As we face challenges due to the Coronavirus (COVID-19) please follow the the recommendations of the CDC and your local medical community. I am available to my clients and new clients by phone, email, teleconferencing and if necessary and safe, in person meetings. The best way to contact me is direct email: Stay well and help others in need.

Has Your Insurance Company Denied
Your Disability Claim?

Whether an insurance company, employer, union or other ERISA governed
plan has denied your insurance claim, we can help.

Types of Disabilities | Disability Claim for Diabetes

What is Diabetes?

Diabetes Claim AttorneyDiabetes is a chronic metabolic disorder characterized by elevated blood sugar levels because of either insufficient insulin production, ineffective use of insulin, or both. Insulin, a hormone produced by the pancreas, plays a crucial role in regulating blood sugar levels by facilitating the absorption of glucose into cells, where it is used as energy. When insulin production is inadequate or its action is impaired, glucose accumulates in the bloodstream, leading to hyperglycemia.

There are primarily two main types of diabetes: Type 1 and Type 2.

Type 1 diabetes, also known as insulin-dependent diabetes or juvenile-onset diabetes, typically develops during childhood or adolescence, although it can occur at any age. It occurs when the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. As a result, the body produces little to no insulin, requiring lifelong insulin replacement therapy through injections or an insulin pump.

Type 2 diabetes, formerly called non-insulin-dependent diabetes or adult-onset diabetes, is more common and usually develops gradually over time, often in adulthood. It is characterized by insulin resistance, where the body’s cells fail to respond effectively to insulin. At first, the pancreas compensates by producing more insulin, but eventually, it may not be able to keep up with the increased demand, leading to elevated blood sugar levels.

In addition to Type 1 and Type 2 diabetes, there are other forms such as gestational diabetes, which occurs during pregnancy and usually resolves after childbirth, and monogenic diabetes, caused by mutations in a single gene.

The prevalence of diabetes has been steadily increasing worldwide, primarily because of factors such as sedentary lifestyles, unhealthy diets, obesity, and an aging population. Genetics predispose certain individuals to diabetes.

Untreated or poorly managed diabetes can lead to various complications affecting multiple organ systems, including the eyes (diabetic retinopathy), kidneys (diabetic nephropathy), nerves (diabetic neuropathy), and cardiovascular system (heart disease, stroke). It can also cause foot problems, skin conditions, and dental issues. Uncontrolled diabetes increases the risk of developing other serious health problems like hypertension, dyslipidemia, and even certain types of cancer.

Managing diabetes involves a combination of lifestyle modifications, medication, and regular monitoring of blood sugar levels. Diet and exercise are essential components of diabetes management, as they help control weight, improve insulin sensitivity, and regulate blood sugar levels. Medications such as oral hypoglycemic agents and insulin therapy may be prescribed to lower blood sugar levels effectively. Continuous glucose monitoring devices and insulin pumps have also revolutionized diabetes management, providing more accurate and convenient ways to monitor and administer insulin.

Education and support are crucial for individuals living with diabetes to effectively manage their condition and prevent complications. Diabetes self-management programs empower patients to make informed decisions about their health, including monitoring blood sugar levels, adhering to medication regimens, and adopting healthy lifestyle habits.

In conclusion, diabetes is a complex and chronic condition characterized by elevated blood sugar levels resulting from inadequate insulin production or ineffective insulin action. It requires lifelong management to prevent complications and maintain overall health and well-being. With proper treatment, education, and support, individuals with diabetes can lead fulfilling lives and reduce their risk of developing serious complications.

Why do long-term disability insurers question a disability claim for diabetes?

