Our founding partner Frank N. Darras, has practiced disability law for more than three decades. His disability litigation firm has more than 100 years of combined litigation and claim experience. After all that time, DarrasLaw’s top-rated individual disability attorneys and award-winning group ERISA lawyers know what age-related degeneration means. It means your individual or group long-term disability insurance company and its doctors acknowledge your illness. Then they conclude you’re not entitled to individual or group long-term disability benefits because your not disabled enough.
DarrasLaw’s nationally respected individual disability attorneys and pre-eminent group ERISA lawyers often see wrongful denials with arthritis claimants. However, not all types of age-related arthritis claims are deniable. The following arthritic problems can also cause disability:
- Joint infections
- Viruses
- Traumatic injuries
- Genetic disorders
- Immune system responses
An illness or injury that prevents you from performing the important tasks of your occupation, such as rheumatoid arthritis, can qualify you for individual or group long-term disability benefits. Many claimants, however, are wrongfully denied individual or group long-term disability benefits for arthritic conditions. Individual or group long-term disability insurers may claim you didn’t catch a truly disabling illness or suffer a traumatic disabling injury.
Furthermore, you won’t qualify for individual or group long-term disability benefits unless you meet the definition of a qualifying injury or illness under the terms and conditions of your individual or group long-term disability insurance policy. Insurers typically define injury as any “accidental loss” or bodily harm that occurs independently of all other causes. They generally define an illness as a physical or mental disease that first manifested or occurred after the policy is in force.
America’s top-rated long-term disability lawyers and award-winning group ERISA attorneys at DarrasLaw can review the terms and limitations of your long-term disability policy for free. We will also conduct a free disability claim consultation to determine whether your individual or group ERISA insurer has wrongfully delayed, denied, or terminated your individual or group long-term disability benefits. To schedule your free disability insurance consultation, call DarrasLaw today at 800-898-7299 or contact us online.
Do You Need a Lawyer for a Disability Claim Due to Rheumatoid Arthritis?
As discussed above, rheumatoid arthritis is a legitimate disabling condition. People might feel fine one day and face a debilitating flare-up the next. This can keep them from reliably performing their occupational duties, and their condition might prevent them from working, more often than an employer would tolerate or accept.
If you need to file a disability insurance claim due to rheumatoid arthritis, you should always discuss the process with a disability attorney. You might think that because you pay premiums for your coverage, the insurance company will timely begin paying benefits with little issue. However, most insurance companies focus first on profits, which means they try to limit benefit payments whenever they can.
You can expect the disability insurer to make the claim process difficult and complex for you.
This might involve:
- Creating delays during the claim process and not giving you updates or status reports
- Requesting duplicative medical, occupational, vocational or financial documentation or unnecessary records that are unwieldy for you to gather and provide
- Failing to timely communicate with you regarding your claim
- Denying your claim for an invalid reason or failing to give a reason
A disability attorney can help in many ways during the claims process. First, we handle the preparation of your claim and submission of all your records to support your claim to the insurer. We also handle all communications with the insurance company, so that you never deal with constant calls, emails, or duplicative requests. All of this allows you to focus on your physical condition and management while we take on the insurance company.
If the insurer wrongfully denies your claim, we can take the necessary steps to timely and comprehensively appeal the denial. If an insurer acts particularly egregiously, we can file an insurance bad faith claim in civil court against the insurance company for your individual private policy or appeal your group ERISA denial, then file your ERISA complaint in Federal court. This can help to ensure you end up with the timely monthly disability insurance benefits you deserve if you struggle with rheumatoid arthritis.
Age-Related Arthritis versus Rheumatoid Arthritis
Arthritis is a Latin phrase that means “inflammation of the joints.” According to the Arthritis Foundation, arthritis is actually a catchall term for various types of joint pain and disease. Arthritis most commonly refers to osteoarthritis, which occurs when the padding between your joints wears down with time, causing your bones to rub together. This is common with age, and can cause movement limitations and pain that is often disabling.
Most individual and group long-term disability insurance companies assume that all joint pain and swelling is osteoarthritis. They typically deny claimants’ individual or group long-term disability benefits because osteoarthritis is allegedly the result of age-related wear and tear that happens with time. The term “age-related” degeneration refers specifically to this type of arthritic condition. However, this is only one type of arthritis.
Joint pain, stiffness and swelling can result from a condition called rheumatoid arthritis. This is an illness, not an injury. Rheumatoid arthritis is an autoimmune disorder diagnosed when your immune system malfunctions and attacks the healthy cells surrounding your joints. This attack inflames the tissues around your joints, resulting in pain and swelling along with disability.
Rheumatoid arthritis occurs on both sides of the body. This can distinguish it from age-related arthritis. For example, a right-handed tennis player may develop arthritis in the right elbow after years of overuse. However, she may not develop the same pain in her left arm. Either can be totally disabling with proper documentation.
Overuse of the joint doesn’t factor into the analysis with an immune system attack like rheumatoid arthritis. Anyone can develop rheumatoid arthritis, even children. It also can attack other parts of the body, not just the joints.
