healthcare providers describing the severity of symptoms, functional limitations, and the inability to work are also essential.

Common Challenges and Obstacles

Dealing with the complexities of long-term disability claims can often feel like navigating a maze without a map. From insurance company hired doctors to underhanded surveillance tactics, there are a number of common challenges in LTD claims that require careful consideration and expertise to overcome.

Peer Review Reports

Claimants often face an uphill battle when a doctor who has never treated them reviews their medical records. These “paper reviews” rely solely on written records and lack the critical context of direct patient interactions. Physicians conducting these reviews may miss important nuances or underestimate the severity of a claimant’s condition. As a result, their assessments can lead to the unfair denial or termination of disability benefits, leaving vulnerable individuals without the support they desperately need.

Vocational Assessments

Vocational evaluations ordered by insurers in long-term disability claims are a major hurdle for claimants. These assessments often rely on outdated labor market data, fail to accurately reflect the claimant’s limitations, and place undue emphasis on theoretical job prospects rather than realistic employment opportunities. Insurers use these flawed evaluations to terminate or deny legitimate claims.

Independent Medical Examinations

These exams, conducted by doctors hired by insurance companies, often result in unfavorable outcomes for claimants. Insurers often rely on IME findings to deny or terminate claims, even when a claimant’s treating physicians support their disability. However, the inherent conflict of interest inherent in IMEs raises concerns. Physicians performing these examinations may feel pressured to provide opinions that favor the insurance company that hired them, potentially compromising their objectivity.

Surveillance

Insurers often conduct surveillance of claimants to verify the extent of their disabilities. Private investigators observe and document daily activities through videotaping, potentially calling into question the severity of the claim. It’s a controversial practice that has drawn criticism for invading privacy and taking snippets out of context. Evidence of performing tasks that negate restrictions can jeopardize benefits. However, brief periods of minimal activity don’t necessarily indicate the ability to work full time.

Claim Denials

One of the most common challenges faced by individuals with Stiff Person Syndrome is the initial denial of their disability claim. This can be a discouraging setback, but it’s important to understand the appeals process and, if necessary, seek legal assistance to challenge the denial and provide additional evidence to support the claim.

Support and Resources for People with Stiff Person Syndrome

Pursuing long-term disability for Stiff Person Syndrome can present unique challenges, but you don’t have to face them alone. Our team is here to provide support and resources to help you navigate the complexities of your claim. Here are some of the resources we offer to help you effectively manage your long-term disability claim:

Download One of Our Free Resources

• The Top Ten Mistakes That Will Destroy Your Long-Term Disability Claim: Get exclusive access to our insightful eBook outlining common pitfalls to avoid when dealing with long-term disability claims. Learn about the critical missteps that can jeopardize your claim and gain valuable knowledge to protect your rights.
• Disability Insurance Claim Guide: Navigating the intricacies of disability insurance claims can be overwhelming. Our comprehensive guide breaks down the process into simple, actionable steps to help you understand your rights, responsibilities, and options when filing a disability insurance claim.
• Long-Term Disability Appeal Guide: If your insurance carrier has denied your long-term disability claim, our detailed appeal guide can help you understand the reasons for the denial and provide you with a roadmap for appealing the decision. Don’t give up hope—our guide will give you the tools you need to strengthen your appeal and potentially overturn the denial.

Get a Free Case Evaluation to Discuss Your LTD Denial with a National Disability Attorney

Facing denials and navigating the appeals process can be complex and emotionally taxing for individuals with Stiff Person Syndrome. Having legal representation or assistance from disability advocates can help present a stronger case during the appeal and increase the chances of a successful outcome in obtaining long-term disability benefits.

If your long-term disability claim has been denied, take advantage of a free case review to get personalized guidance on how to proceed with the administrative appeal process. Our long-term disability attorney, Nick Ortiz, will thoroughly review your case, provide valuable insight, and outline potential appeal strategies to help you secure the benefits you deserve. Contact us online or call us at (888) 321-8131 for help with your claim.