Long-term disability insurers often scrutinize disability claims related to diabetes because of several factors that can complicate the assessment of disability in these cases. While diabetes itself can lead to disabling complications, insurers may have concerns over the severity and impact of the condition on an individual’s ability to work and perform daily activities. Insurance companies may stereotype you and say most people with diabetes can work. So why can’t you? A very well-known Seventh Circuit Court of Appeals Judge commented on the silliness of this argument when considering an insurance company’s choice to deny an insured long-term disability benefits. The Court recognized that sometimes people tough-it-out for a long time, but then cannot continue at the same pace:

The plan’s bad argument is that because Hawkins worked between 1993 and 2000 despite his fibromyalgia and there is no indication that his condition worsened over this period, he cannot be disabled. This would be correct were there a logical incompatibility between working full time and being disabled from working full time, but there is not. A desperate person might force himself to work despite an illness that everyone agreed was totally disabling. Perlman v. Swiss Bank Corp. Comprehensive Disability Protection Plan,195 F.3d 975, 982-83 (7th Cir. 1999); Wilder v. Apfel,153 F.3d 799, 801 (7th Cir. 1998); Wilder v. Chater,64 F.3d 335, 337-38 (7th Cir. 1995); Jones v. Shalala,21 F.3d 191, 192-93 (7th Cir. 1994). Yet even a desperate person might not be able to maintain the necessary level of effort indefinitely. Hawkins may have forced himself to continue in his job for years despite severe pain and fatigue and finally have found it too much and given it up even though his condition had not worsened. A disabled person should not be punished for heroic efforts to work by being held to have forfeited his entitlement to disability benefits should he stop working.

Hawkins v. First U. Corp. Long-Term Dis. Plan, 326 F.3d 914, 918 (7th Cir. 2003)

Here are reasons why long-term disability insurers may question a disability claim for diabetes:

Varied Severity of Symptoms: Diabetes can manifest in a wide range of symptoms and complications, varying from mild to severe. Some individuals with diabetes may experience mild symptoms that do not significantly impair their ability to work, while others may suffer from debilitating complications such as neuropathy, vision loss, or kidney disease. Insurers may request detailed medical documentation to assess the severity of the claimant’s diabetes and its impact on their functional abilities.

Control and Management: Insurers may inquire about the claimant’s efforts to control and manage their diabetes through medication, diet, exercise, and regular medical care. Individuals who demonstrate proactive management of their condition and achieve good glycemic control may be perceived as having fewer limitations than those with poorly managed diabetes. Even so, even well-controlled diabetes can still cause disabling complications that warrant disability benefits.

Potential for Improvement: Long-term disability insurers may question the long-term prognosis of diabetes and the potential for improvement with ongoing treatment and lifestyle modifications. They may seek evidence specifying whether the claimant’s condition is expected to stabilize, improve, or worsen over time. This assessment is crucial for determining the duration and eligibility for disability benefits.

Secondary Complications: Diabetes increases the risk of developing secondary complications affecting various organ systems, including the eyes, kidneys, nerves, and cardiovascular system. Insurers may request comprehensive medical records and specialist evaluations to assess the presence and severity of these complications and their impact on the claimant’s ability to work. Chronic complications such as diabetic neuropathy, retinopathy, or chronic kidney disease can significantly impair mobility, vision, or cognitive function, thereby justifying a disability claim.

Functional Limitations: Disability insurers evaluate the claimant’s functional limitations and assess whether they can perform the essential duties of their occupation or any other suitable work considering their medical condition. Diabetes-related impairments such as neuropathic pain, diabetic foot ulcers, or severe hypoglycemic episodes may limit mobility, dexterity, or concentration, making it difficult to sustain gainful employment. Claimants may undergo functional assessments or vocational evaluations to determine their work capacity and eligibility for disability benefits.

Duration and Persistence of Symptoms: Insurers may question the duration and persistence of diabetes-related symptoms and their impact on the claimant’s ability to engage in substantial gainful activity. Chronic symptoms such as fatigue, frequent urination, excessive thirst, or recurrent infections can significantly impair productivity and quality of life, especially if they are severe or unresponsive to treatment. Claimants may need to provide evidence demonstrating the ongoing nature of their symptoms and their functional limitations over time.

Medical Evidence and Documentation: Long-term disability insurers rely heavily on medical evidence and documentation to support disability claims. Claimants must provide comprehensive medical records, diagnostic tests, treatment history, and physician statements corroborating the severity and impact of their diabetes and related complications. Incomplete or inconsistent medical documentation may raise red flags and lead to further scrutiny of the claim.