What Is Rheumatoid Arthritis?
When you have rheumatoid arthritis, your immune system is specifically attacking something called the synovium, the lining that surrounds your joints. Rheumatoid arthritis gets worse with time because your synovium inflames and thickens as it tries to heal and protect itself from the attacks.
This thickening eventually destroys both the cartilage and bone within the joint as the tendons weaken. Your joints will eventually fall out of alignment. Your immune system mistakenly creates antibodies that identify synovium as a germ or foreign body and begins to attack it.
Any part of your body with synovium in it is susceptible to a rheumatoid arthritis attack. As a result, rheumatoid arthritis is much more than a joint disease. According to the Mayo Clinic, almost half of all rheumatoid arthritis patients also suffer from swelling and pain in the following areas:
- Eyes
- Lungs
- Skin
- Heart
- Kidneys
- Nerve tissues
- Blood vessels
- Bone marrow
- Salivary glands
Rheumatoid Arthritis—Risk Factors and Initial Symptoms
Often, providing objective, compelling medical evidence and proof of rheumatoid arthritis is necessary to claim individual or group ERISA long-term disability benefits. Unfortunately, some carriers deny rheumatoid arthritis claims, intentionally miscategorizing the problem as normal age-related non-disabling degeneration.
Rheumatoid arthritis commonly occurs between the ages of 40 and 60, which is why it’s often mistaken for age-related osteoarthritis. However, the following factors can increase your risk of rheumatoid arthritis:
- Smoking – Smokers, especially those genetically predisposed to rheumatoid arthritis, are at a higher risk of developing it. Smoking also increases the severity of the condition.
- Environmental factors – Exposure to asbestos or other germs can result in an increased risk of developing rheumatoid arthritis. Emergency and disaster relief workers are known to have developed this condition disproportionally to the rest of the population. Workers’ compensation insurance may cover on-the-job injuries and illnesses and long-term disability insurance may not. Many states, however, permit dual recovery for asbestos-related conditions that develop years after the initial exposure. Talk to an experienced long-term individual disability attorney or award-winning group ERISA lawyer at DarrasLaw if you developed rheumatoid arthritis after asbestos or silica exposure.
- Obesity – Overweight individuals are at a greater risk of developing rheumatoid arthritis.
- Genetics – You have an increased risk of developing rheumatoid arthritis if a biological family member has it. You should always tell your treating physician about your family history.
- Gender – Women have a higher risk of developing rheumatoid arthritis than men.
You may have rheumatoid arthritis if you have one or more of the above risk factors in combination with the following initial symptoms:
- Pain and swelling in the joints on both sides of your body
- Increased symptoms in smaller joints first, such as fingers and toes
- Progressive symptoms in your wrists, ankles, knees, elbows, hips, and shoulders
- Warm and tender joints
- Joint stiffness that’s worse in the morning or after periods of inactivity
- Fatigue
- Fever
- Weight loss
You may experience a rheumatoid arthritis-related disability as soon as the pain and stiffness in your fingers prevents you from performing the important tasks of your occupation. This can even take place during early stage rheumatoid arthritis.
Conditions and Complications Associated With Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder, so treating this condition can prove tricky. It requires patients to take powerful steroids and inhibitors that suppress their immune systems. Treatments leave them more susceptible to other disabling diseases. The common cold can easily turn into a serious condition that requires a hospital stay, leading to disability. Your treating doctor may determine that a traditional work environment presents too many dangers to your health and the risk of infection is too great for you to continue working.
The following conditions often develop as the result of or concurrent with rheumatoid arthritis:
- Disproportional body composition: Even people with a normal body mass index may have a disproportionate amount of fat compared to people without rheumatoid arthritis. This often results from loss of muscle mass due to rheumatoid arthritis and can lead to other diseases and problems.
- Osteoporosis: This condition causes weak and brittle bones that easily fracture. Certain medications taken for rheumatoid arthritis can cause osteoporosis. However, osteoporosis can also occur after years of immune system attacks that continuously weaken your joints and bones.
- Sjogren’s syndrome: This autoimmune disorder is commonly associated with rheumatoid arthritis. It attacks the entire body and results in extensive eye and mouth dryness, extreme fatigue, neuropathies, cancerous lymphomas, chronic pain, and major organ failure. It’s associated with the following symptoms:
- Dry mouth
- Sore and cracked tongue
- Dry and burning throat
- Dental decay
- Joint pain
- Digestive problems
- Difficulty talking, chewing or swallowing
- Infections – Rheumatoid arthritis treatments suppress your immune system, so opportunistic infections may attack. Patients are especially susceptible to respiratory infections (especially fungal infections), sexually transmitted diseases, tuberculosis, immune system cancers (like lymphoma), and pneumonia.
- Rheumatoid nodules – These bumps of tissue form around pressure points in your joints and even in your lungs. They can range in size from a bean to a walnut. While they are firm and don’t normally hurt, they can cause extreme pain and discomfort if they form near a nerve, resulting in disability.
