Is Chiari Malformation a Disability?
While Chiari malformation is a rare condition it is being diagnosed more frequently due to the increased use of imaging tests. But is Chiari malformation a disability? If you suffer from this condition and it keeps you from being able to fully function at work, you may be eligible for disability benefits.
What Is Chiari Malformation?
Chiari malformation is caused by brain tissue that extends into the spinal canal because of a small or malformed skull. The skull presses on the brain, forcing the two tonsils on the underside of the cerebellum into the upper spinal canal. This condition restricts the flow of the cerebrospinal fluid that protects the brain and spinal cord, which may lead to spinal fluid building up.
There are two primary types of this condition. Which type you have may depend on 1) whether or not you have developmental abnormalities in the spine and brain, and 2) the structure of the brain tissue that is pressing into the spinal canal.
- Type I: Develops while the brain is growing and may not be discovered until late childhood or into adulthood.
- Type II: Pediatric form of Chiari malformation, present at birth.
The condition can lead to serious complications, including:
- Tethered cord syndrome: Spinal cord attaches to the spine; stretching causes muscle and nerve damage in the lower body.
- Syringomyelia: Cyst or a cavity in the spinal column.
- Spina bifida: Spinal cord doesn't fully develop and leaves a portion of the spine exposed.
- Hydrocephalus: Excess fluid accumulates in the brain and may require the implantation of a flexible tube, or shunt, to drain and then divert the cerebrospinal fluid.
How Is the Condition Diagnosed?
Since Chiari malformation is so uncommon, many long-term disability insurance companies refer to the CDC for information. Chiari malformation is defined as a disorder that affects the brain and spinal cord with physical or neurological symptoms that can interfere with work, school, or family activities. It appears in imaging tests and has no other physical or mental cause.
To qualify for benefits, you must be able to prove that you experience the following symptoms:
Chiari Malformation Type I
- Speech problems such as hoarseness
- Blurry/double vision or other vision problems
- Trouble swallowing that can cause choking, gagging, or vomiting
- Tingling or numbness in hands and feet
- Poor fine motor skills
- Balance problems (i.e., unsteady gait)
- Neck pain
Chiari Malformation Type II
- Arm weakness
- Quick downward eye movements
- Problems swallowing such as gagging
- Breathing problems
People with Chiari malformation may also experience less common symptoms, including:
- Sleep apnea or abnormal breathing
- Decreased heart rhythm
- General body weakness
- Tinnitus (buzzing or ringing in the ears)
It is crucial that your medical records document the symptoms you're experiencing.
Defining Disability According to Your Policy
Typically, you are considered disabled if you:
- Cannot perform the duties of your chosen occupation during the first two years of your policy
- Cannot perform the duties of any occupation at the end of the first two years.
Long-term disability policies vary, so it is imperative that you review your policy for the insurance company definitions of disability and total disability. You must also demonstrate how your condition prevents you from working, not just that you have a diagnosis.
How Do Chiari Malformation Disability Claims Work?
An insurance company adjuster will be assigned to review your long-term disability claim. They may request that several medical professionals such as a psychologist and/or a physician, or a medical disability examiner look over your file. They will work together to assess your level of disability.
You may be asked to undergo a functional capacity evaluation or medical exam as part of the evaluation process. The claims adjuster will consider all the documentation, medical records and test results about your illness, your treatments, and how the disorder impacts the functioning of your body's systems.
If the adjuster requires additional information, they will contact you. You should always keep copies of the documentation you submit to the insurance company and any correspondence you receive from them. In some cases, the insurance company will try to delay your case claiming they didn't receive specific documentation.
If you receive a denial, don't give up. You have the right to appeal the decision, and an experienced Ocala long-term disability attorney can help.