In summary, long-term disability insurers may question disability claims for diabetes based on concerns about the severity and impact of the condition on the claimant’s ability to work and perform daily activities. Insurers assess factors such as the severity of symptoms, control and management of diabetes, potential for improvement, presence of secondary complications, functional limitations, duration and persistence of symptoms, and the strength of medical evidence supporting the claim. Claimants should provide thorough and compelling documentation to substantiate their disability and increase their chances of approval for benefits.

How to seek a medical diagnosis and treatment for diabetes?

Navigating a medical diagnosis and treatment plan for diabetes is a multifaceted process that involves collaboration between the individual diagnosed, healthcare providers, and sometimes specialists. Given the complexity of diabetes and its potential effect on various aspects of health and well-being, understanding the diagnosis process and available treatment options is crucial. Here’s a comprehensive guide:

  1. Recognizing Symptoms and Risk Factors:

Diabetes can present with a range of symptoms, including increased thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, slow wound healing, and recurrent infections.

Individuals with risk factors such as family history of diabetes, obesity, sedentary lifestyle, high blood pressure, high cholesterol, or gestational diabetes during pregnancy should be particularly vigilant about monitoring for symptoms.

  1. Seeking Medical Evaluation:

If you suspect you have symptoms of diabetes or have risk factors, it’s essential to seek medical evaluation promptly. Schedule an appointment with your primary care physician or a healthcare provider experienced in managing diabetes.

Be prepared to discuss your symptoms, medical history, family history of diabetes, lifestyle factors (diet, exercise, smoking, alcohol consumption), and any medications or supplements you are taking.

  1. Diagnostic Tests:

Your healthcare provider will conduct various diagnostic tests to confirm a diagnosis of diabetes and determine the type and severity of the condition.

Common diagnostic tests include:

Fasting Plasma Glucose Test: Measures blood sugar levels after fasting for at least eight hours. A fasting blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on two separate occasions indicates diabetes.

Oral Glucose Tolerance Test (OGTT): Measures blood sugar levels before and two hours after drinking a sugary solution. A blood sugar level of 200 mg/dL or higher after two hours suggests diabetes.

Hemoglobin A1c Test: Measures average blood sugar levels over the past two to three months. An A1c level of 6.5% or higher suggests diabetes.

Random Plasma Glucose Test: Measures blood sugar levels at any time of the day. A blood sugar level of 200 mg/dL or higher, along with symptoms of diabetes, suggests diabetes.

Additional tests may be performed to assess complications or underlying conditions associated with diabetes, such as kidney function tests, lipid profile, urine tests, and eye exams.

  1. Receiving a Diagnosis:

Based on the results of diagnostic tests and a thorough medical evaluation, your healthcare provider will diagnose the type of diabetes you have (Type 1, Type 2, gestational, or other forms) and discuss treatment options and management strategies.

Your healthcare provider will also assess your overall health, existing complications, risk factors for complications, and individual preferences when developing a treatment plan.

  1. Treatment Plan:

Your treatment plan will be tailored to your specific needs and circumstances, taking into account factors such as the type of diabetes, your overall health, age, lifestyle, and personal preferences.

Common components of a diabetes treatment plan include:

Lifestyle Modifications: Adopting a healthy lifestyle is fundamental in managing diabetes. This includes eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats; engaging in regular physical activity; maintaining a healthy weight; limiting consumption of sugary and processed foods; avoiding tobacco use; and managing stress.

Medications: Depending on the type and severity of diabetes, your healthcare provider may prescribe oral medications, injectable insulin, or other injectable medications to help lower blood sugar levels, improve insulin sensitivity, and manage other diabetes-related complications.

Blood Sugar Monitoring: Regular self-monitoring of blood sugar levels using a blood glucose meter or continuous glucose monitoring (CGM) system is essential for managing diabetes effectively. Your healthcare provider will recommend target blood sugar levels and frequency of monitoring based on your individual needs.

Education and Support: Diabetes education programs, support groups, and resources are valuable for learning about diabetes management, understanding medications, monitoring blood sugar levels, preventing complications, and making healthy lifestyle choices. Seek out certified diabetes educators, nutritionists, and other healthcare professionals for guidance and support.

Regular Follow-Up Visits: Schedule regular follow-up visits with your healthcare provider to monitor your diabetes, adjust treatment as needed, review blood sugar logs, conduct preventive screenings for complications, and address any concerns or questions.