- Carpal tunnel syndrome – This disorder occurs when the nerves in your wrists are compressed, creating numbness and tingling in the hands and fingers. Carpal tunnel can occur without rheumatoid arthritis, but is often associated because the inflammation from rheumatoid arthritis can compress the nerves in your arms and wrists.
- Lung disease – Your immune system often attacks, inflames, and scars your lungs if you have rheumatoid arthritis. This leads to shortness of breath that can worsen with time.
- Heart disease – Acquired heart disease often occurs when the blood vessels leading to your heart, or arteries, become clogged. This decreases the blood flow to your heart and body. It can result in a heart attack, brain damage, and even death. Certain patients with rheumatoid arthritis may suffer from heart attacks when their immune systems attack the arteries and the actual membrane that encloses the heart. This can lead to a hardening of the arteries that causes blockages and serious heart conditions.
- Lymphoma – A category of cancers of your actual immune system, lymphoma forms in your lymph nodes and white blood cells. Hodgkin and non-Hodgkin lymphomas are the two main types of lymphoma. Immunosuppressants allow certain viruses, such as Epstein-Barr, to attack your body, which often leads to lymphoma. Hospitals will commonly test lymphoma patients for rheumatoid arthritis and HIV.
Rheumatoid arthritis is a degenerative condition. Accordingly, many patients with early stage rheumatoid arthritis may believe it’s simply age-related. The earlier you treat it, however, the more likely you’ll avoid late-stage symptoms such as lung scarring and bone degeneration.
Individual and Group Long-Term Disability Benefits and Rheumatoid Arthritis
Autoimmune disorders often manifest with flare-ups. This means your symptoms aren’t constant. Still, you need to consistently treat your rheumatoid arthritis, even if you aren’t constantly symptomatic. This can help prevent serious conditions such as heart and lung disease from developing.
You may be fine one day and bedridden the next. This creates problems when you attend an “independent medical examination (IME)” with your insurance company’s physicians—who may also lack the proper training or specialization to diagnose rheumatoid arthritis.
For example, what if you’re completely stiff in the mornings but don’t have an IME appointment until the afternoon? How can your treating physician or insurance company doctor accurately measure your disability? What if you’re not suffering from a flare-up during your orthopedic examination or the pain and swelling seems to move between joints?
Always be honest during your examinations. Tell your treating doctor and any insurance company doctors if a movement is extremely painful or if they failed to address nerve pain and swelling in certain areas. Our stellar disability lawyers and skilled ERISA attorneys know what the IME doctors are looking for and can suggest protections for you during the examination. Furthermore, DarrasLaw understands rheumatoid arthritis and can help you and your treating doctors present the proper medical and occupational evidence to your disability carrier.
You can claim individual or group long-term disability benefits for diseases such as rheumatoid arthritis if it prevents you from performing the material and substantial duties of your occupation. Whether you qualify for individual or group long-term disability benefits may depend on your occupation and the extent and severity of your restrictions and limitations. Joint stiffness is often especially prevalent in the mornings. What if you’re a bus driver and can’t report to work at 5 a.m., or a court reporter who can’t continuously type?
At DarrasLaw, America’s award-winning long-term individual disability lawyers and nationally respected group ERISA attorneys know how to fight bad-faith delays, denials, and terminations of individual or group long-term disability benefits. We can work with you and your treating doctors to advocate for your legal rights.
Treatment for Rheumatoid Arthritis
For many medical conditions, treatment focuses on curing the condition. However, rheumatoid arthritis is not a curable medical disorder. Instead, treatment aims to reduce the incidence of flare-ups and help manage the pain and discomfort that patients experience.
Some treatment plans might include:
- Medications such as corticosteroids, non-steroidal anti-inflammatory agents (NSAIDs), or disease-modifying anti-rheumatic drugs (DMARDs)
- Reducing stress on the joints, which includes resting the joints while a patient is inflamed and having a flare-up, using splints or other walking aids, or if the patient is obese losing weight may help
- Physical and occupational therapy that can help a patient adapt to a program of reduced range of motion and keep joints and supporting tissue as strong as possible
- Surgical treatment, which might include synovectomy, total joint arthroplasties, arthroscopic procedures, nerve entrapment release, or removing the rheumatoid nodule may also work
Treatment is often not enough to fully relieve symptoms or bring someone back to their pre-arthritic condition. Despite time-consuming and costly treatment, the symptoms of rheumatoid arthritis might persist and prevent someone from reliably working part-time or full-time.
Call America’s Top-Rated Long-Term Disability Lawyers and Award-Winning Group ERISA Attorneys for a Free, Confidential Consultation
Arthritis is one of the most common disabling conditions in the United States, but it’s also among the most commonly misunderstood. Rheumatoid arthritis is a serious autoimmune disease and your individual or group ERISA long-term disability insurance company should pay these claims.
The nation’s top-rated long-term disability lawyer, Frank N. Darras, and his firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. Call the compassionate long-term individual disability attorneys and nationally prominent group ERISA lawyers at DarrasLaw to schedule your free disability policy analysis and free claim consultation. If you experienced a bad-faith delay, denial, or termination of your individual or group long-term disability benefits, contact us at 800-898-7299 or online today.
