Heart attacks and other cardiac issues are a leading cause of missed time off from work. A heart attack, also known as myocardial infarction, happens when the arteries which supply blood to the heart become blocked. Before returning to work, most people will require at least some time off to recover. This naturally raises financial concerns. Heart attack victims must consider the availability of short term and long term disability benefits available under group policies and ERISA. The length of time that people need to miss from work will depend on the severity of the heart attack and other individual factors. If you have suffered a heart attack while still working, employment matters should be discussed in depth with your cardiologist.
Will I automatically qualify for Short Term Disability after a heart attack?
A heart attack does not automatically qualify someone for disability benefits. Following any kind of cardiac event, insurance companies may try to minimize its impact upon one’s ability to keep working. Often, they will point to the fact that someone is now taking heart medication and say that it is okay to return to work. Or, the insurance company might point to recent tests which show an improvement in cardiac function or results labeled ‘normal’. If you work a sedentary job, your disability insurance carrier might even say that since there are no real physical demands placed on you, you should be back at your desk. This often ignores reality for many people. Returning to work is a decision that should be made between the employee and his or her doctor/medical team.
Qualifying for disability insurance benefits begins with the language in your policy. If you have had a heart attack and are considering applying for benefits through your disability insurance policy, get a copy of the actual policy (not just a summary of benefits brochure). This starting point will allow you or your attorney to begin evaluating what is required before you can collect benefits. While this may seem like a simple process, it is not. You should keep in mind that insurance companies exist to make money by collecting premiums and will often look for any reason that they can to decline benefits to the policy holders. This is why it is important to have at least a basic understanding of your policy before you submit an application. Some plans will even require you to apply for short term benefits before you are allowed to apply for long term disability, should your heart problems require you to be off of work for an extended period.
Medical Documentation for Insurance Disability Benefits after a Heart Attack
Your medical records are going to be an important part of your submission for short or long term disability, but they may not tell the whole story. Insurance companies tend to ignore or minimize the following difficulties that people commonly experience after a heart attack:
- Fatigue and an overall feeling of not quite being back to normal (subjective)
- Trouble sleeping
- Shortness of Breath or other problems breathing
- Leg swelling
- Side effects from medication
- Psychological stress imposed by your job
- Physical demands of your job and other working conditions
- Other hazards which are a normal part of your job
The success of your claim can depend on how everything is written and presented, and also by the quality of the medical records. Since your medical records will be reviewed by your insurance company, it is important to let your doctor know what symptoms you experience in the follow up visits after your heart attack. This should provide a written record within your medical chart. Keeping a written log for yourself can also help, since days and nights tend to blur together after a while.
You must also be sure that your doctor understands exactly what your job entails. For example, do not just tell your doctor what your job title is. Explain what that means in the practical sense. Does your job involve any lifting or repetitive movements? Are you required to bend, squat, or sit? What is the work environment like and what, if anything, makes it stressful? In some situations, use of a vocational rehabilitation counselor can be helpful to people following their heart attacks. Medical support is a very important part of your claim. Without a doctor to back you up, the insurance company wins.
Be Aware of Offsets
The language in disability policies may provide for “offsets”, with Social Security Disability Insurance being the most common offset. Offsets reduce the amount of money that one can receive if they qualify for some other benefit from another source. This is to prevent people from stacking up benefits and receiving ‘too much money’. Social Security Disability can take a long time and it is often a very good idea to hire an attorney to apply for you (we do not handle social security disability law but can provide you with referrals). Offsets can come into the picture once benefits from the second source come in. If you are in your 60’s and close to retirement age, it might make sense to apply for social security retirement to avoid the issue of offsets but since early retirement may reduce your benefits, this is not the best solution for everyone. A good Social Security lawyer may be able to help you calculate the numbers for you to help determine your best course of action in terms of social security programs available to you.
How we can help with your Disability Claim following a Heart Attack
Your time away from work after a heart attack is crucial for your recovery. It is also a good time to evaluate your next steps in applying for disability, now that you have time. This should not cause you unnecessary stress and it may be helpful to also involve a family member if the process becomes too tiring. Our law firm may be available to help you and your family in the following ways:
- Review of your short term or long term disability policy to help you understand the terms of your policy (please call or email for a quote, as consultation fees may apply)
- Helping you to apply for short term insurance disability benefits
- Helping you to apply for long term insurance disability benefits under ERISA
- Complimentary review of your denial letter if your insurance company denied long term or short term benefits.
- Appeal of your disability benefits if you have been denied under the policy (be sure to claim your complimentary copy of our latest book before you even consider appealing on your own).
- Litigation in court if your appeal is lost. Please note that we may decline representation if you filed the appeal without a lawyer, since in court you will be ‘stuck’ with whatever went into your appeal. If your appeal was not done very well, this will have a huge impact on anyone’s ability to ‘win’ your case in court. This is a very good reason to hire an attorney immediately after you receive a denial letter and before trying to do your own disability appeal.
Give us a call at 630 250-8813 for short or long term disability help following your heart attack, or fill out our webform to tell us your story.