Specialist Referral: Depending on your specific needs and circumstances, your healthcare provider may refer you to an endocrinologist (a doctor specializing in hormone disorders), a registered dietitian, an ophthalmologist (eye doctor), a podiatrist (foot doctor), or other specialists for further evaluation and management of diabetes-related complications.

  1. Self-Management:

Take an active role in managing your diabetes by following your treatment plan, taking medications as prescribed, monitoring your blood sugar levels regularly, making healthy lifestyle choices, and seeking prompt medical attention for any concerning symptoms or complications.

Learn how to recognize and respond to hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) emergencies. Carry glucose tablets or snacks to treat hypoglycemia, wear a medical alert bracelet or necklace, and have a diabetes emergency kit with supplies and instructions readily available.

  1. Emergency Preparedness:

Know how to recognize and respond to hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) emergencies. Carry glucose tablets or snacks to treat hypoglycemia, wear a medical alert bracelet or necklace, and have a diabetes emergency kit with supplies and instructions readily available.

By working with your healthcare team, staying informed, and actively managing your diabetes, you can lead a fulfilling life while minimizing the risk of complications and optimizing your overall health and well-being. Regular communication with your healthcare provider, adherence to your treatment plan, and ongoing education about diabetes management are key components of successful diabetes care.

How to record your systems for diabetes? 

Recording your symptoms and health data is an essential aspect of managing diabetes effectively. Keeping detailed records allows you to track changes in your condition, monitor your progress, identify patterns, and communicate effectively with your healthcare team. Here’s a guide on how to record your symptoms for diabetes:

Choose a Recording Method: Decide on a method for recording your symptoms and health data that works best for you. Options include:

Paper Journal: Keep a dedicated notebook or journal to jot down your symptoms, blood sugar readings, medication doses, meals, physical activity, and any other relevant information.

Digital Apps: Use diabetes management apps or health tracking apps to record and organize your data electronically. Many apps offer features such as blood glucose tracking, meal logging, medication reminders, and customizable reports.

Spreadsheets: Create a spreadsheet on your computer or smartphone to track your symptoms, blood sugar levels, medications, meals, and other relevant data. You can customize the layout and add formulas to calculate averages or trends over time.

Online Portals: Some healthcare providers offer online portals or patient portals where you can log in to view and record your health information, including lab results, appointments, and medication lists.

Identify Key Data to Record: Determine which types of information are most important to track for your diabetes management. Common data points include:

Blood Sugar Readings: Record your blood sugar levels at different times of the day, such as fasting blood sugar in the morning, pre-meal readings, post-meal readings, and bedtime readings.

Symptoms: Note any symptoms you experience related to diabetes, such as increased thirst, frequent urination, fatigue, blurred vision, or symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Medications: Keep track of the medications you take, including the name, dosage, frequency, and any side effects or changes in medication regimen.

Dietary Intake: Record what you eat and drink throughout the day, including portion sizes, carbohydrate counts, and any deviations from your usual meal plan.

Physical Activity: Log your physical activity levels, including the type, duration, and intensity of exercise, as well as any adjustments to your activity routine.

Other Health Data: Include any other relevant health data, such as blood pressure readings, weight measurements, ketone levels, or stress levels.

Establish a Routine: Set aside time each day or week to record your symptoms and health data consistently. Establishing a routine helps ensure that you capture all relevant information and stay organized.

Choose a convenient time and place for recording, such as after meals, before bedtime, or during designated breaks throughout the day.

Make recording your symptoms and health data a priority and integrate it into your daily routine to maintain consistency.

Use Clear and Concise Language: When recording your symptoms, use clear and concise language to describe how you’re feeling. Be specific about the type and severity of symptoms, their duration, and any factors that may have triggered or alleviated them.

Avoid vague or ambiguous descriptions that could lead to confusion or misinterpretation. Instead, provide detailed information that accurately reflects your experience.

Review and Analyze Your Data: Regularly review and analyze your recorded data to identify trends, patterns, and areas for improvement in your diabetes management.

Look for correlations between your symptoms, blood sugar levels, medication adherence, dietary habits, physical activity, and other factors. Identify any triggers or patterns that may contribute to fluctuations in your condition.

