Bell’s Palsy, a neurological disorder characterized by sudden facial paralysis, can significantly impact your daily life and ability to work. If you have Bell’s Palsy, you may be eligible for short or long term disability benefits. However, the process of filing these claims is often fraught with challenges, from proving the severity and persistence of symptoms to dealing with stringent policy stipulations.
In this article, we address common questions about securing long term disability benefits for Bell’s Palsy, what evidence is needed to prove your claim, and tips for successfully navigating the claims process, whether you are just starting to file or facing difficulties with claim denial.
What Is Bell’s Palsy and How Does It Cause Disability?
Bell’s Palsy is a medical condition that results in temporary weakness or paralysis of the facial muscles, typically impacting one side of the face. This condition stems from damage or inflammation of the seventh cranial nerve, which controls the muscles on one side of your face. Although the exact cause of Bell’s Palsy is not entirely understood, it is frequently linked to viral infections that inflame this nerve.
The physical symptoms of Bell’s Palsy may include:
Facial Weakness or Paralysis: The most prominent symptom of Bell’s Palsy is sudden weakness or paralysis of the facial muscles on one side. This can cause the face to droop and make it difficult to express emotions through facial expressions.
Drooping Eyelid or Corner of the Mouth: The affected side of the face may have a noticeable droop, particularly around the eyelid and the corner of the mouth. This can affect the symmetry of the face and impact basic functions like blinking and smiling.
Difficulty Closing the Eye: The weakness of the facial muscles can make it hard to close the eyelid on the affected side completely. This can lead to eye dryness and increase the risk of eye infections or damage.
Decreased Ability to Taste: Some people experience a reduced sense of taste on the front two-thirds of the tongue, which is innervated by the facial nerve.
Pain Around the Jaw or Behind the Ear: Often, there can be pain or discomfort around the jaw or behind the ear on the affected side, which can occur just before or when the other symptoms appear.
Increase or Decrease in Tear and Saliva Production: Changes in tear and saliva production are also common, with some experiencing excessive tearing or dryness in the eye and dry mouth or drooling.
Numbness or Tingling in the Face: Some individuals may feel numbness or a tingling sensation in the skin of the affected part of their face.
Hypersensitivity to Sound: Hyperacusis, or increased sensitivity to sound, can occur on the affected side, making normal sounds seem uncomfortably loud.
These symptoms can lead to disability as they may inhibit your ability to perform daily activities such as eating, drinking, and communicating effectively. For instance, inability to close an eye can require frequent eye care and might prevent safe driving or operating machinery. Likewise, difficulties with eating and drinking due to weakened facial muscles can lead to nutritional concerns and require diet modifications.
While many individuals with Bell’s Palsy recover fully, some may experience long-term complications. These complications can vary in severity and duration, potentially impacting quality of life and the ability to work.
Here are some of the more common long-term complications associated with Bell’s Palsy:
Incomplete Facial Recovery: In some cases, individuals may not regain full movement in the affected facial muscles, leading to permanent facial weakness or asymmetry.
Synkinesis: This is a condition where involuntary movements occur during voluntary movements of the face. For example, when trying to smile, the eye on the affected side may close involuntarily. Synkinesis results from abnormal regrowth of nerve fibers and can be quite distressing and disruptive.
Contracture of Facial Muscles: Over time, some people may experience tightening and shortening of the facial muscles, which can cause the face to pull to one side and further distort facial expressions.
Eye Complications: Persistent inability to close the eyelid can lead to eye dryness, irritation, and potential damage to the cornea. Some people may need to use eye drops regularly or take other measures to protect the eye.
Chronic Taste Disturbance: Damage to the nerve that carries taste sensations from the front two-thirds of the tongue can result in ongoing issues with taste.
Hyperacusis: In this condition, normal environmental sounds may seem unbearably loud due to the paralysis of a muscle in the middle ear, which can be particularly challenging to manage in noisy environments.
Pain: Some individuals may continue to experience facial pain or discomfort, which can be either persistent or triggered by specific movements or facial expressions.
Psychological Impact: The physical changes and challenges resulting from Bell’s Palsy, such as altered appearance and facial function, can lead to social anxiety, depression, and decreased self-esteem.
These complications can contribute to long term disability, particularly if they significantly impair your functional capabilities and require ongoing medical treatment or adaptations in lifestyle and work activities. For individuals whose professional roles are heavily reliant on interpersonal interactions and communication, these effects might severely impact their job performance and sustainability.
