Chiari Malformation and Chiari Malformation Disability Claims

Welcome to Season 3, Episode 20 of Winning Isn't Easy, the podcast that dives into the complexities of disability insurance claims. In this episode, we turn our focus to an essential topic: "Chiari Malformation and Chiari Malformation Disability Claims."

Join us as we explore the unique challenges and intricacies of disability claims related to Chiari Malformation. This condition can have a significant impact on an individual's daily life and ability to work, making it crucial to understand the complexities of navigating the claims process.

Our host, Nancy Cavey, a seasoned disability attorney, shares her expertise in handling Chiari Malformation disability claims. Nancy will provide valuable insights and strategies for effectively advocating for your rights as a claimant and securing the disability benefits you deserve.

Throughout the episode, we'll discuss the medical evidence required to support a Chiari Malformation disability claim, common issues faced during the claims process, and the importance of accurate and comprehensive medical records.

Whether you're personally dealing with a Chiari Malformation disability claim, or seeking to deepen your understanding of this topic, this episode offers valuable information to help you navigate the complexities of Chiari Malformation disability claims.

Tune in to empower yourself to fight for the disability benefits you need during this challenging time.


Resources Mentioned In This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://caveylaw.com/get-free-reports/get-disability-book/

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.

Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.  

Transcript

ERISA Disability Attorney Nancy L. Cavey: 0:11

Hey, I'm Nancy Cavey, national ERISA and Individual Disability Attorney. Welcome to Winning Isn't Easy. Before we get started, I've gotta give you a legal disclaimer. The Florida Bar says I have to say it, so I'll say it. This isn't legal advice now. Nothing is ever gonna prevent me from giving you an easy to understand overview of the world of disability insurance, the games to disability carriers play, and what you need to know to get the disability benefits you deserve. So off we go. Today I'm going to be discussing Chiari Malformations and how , uh, a Chiari mal malformation disability claim works. And I'm gonna talk about three specific things. One, Chiari mal malformation headaches, and your long-term disability claim. Two, the five things that you have to do to win your claim. And lastly, I'm gonna be talking about how keeping a Chiari malformation diary headache diary is key to winning your disability claim. Before we get started, though, we're gonna take a quick break.

Promotional Message: 1:24

Have you been robbed of your peace of mind from your disability insurance carrier? You owe it to yourself to get a copy of robbed of your peace of mind, which provides you with everything you need to know about the long-term disability claim process. Request your free copy of the book@kvlaw.com today.