Use your data to make informed decisions about adjustments to your treatment plan, lifestyle modifications, or strategies for preventing complications.

Share Your Data with Your Healthcare Team: Share your recorded data with your healthcare team during appointments or consultations. Provide them with access to your paper journal, digital records, or online portal, so they can review your information and offer personalized recommendations.

Discuss any concerns or questions based on your recorded data and collaborate with your healthcare team to optimize your diabetes management plan.

By recording your symptoms and health data consistently, you can gain valuable insights into your diabetes management, track your progress over time, and work effectively with your healthcare team to achieve your health goals. Whether you prefer a paper journal, digital app, spreadsheet, or online portal, finding a recording method that suits your preferences and lifestyle is key to maintaining consistency and accuracy in tracking your diabetes symptoms.

How will long-term disability attorney help you win your long-term disability claim?

A long-term disability attorney can be an invaluable resource in helping you navigate the complexities of the claims process and increase your chances of success in obtaining the benefits you deserve. Here are several ways in which a long-term disability attorney can help you win your long-term disability claim:

Legal Expertise and Knowledge of Disability Law:

Long-term disability attorneys specialize in disability law and have a deep understanding of the complex regulations, policies, and procedures governing disability claims.

They can provide expert guidance on your rights under the Employee Retirement Income Security Act (ERISA), Social Security Disability Insurance (SSDI), and other relevant laws and regulations.

Evaluation of Your Claim:

A long-term disability attorney can evaluate the strength of your disability claim based on your medical condition, the terms of your disability insurance policy, and other relevant factors.

They can assess whether you meet the eligibility criteria for disability benefits and advise you on the best strategy to pursue your claim.

Assistance with Initial Application:

Your attorney can help you complete the initial application for long-term disability benefits, ensuring that all necessary information is accurately provided and supporting documentation is included.

They can help you gather medical records, physician statements, and other evidence to support your claim and increase your chances of approval.

Appeals Process:

If your initial disability claim is denied, a long-term disability attorney can guide you through the appeals process, which often involves multiple levels of review.

They can help you prepare and submit a comprehensive appeal, addressing any deficiencies in the initial application and providing more evidence to support your claim.

Your attorney can represent you in administrative hearings, negotiations with insurance companies, or appeals to federal courts if necessary.

Medical Evidence and Documentation:

Long-term disability attorneys understand the importance of strong medical evidence in supporting a disability claim.

They can work with your healthcare providers to obtain comprehensive medical records, diagnostic test results, physician statements, and other documentation to substantiate the severity of your medical condition and its impact on your ability to work.

Communication with Insurance Companies:

Dealing with insurance companies can be intimidating and frustrating, especially when your disability claim is denied or disputed.

A long-term disability attorney can handle communication with insurance company representatives on your behalf, advocating for your rights and ensuring that your interests are protected throughout the claims process.

They can negotiate with insurance adjusters, respond to requests for additional information or documentation, and address any concerns or objections raised by the insurance company.

Legal Representation in Court:

If your disability claim is denied at all administrative levels and you decide to pursue legal action, a long-term disability attorney can represent you in court.

They can sue the insurance company, presenting your case before a judge and arguing for the reversal of the denial and the award of disability benefits.

Your attorney will prepare legal briefs, gather evidence, cross-examine witnesses, and present persuasive arguments to support your claim in court.

Maximizing Your Benefits:

Long-term disability attorneys are skilled negotiators who can work to maximize the benefits you receive under your disability insurance policy.

They can advocate for the payment of retroactive benefits, lump-sum settlements, cost-of-living adjustments, and other forms of compensation to which you may be entitled.

Your attorney will ensure that you receive the full amount of benefits you are owed under your disability insurance policy.
In summary, a long-term disability attorney can provide invaluable assistance in helping you win your long-term disability claim by offering legal expertise, evaluating your claim, guiding you through the appeals process, gathering medical evidence, communicating with insurance companies, representing you in court, and maximizing your benefits. Whether you are filing an initial claim or appealing a denial, having an experienced attorney on your side can significantly increase your chances of success and ensure that your rights are protected throughout the disability claims process.

Contact Us

  • This field is for validation purposes and should be left unchanged.
Skip to content