Kidney Disease | Disability Claims for Kidney Disease

What is Kidney Disease?

Kidney disease, also known as renal disease, encompasses a range of conditions affecting the kidneys’ ability to filter waste products and excess fluids from the blood, which are then excreted as urine. Proper kidney function is vital for maintaining overall health by regulating the body’s electrolyte balance, blood pressure, and red blood cell production.

Types of Kidney Disease

Acute Kidney Injury (AKI)

AKI is a sudden loss of kidney function often caused by injury, severe infection, or medication toxicity. It can be reversible with prompt treatment but can lead to chronic kidney issues if not managed properly.

Chronic Kidney Disease (CKD)

CKD is a long-term condition characterized by a gradual loss of kidney function over time. It is typically divided into five stages, from mild damage (stage 1) to complete kidney failure (stage 5). The most common causes of CKD include diabetes, high blood pressure, and glomerulonephritis, an inflammation of the kidney’s filtering units.

Polycystic Kidney Disease (PKD)

PKD is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts can enlarge the kidneys and interfere with their function, leading to kidney failure over time.

Glomerulonephritis

This refers to inflammation of the glomeruli, the tiny filtering units within the kidneys. It can result from infections, autoimmune diseases, or unknown causes and can lead to significant kidney damage.

Symptoms and Diagnosis

Symptoms

Early stages of kidney disease often show no symptoms. As the disease progresses, symptoms may include:

• Fatigue and weakness
• Swelling in the legs, ankles, or feet due to fluid retention
• Shortness of breath
• Nausea and vomiting
• Persistent itching
• Chest pain (if fluid builds up around the lining of the heart)
• High blood pressure that is difficult to control

Diagnosis

Kidney disease is diagnosed through various tests, including:

• Blood tests to measure levels of creatinine and blood urea nitrogen (BUN), which indicate how well the kidneys are filtering waste.
• Urine tests to check for albumin (a type of protein) and other markers of kidney damage.
• Imaging tests like ultrasound or CT scans to visualize the kidneys’ structure.
• Kidney biopsy, where a small sample of kidney tissue is examined for signs of damage.

Causes and Risk Factors

Causes:

• Diabetes: High blood sugar levels can damage blood vessels in the kidneys.
• Hypertension: High blood pressure can damage the kidneys over time.
• Glomerulonephritis: Inflammation of the kidneys’ filtering units.
• Polycystic Kidney Disease: Genetic condition causing cyst growth in kidneys.
• Autoimmune diseases: Conditions like lupus can affect kidney function.

Risk Factors:

• Family history of kidney disease
• Older age
• Frequent use of medications that can harm the kidneys, such as NSAIDs
• Smoking
• Obesity

Treatment and Management

Medications

Medications can manage symptoms and slow the progression of kidney disease. These may include:

• ACE inhibitors or ARBs to control blood pressure.
• Diuretics to reduce fluid buildup.
• Medications to manage diabetes.

Lifestyle Changes

Adopting a kidney-friendly lifestyle can help manage the disease:

• Diet: Low in salt, phosphorus, and protein to reduce kidney workload.
• Exercise: Regular physical activity to maintain a healthy weight and control blood pressure.
• Smoking cessation: Reduces further kidney damage.
• Limiting alcohol: Prevents additional strain on kidneys.

Dialysis and Transplantation

In advanced CKD or kidney failure, dialysis or a kidney transplant may be necessary:

• Dialysis: An artificial process of removing waste products and excess fluid from the blood when the kidneys can no longer perform these functions.
• Kidney Transplant: Surgical procedure to place a healthy kidney from a donor into a person with kidney failure.

Prevention

Preventive measures include:

• Regular monitoring for those at high risk.
• Managing underlying conditions such as diabetes and hypertension.
• Maintaining a healthy lifestyle to support overall kidney health.

Kidney disease is a complex condition with serious health implications. Early detection and management are crucial to slowing its progression and maintaining quality of life. Regular check-ups, healthy lifestyle choices, and adherence to treatment plans are key strategies in managing kidney health.

Why Do Insurance Companies Question Disability Claims for Kidney Disease? 

Insurance companies often scrutinize disability claims for kidney disease for several reasons, including the complexity of the disease, the variability in symptoms, and the significant financial implications of approving such claims. Understanding the dynamics behind this scrutiny can provide insight into the process and help claimants prepare more effectively.

Reasons for Questioning Disability Claims

1. Complexity of Kidney Disease

Kidney disease, particularly chronic kidney disease (CKD), can vary widely in severity and progression. The symptoms and impact on daily functioning differ significantly among individuals, making it challenging to assess the extent of disability solely based on a diagnosis. For instance:

• Early Stages of CKD: Individuals in the early stages may not exhibit significant symptoms or impairment.
• Varied Symptoms: Symptoms such as fatigue, swelling, and high blood pressure can be attributed to various conditions, not exclusively to kidney disease.