Can I Qualify for Short or Long Term Disability Benefits With Bell’s Palsy?
Yes, you can qualify for short or long term disability benefits with Bell’s Palsy, depending on the severity and duration of your symptoms, as well as the specific definitions and requirements of your disability insurance policy. Most disability insurance policies categorize disability in one of three ways: “own occupation,” “any occupation,” or a hybrid of the two. Understanding these categories is crucial in determining your eligibility for benefits.
Own Occupation: Under an “own occupation” definition, you are considered disabled if Bell’s Palsy prevents you from performing the material duties of your specific profession, as it was before you became ill. This definition is generally more favorable for claimants, as it considers the specific demands of your job. If your role requires fine motor skills, precise facial expressions, or other specific functions that are significantly impaired by Bell’s Palsy, you may qualify for benefits under this definition.
Any Occupation: This definition is stricter. To qualify for disability benefits under the “any occupation” category, you must demonstrate that your symptoms prevent you from performing any job for which you are qualified by education, training, or experience. If Bell’s Palsy leads to complications or severe long-term symptoms that broadly limit your employability, then you may qualify under this definition.
Hybrid Definitions: Some policies combine elements of both definitions. For example, a policy might offer benefits under the “own occupation” definition for a certain period (commonly the first 24 months) before transitioning to an “any occupation” definition. This approach means you could initially receive benefits if you are unable to perform your current job, but to continue receiving benefits after the specified period, you must prove that you are unable to perform any job.
How your insurance company assesses your short or long term disability claim will highly depend on the extent to which Bell’s Palsy affects your daily activities and job functions. If Bell’s Palsy severely affects crucial aspects of your job performance, or if it leads to other complications that prevent you from working, you may qualify for disability insurance benefits.
It’s also essential to comply with all procedural requirements of your insurance policy, such as timely filing of claims and providing complete and accurate medical information.
Consulting with a disability insurance attorney can help you navigate these requirements effectively.
What Evidence Can Support My Disability Claim for Bell’s Palsy?
To support your short or long term disability claim for Bell’s Palsy, it’s essential to gather comprehensive and compelling evidence that convincingly demonstrates the severity of your symptoms and their impact on your ability to work and carry out daily activities. Here are the types of documentation you should consider including in your claim:
Comprehensive Medical Records: Include records from all healthcare providers involved in your care, which should detail your visits, the progression of your condition, treatments provided, and notes on consultations with specialists such as neurologists or ENT doctors.
Results of Diagnostic Tests: Incorporate detailed results from imaging tests like MRI or CT scans that demonstrate any anatomical reasons for nerve compression or damage. Additionally, include findings from Electromyography (“EMG”) tests that measure the electrical activity of muscles and can help to confirm nerve function loss.
Physician Statements: Secure detailed statements from your treating physicians that articulate your diagnosis of Bell’s Palsy, the treatment regimen followed, your body’s response to treatments, and a prognosis. These statements should also discuss the severity of your symptoms and the specific physical limitations they impose, such as difficulties with eye closure, facial movement, eating, and speaking. Providing a detailed attending physician statement is crucial.
Specialist Evaluations: If you’ve received treatment from specialists, their evaluations can provide a deeper insight into the severity and specific effects of your condition. These evaluations are particularly persuasive if they involve tailored treatments or ongoing rehabilitation efforts.
Documentation of Treatment and Response: Gather detailed documentation related to the therapies you have undergone, such as physical therapy, steroid treatments, or antiviral medications. This should include information on the frequency, duration, and effectiveness of these treatments.
Detailed Job Description: A comprehensive description of your job duties and requirements can illustrate the impact of Bell’s Palsy on your professional capabilities. This description can be sourced from your employer or crafted by a vocational expert.
Educational and Professional Background: Include evidence of your education, skills, and work experience to demonstrate that your symptoms prevent you from performing not only your current role but any job for which you are qualified.
Personal Affidavit: A personal statement in which you detail your experiences living with Bell’s Palsy can provide valuable insight into the daily effects of your symptoms. Discuss changes in your life, specific challenges you face, and how you manage these issues on a day-to-day basis.
Symptom Diary: Keeping a detailed diary that logs your symptoms, their severity, and frequency can provide concrete evidence of how Bell’s Palsy affects you over time, especially useful for documenting fluctuations in your condition.
Witness Statements: Collect statements from family, friends, employers, and coworkers. These can reinforce your claim by offering third-party observations of how your condition affects your daily life and work performance.
