Pelvic Floor Dysfunction And Long-Term Disability Claims

Your pelvic floor comprises the ligaments and muscles in your pelvic region. It acts as a sling to hold up the organs in your pelvis, including the prostate or uterus, rectum, and bladder. By relaxing or contracting these muscles, you control your urination, bowel movements, and sexual intercourse, particularly in women.

What Is Pelvic Floor Dysfunction?

Causes of Pelvic Floor Dysfunction

Pelvic floor dysfunction can stem from various factors, including childbirth, trauma, pelvic surgery, connective tissue disorders, or even age. Weakness or tightness in the pelvic floor muscles can contribute to dysfunction, leading to issues with bladder control, bowel movements, and even sexual function.

Symptoms of Pelvic Floor Dysfunction

Symptoms of pelvic floor dysfunction can manifest in different ways, such as urinary incontinence, frequent urination, painful intercourse, pelvic pain, or difficulty with bowel movements. These symptoms can vary in intensity and frequency, impacting an individual’s quality of life and overall well-being. PFD can sometimes lead to pudendal nerve compression or irritation, resulting in pudendal neuralgia.

Similar Conditions

Pelvic floor dysfunction may share similarities with conditions like endometriosis, interstitial cystitis, or irritable bowel syndrome (IBS). Proper diagnosis by a healthcare professional is essential to differentiate between these conditions and tailor treatment accordingly.

Diagnosing Pelvic Floor Dysfunction

Diagnosing pelvic floor dysfunction often involves a thorough medical history review, physical examination, and potentially further tests such as urodynamic studies or MRI scans. Seeking a specialist in pelvic floor therapy or urology can aid in accurate diagnosis and personalized treatment plans.

While physical therapy is a primary treatment for pelvic floor dysfunction, severe cases may require surgical decompression to alleviate pudendal nerve pain. When left untreated, pelvic floor dysfunction can also lead to infection, long-term colon damage, and discomfort.

Impact on Daily Life

The impact of pelvic floor dysfunction on daily life can be profound, affecting one’s ability to engage in regular activities, exercise, or even work. Emotional distress and social isolation may also accompany the physical symptoms, emphasizing the importance of holistic care and support for individuals dealing with this condition.

Long-Term Disability Claims for Pelvic Floor Dysfunction

Individuals with PFD may be unable to perform work duties full-time, leaving them with few financial options. Long-term disability benefits can help ease the burden, but you must apply for them. The insurance company will decide whether you qualify as disabled under an LTD insurance policy.

The insurance company bases its decision on the information you and your doctors provide during the application or appeal process. The following information will help you understand what the insurance company is looking for to evaluate your LTD claim based on pelvic floor dysfunction.

Filing a Long-Term Disability Claim

Initiating a Long-term disability claim for pelvic floor dysfunction involves gathering essential medical records highlighting the diagnosis, treatment plans, and expected duration of disability. Providing detailed information about how the condition impairs daily activities and work responsibilities is critical. Completing claim forms accurately and promptly is vital to avoid delays in the approval process.

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Definition of Disability

You will be considered disabled under most LTD policies if you are (a) unable to perform the ordinary duties of your current occupation for the first two years of the policy and (b) unable to perform the job duties of any reasonable occupation after the first two years of the policy. The definition of disability varies between policies, so you’ll need to review your policy to discover how “disability” and “totally disabled” are defined for your specific case.

Proof of Pelvic Floor Dysfunction

Thorough medical documentation plays a critical role in the approval of claims for PFD. The effects of your symptoms may be considered when the insurance company decides whether you are disabled; symptoms and a simple diagnosis are not enough for approval. Detailed reports from healthcare providers outlining the diagnosis, treatment history, functional limitations, and prognosis are essential. Including test results, imaging studies, and physician notes can strengthen the claim’s validity. Medical evidence demonstrating the ongoing impact of pelvic floor dysfunction on daily life and work abilities is crucial for establishing the need for disability benefits.

Evaluating Disability for a Pelvic Floor Dysfunction Diagnosis

The insurance company will assign an adjudicator, an insurance adjuster, to your claim. If the adjuster finds that they don’t have enough evidence to make a formal decision, they may contact you to provide additional documentation. If you have it, you can submit this information yourself. Otherwise, an independent medical source may be required.

Your physician may diagnose your pelvic floor dysfunction based on your symptomatology, but you’ll need to back your diagnosis up with medical tests to qualify for long-term disability. The insurance company wants to see reports documenting your objective clinical and laboratory findings, so be sure your doctor submits all available evidence concerning your condition. This is true even if it points toward another disorder or condition.

The adjuster may work with the help of a physician or another medical disability examiner, such as a nurse practitioner, to provide an opinion about your level of impairment. In addition, you may be required to have a functional capacity evaluation or a compulsory medical examination. The insurance adjuster will then take all the available evidence into account, including treatment since the onset of the disorder and the impact of the disorder on your physical health.

Working with a Long-Term Disability Attorney

Pelvic floor dysfunction can be a debilitating and painful disorder. If you suffer from these muscle contractions or another physical or mental disorder that keeps you from effectively performing your work duties, long-term disability benefits could be the answer to your financial woes.

Unfortunately, these benefits can be challenging to obtain, so speaking with legal counsel is imperative. If you’ve been denied long-term disability benefits despite having a genuine disability, contact Ortiz Law Firm today at (888) 321-8131 to find out how we can help you get the benefits you so desperately need.