2. Documentation and Medical Evidence

Insurance companies require substantial and specific medical evidence to approve disability claims. This includes:

• Medical Records: Detailed records of the diagnosis, lab results, imaging studies, and treatment history.
• Functional Limitations: Documentation from healthcare providers about how the disease limits the individual’s ability to work and perform daily activities.
• Consistency: Consistent reports from various healthcare professionals reinforcing the extent of the disability.

3. Economic Implications

Approving disability claims can be financially significant for insurance companies. To manage costs effectively, they aim to ensure that only valid claims are approved, leading to rigorous examination of each claim to prevent fraudulent or exaggerated claims.

Common Areas of Scrutiny

1. Severity and Stage of Disease

Insurance companies closely examine the stage of kidney disease:

• Mild to Moderate CKD: Often questioned because individuals at these stages may still be able to perform some work-related tasks.
• End-Stage Renal Disease (ESRD): Claims are more straightforward due to the necessity of dialysis or a transplant, which clearly indicates severe impairment.

2. Treatment and Response

• Adherence to Treatment: Insurers look at whether the claimant is following prescribed treatments and how they are responding. Non-compliance can be seen as a reason to question the severity of the disability.
• Impact of Treatments: The effectiveness of treatments such as medication, dialysis, or dietary changes in managing symptoms is scrutinized. If treatments effectively manage symptoms, claims may be questioned.

3. Functional Capacity Evaluations (FCE)

FCEs assess an individual’s capacity to perform work-related activities despite their medical condition. Insurance companies often request these evaluations to objectively measure physical and cognitive abilities.

Preparing a Strong Kidney Disease Disability Claim

To improve the likelihood of approval, claimants should focus on comprehensive documentation and clear evidence of their condition’s impact on their ability to work:

1. Medical Evidence

• Detailed Medical Records: Ensure that all medical records, including lab results, imaging studies, and specialist reports, are up-to-date and detailed.
• Physician Statements: Obtain detailed statements from treating physicians outlining the severity of the condition, treatment history, and its impact on daily activities and work capacity.

2. Symptom Documentation

• Daily Logs: Maintain logs of daily symptoms and their impact on activities.
• Consistent Reporting: Ensure that all healthcare providers involved in treatment consistently report the same symptoms and limitations.

3. Functional Impact

• Work History: Provide a detailed work history showing how the disease has affected job performance.
• Vocational Assessments: If possible, obtain a vocational assessment to objectively demonstrate how kidney disease limits the ability to perform any gainful employment.

4. Legal and Advocacy Support

• Legal Representation: Consider consulting with an attorney who specializes in disability claims. They can help you navigate the complexities and present a strong case.
• Advocacy Groups: Reach out to kidney disease advocacy groups for additional support and resources.

Insurance companies question disability claims for kidney disease due to the complexity and variability of the disease, the need for detailed and specific medical evidence, and the financial implications of approving such claims. By understanding the reasons behind the scrutiny and preparing a well-documented, comprehensive claim, individuals can improve their chances of obtaining the disability benefits they need. Careful documentation, consistent medical reporting, and possibly seeking legal or advocacy support are critical steps in this process.

How to Record Symptoms for Kidney Disease? 

Recording symptoms for kidney disease systematically is crucial for effective management and treatment. Accurate symptom tracking helps healthcare providers understand the progression of the disease, evaluate treatment efficacy, and make informed decisions. Here’s a comprehensive guide on how to record symptoms for kidney disease:

1. Choose a Tracking Method

Select a convenient and consistent method for recording symptoms. Options include:

• Paper Journal: A dedicated notebook or diary.
• Digital Apps: Smartphone applications designed for health tracking, such as MyKidneyCare.
• Spreadsheets: Customizable and easy to analyze.
• Templates: Printable symptom tracking sheets.

2. Daily Log Entries

Make daily entries to capture the day-to-day variations in symptoms. Include the following:

• Date and Time: Record the specific date and time of each entry.
• Medications and Dosages: Note any medications taken, including dosages and times.

3. Detailed Symptom Description

For each symptom, provide detailed descriptions, including:

• Type of Symptom: Identify the symptom (e.g., fatigue, swelling, nausea).
• Severity: Use a scale from 1 to 10 to rate the intensity of the symptom.
• Duration: Note how long the symptom lasts (e.g., continuous, intermittent, hours).
• Frequency: Record how often the symptom occurs (e.g., daily, weekly).

4. Specific Symptoms to Track

Kidney disease can present with a wide range of symptoms. Keep a close watch on:

Fatigue

• Description: Unusual tiredness or lack of energy.
• Severity: Mild (tired but can perform tasks) to severe (unable to perform daily activities).
• Duration: How long the fatigue lasts each day.

Swelling (Edema)

• Location: Legs, ankles, feet, or face.
• Severity: Mild (slight swelling) to severe (significant swelling).
• Duration: Persistent or intermittent.

Urinary Changes

• Frequency: Increased or decreased urination.
• Appearance: Foamy, bloody, or discolored urine.
• Pain: Pain or burning sensation during urination.

Shortness of Breath

• Description: Difficulty breathing or shortness of breath.
• Severity: Mild (noticeable on exertion) to severe (at rest).
• Triggers: Specific activities or times of day.