ERISA Disability Attorney Nancy L. Cavey: 1:44

Welcome back to Winning Isn't Easy. The are a malformation, headaches and your long-term disability claim. Kiri mal formation is a group of defects affecting the brain and the spinal canal that can cause debilitating headaches and that could qualify you for your long-term disability benefits. This condition is present from birth and according to the American Association of Neurological Surgeons, only 0.1% of the population have this malformation. Now, not everyone who has a Q R A malformation has symptoms, but if you've been diagnosed with the malformation and you are having symptoms, I think there are a number of things that you should understand before you stop work and apply for your long-term disability benefits or appeal a wrongful denial or termination of your claim. Number one, the most important thing I think you have to is to know is your burden of proving that your disabled as the term disabled is defined by your policy or plan. So you're going to have the burden of proving what type of Chiari malformation that you have, the objective basis for the diagnosis, your disabling symptoms, what treatment you've had, and your response to that treatment. Now, in my view, that can take teamwork between you and your doctor and your disability lawyer. These cases can be difficult and I think you need an experienced service , a disability attorney, to help you meet the burden of proof. First thing we need to talk about after we understand the burden of proof, is the four types of the Chiari mal malformations. Because the disability carriers don't understand this, and it's crucial that your doctor is making a clear diagnosis of the type that you have. Now, type one is the most common form and people will generally experience symptoms in late childhood or adulthood. And these can include headache, neck pain, dizziness, balance problems, weakness of muscles, tinnitus and hearing problems, nauseousness , uh, and excessive vomiting or drooling, scoliosis of the spine, coordination problems and psychological problems including depression. Type two , uh, is a situation where there's a larger amount of tissue pushing into the spinal canal, and it's called classic Chiari malformation. The symptoms are more severe than type one and they can require surgery. Now, these symptoms include difficulty swallowing, breathing changes and weakness in the extremities. There's type three . Now this is rare, but it happens when a lower part of the brain protrudes into the back of the head or the neck. It's usually diagnosed at birth and unfortunately it's fatal. But if you have a type three malformation and you survive, you might have neurological defects, seizures and developmental delays. Type four . Well, this is where the cerebellum is not fully formed and it's generally fatal. So as a matter of course, we're generally dealing with types one and two, and your doctor needs to make sure , uh, that they've explained the objective basis of the diagnosis because that's the something that the disability carrier is going to be looking for. Now, it's important that you have that diagnosis , um, and it's classified because the symptoms of car malformation can be linked to other types of common disorders. Uh, and this disease is , um, sometimes a disease that is , um, diagnosed sort of based on a differential diagnosis. After a complete workout, a workup and other conditions have been eliminated. At a minimum, the disability carrier is gonna wanna see a positive brain, m r i and the reason in the medical records why your doctor is making this diagnosis. Now, the carrier's also gonna wanna see information about your disabling symptoms. They're gonna get your medical records and they're gonna review your medical records cover to cover. They're gonna have their liar for hire , doctor review the medical records, and that medical provider is going to be looking for your medical history, your symptoms , uh, and um, you know, the basis of the diagnosis and how those symptoms correlate with a diagnosis. I think the most important thing you can do is to make an Excel spreadsheet of your symptoms and document the frequency, nature and intensity of those symptoms. Just as important as documenting the symptoms are, is to explain how those symptoms impact your functionality, both at home and at work. So, for example, you might have headaches that occur daily. They interfere with your ability to use a computer to complete various job tasks or cause you to make mistakes. You wanna provide your doctor with this information at each visit. And ultimately, when you apply for your benefits, submit this spreadsheet to the disability carrier. I don't want you to exaggerate. You need to be , uh, accurate because exaggeration will kill your case. Now, the carrier's also gonna be looking at the medical records for information about treatment in your response to treatment. And that can range from conservative treatment to radical surgery. You might even also end up treating with a pain management provider for the headaches and the neck pain. Um, if the conservative medical treatment doesn't relieve the symptoms, surgery might be recommended. And if you have the surgery, then obviously what's important are the symptoms that you had before the surgery and how , uh, your symptoms may have changed. Uh, in terms of the nature, location, frequency, duration. So your medical records need to document the nature of the treatment