Visual Disabilities and Disability Insurance Claims
Friday, September 27th, 2013
The loss of sight, whether it occurs slowly or suddenly, is a life-changing event. If your work depends on the ability to see – i.e., a surgeon, dentist, architect, professional driver – then the loss of sight or a severe visual impairment may also mean the end of a career.
Our firm has worked with many individuals who have lost all or part of their vision, and the impact on their ability to continue in their positions, professional or trades, has been significant. Filing for a disability insurance claim by a person with a visual impairment is just as challenging as any other disability. Even when the loss of sight is 100%, there are many disability insurance companies that will persist in trying to deny or delay the claim.
The problem is simple: the insurance company generally requires an extremely high level of visual loss before the person is considered truly disabled. Therefore, if a neurosurgeon has a vision loss, the insurance company will attempt to prove that there related tasks that can be performed and the doctor is not totally disabled. Even with the highest magnification systems available, a surgeon still needs to have excellent eyesight. The insurance company may feel otherwise.
There are several illnesses that lead to vision loss: macular degeneration, retinitis pigmentosa and glaucoma. Diabetes can also lead to vision loss, from diminished vision to total blindness. LASIK surgery patients suffer visual impairments if they have had bad side effects (visual coronas, dry eyes).
There are two different types of documentation necessary for a disability insurance claim to have a chance of succeeding. One is the medical evidence. The claimant must be under the care and treatment of a doctor, preferably an ophthalmologist, with clear documentation that the vision loss has occurred or is in process. This includes studies and reports.
If this is a degenerative disease, or the result of a disease where loss of vision occurs in stages, the degree of vision loss and reports on the physical changes that are occurring that are leading to vision loss must be clearly recorded in the medical record.
The medical record must also clearly reflect the connection between the claimant’s occupation and their ability to see. The record must list the specific tasks of the occupation that can no longer be performed as a result of the vision loss.
The impact of vision loss for an architect or surgeon is readily apparent. But there are many individuals who are born without the ability to see, and many visually impaired women and men overcome their disability to lead productive lives, including successful careers. Therefore the insurance company may compare an individual who has newly lost their sight with an individual who has maintained their high level of performance without sight.
The difference is, of course, significant. A person born without sight with a lifetime of training and assistance is in a different position as someone who had clear vision their entire lives and suddenly experiences a vision loss.
If you have a visual disability and the insurance company is delaying your benefits, asking for further information or otherwise failing to pay your claim, contact our office today to learn how we can help. Do not delay, as there are time constraints on these claims.