By including this wide range of evidence with your disability claim, you can paint a robust and detailed picture of how Bell’s Palsy affects your professional and personal life. This documentation not only proves the presence of your medical condition but also highlights the practical implications it has on your ability to perform at work and manage everyday activities, strengthening your case for receiving disability benefits.
Are There Specific Challenges When Filing for Short or Long Term Disability with Bell’s Palsy?
Yes, there are specific challenges when filing for short or long term disability benefits with Bell’s Palsy, which can complicate the process and affect the outcome of your claim. Understanding these challenges can help you prepare and possibly mitigate them when filing your claim:
Variability of Symptoms: Bell’s Palsy symptoms can vary greatly in severity and duration from one person to another. Some individuals may experience mild symptoms that resolve quickly, while others could have severe paralysis that lasts for months or even results in permanent complications. This variability can make it difficult to predict and prove the long-term impact, especially for long term disability claims.
Perception of Severity: Because many cases of Bell’s Palsy resolve spontaneously within a few months, insurance companies might not perceive it as a condition that typically qualifies for long term disability benefits. Convincing your insurance company that your case is severe enough to warrant such benefits can be challenging, particularly if you are still within the early stages of recovery.
Requirement for Comprehensive Documentation: As with any disability claim, there is a high burden of proof to demonstrate that your condition significantly impairs your ability to work. For Bell’s Palsy, this often means detailed medical records, physician statements, and possibly testimonies about how the symptoms affect your daily life and job performance. Gathering this extensive documentation can be time-consuming and requires cooperation from your healthcare providers.
Proving the Impact on Job Functions: Especially under “any occupation” disability policies, proving that Bell’s Palsy prevents you from performing any job for which you are qualified can be particularly difficult. You must demonstrate not just the existence of your symptoms but how they specifically hinder your job performance, which may require detailed job descriptions and vocational expert opinions.
Dealing with Short Benefit Durations: Many disability policies provide short term disability benefits for a period that might align with the typical recovery time for Bell’s Palsy. However, if your symptoms persist beyond this period, transitioning to long term benefits can be difficult without clear evidence of ongoing or permanent complications.
Misunderstandings About the Condition: There may be a lack of understanding or awareness about the potential for serious complications associated with Bell’s Palsy, such as synkinesis, contractures, or chronic pain. This can lead to underestimating the true impact of the condition on your life and work, which in turn affects the evaluation of your disability claim.
To address these challenges, it’s crucial to provide a well-documented case with clear evidence from medical professionals, detailed records of your symptom progression, and documentation of your occupational demands. Preparing for potential skepticism or requests for additional documentation will help you navigate these hurdles more effectively. It’s always recommended that you consult with a long term disability attorney who understands ERISA and individual disability insurance claims. They can help you navigate the process and maximize your chances of a successful claim.
How Can The Maddox Firm Prove My Bell’s Palsy Short or Long Term Disability Claim?
At The Maddox Firm, we recognize the unique challenges faced by those with Bell’s Palsy when filing for short or long term disability claims. Our experienced team is dedicated to guiding you through the complexities of the claims process, ensuring that your case is accurately represented and vigorously advocated.
Here are a few ways we help prove your disability claim:
We Examine Your Policy and Assess Your Claim: Initially, we meticulously review your disability insurance policy to decipher its specifics, including coverage scope and limitations. We evaluate your Bell’s Palsy-related claim against these details, advising you on your eligibility for benefits and the optimal strategy for aligning your claim with your insurance company’s criteria.
We Handle All Communications with Your Insurance Company: Navigating communications with insurance companies can be overwhelming. We manage this aspect for you, handling all correspondence, including the submission of medical evidence, completion of forms and paperwork, and responding to any inquiries about your condition and its impact on your daily life.
We Help You Obtain Evidence to Support Your Claim: The success of your disability claim hinges on robust evidence. We collaborate with your healthcare providers to secure detailed medical records and physician statements that document the onset, progression, and current status of your Bell’s Palsy. Additionally, if needed, we can refer you for additional testing and evaluations, such as a Functional Capacity Evaluation or vocational assessment.
We Handle Appeals and Litigation: Should your claim be initially denied, The Maddox Firm is ready to pursue appeals and, if necessary, litigation. We will sue your insurance company on your behalf, advocating strongly to achieve the disability benefits you rightfully deserve.
A short term disability or long term disability claim with for Bell's Palsy can be a complicated process. If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help. The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.