that you've been , uh, prescribed and your response to that treatment. If surgery has been recommended, they're just gonna wanna see some comment about that. There's decompression surgery, which involves opening the base of the skull and removing small , um, pieces of bone , uh, either from the skull or at the top of the spine. This , it releases the pressure and it can help the headache. However, at least in my experience with my clients, it's not always successful. There's hydrocephalus surgery that involves the PLA placement of a shunt that helps drain excess fluid into the chest or the stomach so that the body can absorb this fluid. This also relieves pressure in the skull. Now, the disability carrier can't make you have surgery as a precondition to paying benefits, but if you've had the surgery, again, your records should be speaking to the symptoms that you had before the surgery and then the symptoms that you've had after this surgery, including , um, not only your symptoms, but comments about your functionality. Remember, you've got the burden of proof, not the disability carrier. So I , I don't want you to give the disability carrier a reason to deny your claim. Got it. That was a lot of information. Let's take a break so you can digest it. Welcome back to Winning Isn't Easy, the five things that you have to do to win your Chiari malformation long-term disability case. Look, disability carriers and plans aren't gonna make it easy for you to get the benefits you deserve. As I've explained, they want objective proof of your medical condition. They wanna see x-rays, MRIs, E M G , nerve conduction study tests , CT scans. Now the problem is that there is generally not an objective medical test for migraines. Uh, and in the car malformation cases, they wanna see brain MRIs. But in a migraine case , um, it can be difficult to win because there's no gold standard test. And the disciplinary carrier is also gonna be questioning the severity and disabling nature of your migraines. So how do you overcome these challenges? In my view, it starts with your medical records and those records should be from a headache specialist, a neurologist, or better yet a Chiari mal nation specialist. So what are the things that you should be , that should be in your medical records, your case is gonna be won or lost in part based on your medical records. So, number one, a diagnosis of your headaches or migraines. As I said, there's no objective basis , uh, for the diagnosis, and it's one of elimination. Using the American , uh, academy , uh, uh, criteria for the diagnosis of Chiari malformations, I want you to make sure that your records are documenting the analysis of the criteria or are documenting the , uh, analysis of the criteria for migraines. Number two, document the severity and frequency of your headaches. You should be keeping a headache diary at a log of your symptoms. Symptoms and functionality are the key. Number three, you need proof that your headaches are disabling. So the diary will go a long way to helping your doctor document the frequency, severity, and intensity and nature of your headaches, migraines, or carry mal headaches and how your symptoms are impacting your ability to function. That's all important 'cause your doctors are gonna be asked to complete attending physician statement forms that don't always ask the right questions or in cases I handle, I also have them , uh, do a migraine headache questionnaire because that asks the right questions. But the doctor needs information from you about the nature of your symptoms, the frequency, the duration, how they impact your functionality to help fill out those forms. So help your doctor help you. Number four, they're looking for regular treatment and you being compliant with those treatment recommendations. If you're not getting treatment at least monthly. And if you're not following your doctor's recommendations, the carrier of the plan is going to doubt how often you have the headaches or migraines, how severe they are, how they prevent you from working, and how they interfere with your activities of daily living. So you should be getting treatment, as I said, from a specialist who is conversant with the symptoms and functionality issues of a person who has headaches or migraines. A garden variety family doctor or A P C P is just not going to cut it. So what's the fifth thing you should be doing to win your long-term disability case? In my view, it's hiring an experienced ERISA disability attorney. These cases are complex because of the lack of objective basis of the diagnosis. The disability carrier plans bias, you know , because of fact that anybody, everybody has a headache and can't work approach to these claims and their requirement for proof that can be hard to , um, produce. Uh, and lastly, because they hate to rely on subjective medical complaints and your physician's diagnosis of your condition and opinion about your restrictions and limitations are significantly but based on your subjective complaints. So before you stop work and apply for benefits, I think you should be speaking with an experienced or a disability attorney. Have them review your medical records, your disability insurance policy or plan so you understand what it is you have to prove. And then create a strategy for making sure that your records are complete and accurate , picking the right date to become disabled and submitting a winning application. Got it. Time for a break.