Nausea and Vomiting

• Frequency: How often nausea or vomiting occurs.
• Triggers: Specific foods, smells, or activities.

Itching (Pruritus)

• Severity: Mild (occasional itching) to severe (constant itching).
• Duration: Times of day when itching is worst.

Mental Confusion (Cognitive Issues)

• Description: Episodes of confusion, forgetfulness, or mood changes.
• Severity: Mild (slight forgetfulness) to severe (unable to concentrate or remember).
• Triggers: Specific activities or times of day.

5. Diet and Lifestyle Factors

Record dietary habits and lifestyle factors that might influence symptoms:

• Meals: Note what you eat and drink, including portion sizes and timing.
• Exercise: Type and duration of physical activities.
• Fluid Intake: Record daily fluid consumption.
• Weight Changes: Daily or weekly weight measurements.

6. Medical Appointments and Tests

Keep track of:

• Doctor Visits: Dates, names of healthcare providers, and key points discussed.
• Lab Results: Blood tests, urine tests, and imaging results.
• Treatments: Any treatments or procedures, with dates and outcomes.

7. Review and Reflect

Regularly review your symptom log to identify patterns or triggers. Reflect on:

• Symptom Trends: Look for any worsening or improvement of symptoms.
• Triggers: Identify any activities, foods, or situations that seem to exacerbate symptoms.
• Effectiveness of Treatments: Note any changes following new medications or therapies.

8. Share with Healthcare Providers

Bring your symptom log to medical appointments. This helps to:

• Provide Accurate History: Give your doctor a detailed account of your symptoms.
• Inform Treatment Decisions: Aid in assessing the effectiveness of treatments.
• Improve Communication: Enhance discussions about your condition and care plan.

Systematic and detailed recording of symptoms for kidney disease is essential for effective disease management. By using a consistent method, providing detailed descriptions, and regularly reviewing and sharing this information with healthcare providers, patients can play an active role in their treatment and potentially improve their outcomes.

How Can a Long-Term Disability Attorney Help You Receive Disability Benefits for Kidney Disease? 

A long-term disability attorney can play a crucial role in helping individuals with kidney disease secure the disability benefits they rightfully deserve. Kidney disease, whether chronic or acute, can severely impact a person’s ability to work and maintain a stable income. However, navigating the complex process of applying for and receiving disability benefits can be overwhelming, especially when dealing with a debilitating illness. Here’s how a long-term disability attorney can assist you in obtaining disability benefits for kidney disease:

1. Understanding the Law and Regulations: Long-term disability attorneys are well-versed in the laws and regulations surrounding disability benefits, including the criteria for qualifying conditions such as kidney disease. They can provide valuable guidance on eligibility requirements and ensure that all necessary documentation is in order.
2. Assistance with the Application Process: Applying for disability benefits involves a significant amount of paperwork and documentation. A disability attorney can help gather medical records, obtain supporting evidence from healthcare providers, and complete the necessary forms accurately and efficiently. This reduces the likelihood of delays or denials due to incomplete or incorrect information.
3. Medical Evidence Compilation: One of the key factors in a successful disability claim is providing sufficient medical evidence to support the severity of the condition. A long-term disability attorney can work with healthcare professionals to obtain detailed medical reports, test results, and other documentation that demonstrate the impact of kidney disease on the individual’s ability to work.
4. Navigating the Appeals Process: In many cases, disability claims are initially denied by the Social Security Administration (SSA). If this happens, an attorney can assist with the appeals process, which may involve requesting reconsideration, attending hearings, and presenting the case before an administrative law judge. Having legal representation significantly improves the chances of a successful outcome at the appeals stage.
5. Understanding Vocational Issues: Disability attorneys have a thorough understanding of how various medical conditions, including kidney disease, can affect a person’s ability to perform work-related tasks. They can work with vocational experts to assess the individual’s functional limitations and how these limitations impact their ability to engage in substantial gainful activity.
6. Advocacy and Representation: Perhaps one of the most valuable roles of a disability attorney is acting as an advocate for their clients. They understand the challenges individuals with kidney disease face and can effectively communicate these challenges to the SSA or insurance company. This advocacy can significantly influence the outcome of the disability claim.
7. Negotiation and Settlement: In cases where disability benefits are provided through a private insurance policy, rather than through government programs like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), an attorney can negotiate with the insurance company on behalf of the claimant. This may involve reaching a fair settlement that provides adequate financial support to cover medical expenses and lost income.
8. Continued Support and Monitoring: Even after disability benefits are approved, a long-term disability attorney can provide ongoing support and monitoring to ensure that the individual’s rights are protected. They can assist with issues such as benefit adjustments, reviews, or appeals if benefits are ever terminated or reduced.

In summary, a long-term disability attorney can be an invaluable asset for individuals with kidney disease seeking disability benefits. From navigating the application process to advocating for their clients’ rights, these attorneys play a critical role in helping individuals secure the financial support they need during a challenging time. By leveraging their expertise and experience, disability attorneys can maximize the chances of a successful outcome and provide much-needed peace of mind for their clients and their families. Feel free to call Jonathan M. Feigenbaum for a complimentary consultation.