Promotional Message: 13:55

Are you a professional with questions about your individual disability policy? You need the Disability Insurance Claim Survival Guide for Professionals. This book gives you a comprehensive understanding of your disability policy with tips and to-dos regarding your disability application that will assist you in submitting a winning disability application. This is one you won't wanna miss for the next 24 hours. We are giving away free copies of the disability insurance Claim Survival Guide for professionals. Order yours today at disability claims for professionals.com.

ERISA Disability Attorney Nancy L. Cavey: 14:31

Welcome back, how keeping a Chiari malformation diary is key to winning your disability claim. As I've said, in disability carriers hate subjective medical condition, disability claims like migraine headache claims, they want evidence, objective evidence of the diagnosis of the qre malformation objective, evidence of the diagnosis of the migraines, documentation of the severity of your migraines, and how they impact your functionality. That can be difficult to do as we've talked about because of the lack of objective testing and your physician's reliance on your subjective complaints. So while your medical records are key to winning your social security, I'm sorry, your , uh, ERISA disability claim, one of the most important tools I think that you can do to help create , um, uh, confidence in the nature of your subjective complaints is to keep a migraine diary. And what you want to document in that migraine diary is going to be how your symptoms occur daily, how those, how long those symptoms last, what you try to do to control your symptoms, what activities may reproduce or , uh, increase your symptoms , um, what you do to prevent or control them on a prophylactic basis. And then once you have one, what you're doing to try to , um, to limit the impact. So you might be in a cool dark room, you might be taking medication, so the carrier wants to understand what it is you're doing. They also wanna understand any side effects that you're having from medication and the impact that the treatment is having on your ability to function. And you know that treatment can run the gamut from conservative to medications , uh, to injections, Botox injections, for example. And in the case of Cary Malformation potential surgery. So what are the eight secrets , uh, in terms of what you should be doing in keeping that diary? So one, obviously you should be using a record keeping tool and you can go online , uh, to get an app like migraine buddy or eye headache, or you could keep a paper diary if you aren't sure. Ask your doctor what format they wanted on. And two, keep time document when you've had a warning of your symptoms or the onset of the migraine when it began, how long it lasted , uh, whether you had a post migraine symptoms like the hangover, and how long that hangover situation lasted. Number three, document what you were doing at the time of the onset. Um, what did you do the eight hours before the onset, and what symptoms did you have in that period of time? Four, you wanna document triggers, loud noises, flashing lights, bright lights. They're among the most recognized triggers, but each person has their own set of triggers and they can also vary from migraine episode to migraine episode. So that will help , um, document the nature of, of your episodes. Number five is actually documenting the symptoms. Now, symptoms again, vary from person to person from the time they start to how they progress , uh, how the medication impacts those symptoms, and of course the post migraine symptoms that that you have. So I want you to make sure that as that we are doing the whole spectrum, if you will, of your symptoms. Number six, treatment and medication. Now, as I've said, your Dr. May be recommending Botox injections, cervical neck injections, various trials of medication, and ultimately, you know , potentially surgery. Uh, for the qra malformation issues, you wanna document what benefit, if any you're getting from injections, for example, how long that benefit lasts, record what medication you're taking before, during, and after your migraine, including vitamins and supplements, log the dosage of the medication, and of course, document any side effects that you have. Commenting on the effectiveness of the medication , uh, I think is also , uh, important so that the carrier can see not only the nature of the treatment, you're getting your response to that treatment and how your response may vary. Number seven, proving the impact of your symptoms on your functionality. Remember, you've got the burden of proof, not only that you've got these severe and debilitating migraines, but that they prevent you from doing your own or any occupation. So the starting point here, especially in an own occupation claim, is understanding how the policy defines the term occupation. Is it how you perform it for your employer, how it's performed in the local economy, how it's performed in the national economy, how it's performed consistent with a dictionary of occupational titles, which hasn't been updated in a million years. So you've gotta prove that you can't do the material and substantial duties of your occupation as those terms are defined in the policy or plan, because that's the starting point, I think, for beginning to keep the diary and of course to make sure that your doctor knows what those duties are, so that when they are asked to fill out these a p s forms or um, uh, uh, R f C forms, residual functional capacity forms that they know and in fact what your occupational duties were as related to that definition. And with your diary, you can be documenting how your symptoms are interfering with not only your ability to do these , um, maternal and substantial duties, but activities of daily living. Now if you're at the , um, any occupation stage, this is going to be important also for the , the doctor to understand in terms of, of , uh, whether this, again, is going to be a definition of an inability to do , uh, the , um, the main duties , um, or the key duties or the material and substantial duties of any occupation. Again, how occupation is defined. Generally it's the national economy , uh, in consideration of your restrictions and limitations. The game for disability carriers at the , uh, any occupation stage is to show that you can do at least sedentary work. Uh, and , uh, you need to be able to think, if you will, why it is you couldn't do a sedentary occupation because of your migraines. It might be the nature of the light, it might be , um, issues with your neck moving side to side that will trigger your migraines. It might be , um, how you feel on the onset of a migraine, how long the migraine lasts, whether you have these post , uh, migraine , uh, hangovers, if you will, the impact of the medication. Um , and obviously , uh, what we ultimately wanna establish is that you can't do a sedentary job sitting down all day using your , uh, upper extremities and meet the pace and production , uh, requirements without having excessive absenteeism. So again, those are the kinds of things you should be documenting in your diary. You may start something and have to stop because of the, the migraine, and it doesn't, you know, it goes on for days and you can't get back to it for that. Um, or your headache is so bad that you're in the bathroom, you know, vomiting or you're in a cool dark room. Those things are important to establish that you couldn't meet the functional , uh, requirements, production requirements and attendance requirements. Again, all of that is key and material that should be in your , um, uh, diary. Number eight, hire an experienced long-term disability attorney and have them review that diary before you file it with a doctor or the carrier. As I've said , uh, I think the diary is key, but you can say the wrong thing and hurt yourself. You can say things that are inconsistent , um, internally with what you're putting on , uh, the , um, activity of daily living forms. And your doctor's records may be inconsistent with what you're reporting because they're not a good history taker , uh, and , and or they haven't considered what you're telling them in the diary. So again, ultimately your doctor's gonna be rendering an opinion about your functionality and , uh, in part based on this diary. So your diary's gotta document the right things in the right way. And again, consistency is key. Your lawyer should be looking at your medical records, your , uh, forms , uh, and other documents to make sure it's all consistent and obviously giving you advice and creating a strategy to win your Chiari malformation or migraine headache claim. I hope you've enjoyed this week's episode of Winning Isn't Easy. If you've enjoyed it, please like our page, leave a review, share it with your friends and family, and of course subscribe to this podcast. Thanks for listening, and I hope you tune in next week for another insightful episode of Winning Isn't Easy.